Unscheduled bleeding

[pumpeddown]

Hi
can anyone advise? I’m 52, have used cyclical hrt for many years. 2 pumps gel and 13 days of utrogestan and normally get a bleed about a week into progesterone.

Two cycles ago I started bleeding 2 days before started progesterone, bled for 3 days like a period, then a withdrawal bleed a few days later as normal.
The month after I started spotting 2 days before progesterone, spotted for a week, no withdrawal bleed at all. I was booked for an USS after that withdrawal and I delayed once, waiting for the bleed and then went ahead when it didn’t coma

Scan showed an endometrium thickness of 7.5mm plus a simple ovarian cyst. Plan is to have a ca125 test plus come off HRT for 6 weeks and see what happens - which I’m fine with. Does all this sound like I should be concerned. I’ve no other symptoms, no abdominal pain, mo bloating, nothing. But I am very much a.worrier unfortunately.

TIA

It sounds as if you’re in good hands, with a plan underway.

It’s great news that your ovaries are normal - that’s the scariest scenario ruled out!

I know it sounds trite, but try not to worry. The doctors have got this. They’ll sort out whatever’s going on.

In the meantime, look after yourself. Try some supplements to replace the HRT, feed yourself well, lots of rest to help deal with the stress of it all.

Who’d be a woman, eh?

Somethinb similar is happening to me. Ive talked to the doctor and ive had a scan and now hysteroscopy to check is all is well.

At the same time, I moved to the coil as I think the view was that my HRT hormone balance was incorrect and I wasn’t absorbing enough progesterone..

At the hysteroscopy I also had a polyp removed as it might have been contributing to extra bleeding.

Also , the doctor thinks I may just still be having a hormonal cyclal which is giving me bleeding and that periods haven't actually stopped.

The thickening in my lining was generally even and my doctor wasn’t concerned.

i’m not too concerned. A few of my freinds have had the same problems - it’s basically HRT related

I should have added - I was put on the 2 week referral for unscheduled bleeding recently. All normal, thankfully, so the bleeding was HRT related. I’ve dropped my oestrogen from 100mg to 75mg and it seems to have settled.

I’m surprised you’re not on continuous progesterone if you’ve been on HRT for years. Usually they take you off cyclical and onto continuous after four years, to protect your womb lining. I wouldn’t be surprised if that’s what’s caused the thickening - although I’m not a doctor!

@BlueEyedBogWitchI’m also thinking it is HRT related but it’s unsettling in the meantime. I tried continuous two years ago but the bleeding didn’t settle at all and after six months my GP switched me back to cyclical and said it was likely I wasn’t yet fully menopausal. My GP said if I return to HRT after my six week break it will be on continuous. I’m glad it all worked out for you.

Yeah I had all this with HRT. Plus weight gain. I came off it and no problem since.

Take your doctor’s advice and try not to worry 💐

i had bleeding after no periods for a long time. Hysterectomies showed thickening of womb, which is a risk of cancer. I had three options, hrt, regular hysterecopies or hysterectomy. Because of breast cancer, couldn’t take the hrt route. Had a couple of hysteriscopies, but then decided to go down the hysterectomy route as didn’t want general anaesthetics every six months.

I'm not exactly sure of the timeline for your scan but if you'd not just had a bleed, a measurement of 7.5mm on sequential HRT is normal. I've been advised that up to 9mm is acceptable for anyone on sequential HRT (unless the scan is immediately after the withdrawal bleed before the lining has grown again.)

What is a bit unusual is that your HRT has never followed the normal pattern.

I’m 52, have used cyclical hrt for many years. 2 pumps gel and 13 days of utrogestan and normally get a bleed about a week into progesterone.

You've never had a withdrawal bleed at the end of the progesterone phase?

Has anyone mentioned increasing it to 14 days - why 13?

Also, if you take it orally and with food it doubles its efficacy- so that's worth trying- a small snack before you take it at night.

Sorry, that should have said 12 days, not 13. My GP has never suggested anything more than 12. My bleeds have always been about a week into progesterone, never after I finish the 12 days. My scan was booked for when I should have just finished the withdrawal bleed but I just ended up spotting from 2 days before I started the progesterone until a week later and no subsequent withdrawal bleed. I went ahead with the scan anyway. I hope that makes sense.

The patient leaflet says 12 to 14 days.
14 days is if there is early or heavy bleeding.
You should be taking 14 days.
Your GP sounds a bit clueless.

Going forwards, what you could do is try to reset the cycle.

So if and when the withdrawal bleed happens next time, use the first day as Day 1 ( as if a normal period) and count for 14 days then take 14 days or progesterone. That means it should correspond to your normal cycle if you're still ovulating monthly.

The scan result is pretty much normal as you weren't scanned after a bleed.