Thickened Endometrium

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Hi , I’ve been on HRT for 6 years which hasn’t been easy trying to find the correct dose which is still ongoing reducing my patch from 75 to cutting to 62.5 and 200 Utrogestan with the advice of my menopause Dr
Each time I’ve had slight spotting which has only lasted a couple of days Ive had to have pelvic scans

Last year I had spotting and my lining was 5.3 I spoke to a Gynaecologist after the scan and she said it was ok although it should be 4mm.

Then about 6 weeks ago odd spotting again I had a pelvic scan today and the lining is 5 but the lady said she’s sending a referral to Gynaecology.
I know that it’s going to be suggested that I have a hysteroscopy which I’m petrified about .

Has anyone been through this? Any advice please

As much as I’m not happy atm with the way the appointment was booked , I’m hoping on the day that the consultant will allow me time for a few questions but there’s no way I would cancel my appointment and risk my health

Its a procedure that requires informed consent so yes absolutely time for questions. And @SweatySpider321i am sorry that was your experience but it’s no more universal than mine! In my case they set out that we could try with nothing, I could have local which obvs involves an injection or I could have a ga arranged with 2-3 weeks. I was keen to press on and was honestly astonished when said she was through the cervix. The biopsy was a wee bit nippy for a matter of seconds and I felt a bit crampy afterwards but otherwise nothing. Honestly had a worst smear in the past.

I wasn't suggesting you cancel the appointment.
I wouldn't advise anyone to do what I did. Unfortunately my fear took over and I panicked.

I'm sure you will meet understanding staff on the day and they will give you all the information you need.

Thankyou for your reply , I hope that I have the same experience as you , and they don’t rush me through as I’ve got questions

I had a bleed and had a hystteroscopy. I couldn’t cope with it, so had it under general. They were worried because I had an increased risk from womb cancer. I’d had breast cancer a few years before.

Going forward, I had three options, hrt , six monthly hysterectomies or hysterectomy. The hrt option was out, because of the type of breast cancer I had previously, and I decided having a general anaesthetic wasn’’tva good idea every six months, so went for hysterectomy.

I had a hysteroscopy before all the negative publicity about them started. I was told gas and air could be used if I need it but it meant staying at the hospital for longer after the procedure.
Like @Berengariaoftheverylowcountries I would say it was only mildly uncomfortable and the only part where I was tempted by the gas was when they took the biopsy and the lovely lady doing it reassured me she was so close to being out of there it wasn't worth it and she was right.
Hysteroscopy is rather like the whole menopause discussion, the prevailing narrative is to tell women it will be dreadful for everyone when it really isn't for a significant number of us

I’ve had two recent (in last 6 months) hysteroscopy and biopsies, both on 2 week pathway. Both definitely in the uncomfortable rather than agonising camp. First one I just used pain killers, second one also used gas and air which helped (the consultant/team were defo pushing b&q option!) I had a reasonable consult before both, especially the second one. You need to sign to give consent which helps with the slowing down of the process imo. My measurement was iirc 11mm in my second one so much higher, and all clear just so you hear some positive outcome stories.

You were given some degree of choice. Lots of women myself included are led to believe it will be “fine, not a problem” and pain relief simply isn’t possible or needed. Which often isn’t true. Yet Royal College of Obstetricians and Gynaecologists guidelines say anaesthetic would be needed for my particular set of circumstances. Some countries e.g. Czech Republic only do hysterectomy with heavy sedation or general

Often doctors claim they are “having a look” then start ripping out polyps, taking samples etc. With no discussion or any consent being sought or discussed. There are a fair few stories of women being held down for procedures as they screamed and blacked out. That would have resulted in my feet in their faces. Plus me contacting the police, CQC, GMC and NNC

My hospital aren’t keen to sort it out as my original referral to them was last year. They did one pre operation assessment which expired and then they had to repeat it 🙄. They have dithered and faffed for so long

Thankyou for your advice , as women we are made to feel like we are to be rushed in and out of a Hystereocopy which as you know is a very invasive procedure .

Im booked in to have one for the first time , I am thankful that the 2 week pathway has been organised so quickly but on the other hand I just thought that a nurse or consultant would have phoned me to discuss what would happen on the day and how to be prepared this wasn’t the case .

I was talking to a friend last night she said years ago she had the procedure to remove polyps and she had a local to numb the area and apart from period like cramps it was fine .

We all have different pain thresholds our bodies are different some ladies might have Gynaecological problems that make the procedure even more painful ,
I will see what happens on the day as one lady said a consent form has to be signed so hopefully there will be a conversation before hand where I can ask questions .

Agreed everyone is an individual

I wouldnt bank on a consent form as they often don’t bother or try to do it afterwards. But l would insist on one

@SweatySpider321 please stop scaremongering. A procedure without consent is assault. Not only would it involve the police but it will likely end the careers of all involved. And for that reason it doesn’t happen. Women can go to these appointments safe in the knowledge they can withdraw consent and it’s really important they do go.

I know it’s assault and so do lots of people, l have heard of a number of accounts of it happening.

There’s even a campaign for treating women better for this procedure

https://www.hysteroscopyaction.org.uk

https://www.bbc.co.uk/news/articles/c4g3450m5lmo

https://www.dailymail.com/health/article-15692353/women-brutalised-routine-procedures-dismissive-doctors-steps-help.html

https://www.bigissue.com/news/social-justice/women-severe-pain-hysteroscopy-nhs/

So are you suggesting the women left traumatised are making it up because it's 'fashionable'? Jesus Christ.

The problem is you don't know if you're going to be one of the 30% who find it unbearable until you are there. I have two friends who blacked out with the pain, one was being physically held down.

It's about awareness. Same as menopause.

I’ve had this. My lining was at 7, though I had a Mirena and Evorel 50. Added utrogestan 100mg and due another scan in December. Last scan they also found an ovarian ‘growth’ at 7cm

Held down ?? They can’t hold you down against your will that’s outrageous !
My friend had a Hystereoscopy with a local injection and was fine , I appreciate it’s different for everyone but no way can a Dr restrain you

The RCOG has a guide on hysteroscopy. It's easy to find online. Just search the terms. You can download the whole doc as a PDF or read the link online.

It was written in 2024 and is to be updated again in 2027.

It covers everything that is discussed here including. TBH the campaign that's been linked to here, seems out of date as the RCOG guidelines make it clear what doctors must do. If they aren't, then that's another issue.

Their most important statement is at the start and it says that women must be fully informed of what it involves before the start. This includes how it's done, the type of instruments, and pain relief available.

It also says that although the majority of women (3 out of 4) find it tolerable or slightly uncomfortable (this is based on research not just their opinion) there has to be the offer of a GA or local if necessary.

I've noticed here that some posters mention sedation - this is covered in the guidance. It's not recommended as routine - possible very serious risks ( it's different to sedation for colonoscopy etc) and is only done if there is a full medical back-up in theatre.

They also make it VERY clear that a woman can ask for the procedure to be stopped at any point.

It's worth reading the guidance so you can advocate for yourself if you ever need to.

Please try not to worry OP, it's more than likely nothing of concern, and you'll come away reassured - best to get these things checked out, but I understand how the language the letters use can be unsettling. I'm not sure if it helps to share experiences, but I'm in perimenopause, am on HRT, I still have (irregular but heavy) periods, I'm 51.
Ultrasound recorded 10mm lining and a polyp, so I was referred for an urgent hysteroscopy and biopsy. All clear, absolutely no signs of anything sinister, and no polyp.

I need to go back to the GP to have my HRT reassessed as it's likely because I'm still having periods and taking HRT, the combination means eostrogen levels may be higher than optimal, and the progesterone isn't countering it effectively. However, I feel great in myself on the current dose.

@MetteBiddler Depending when the scan is done, the lining can be 10mm or even more for women in peri (this is in the RCOG guidance) and wouldn't normally necessitate investigations.

The only valid reading is immediately after a withdrawal bleed and in peri and on HRT the thickness can vary but be normal.

The guidance on lining thickness if very different for women post menopause, in peri, in peri on HRT, etc.

Thankyou JinglingSpringbells you are always so informative , I will be reading up on what you said and will let you all know how I get on
I am very scared but will have my questions ready before they proceed 🙏

Wishing you all the best!

JinglingSpringbells Sorry there are so many posts now on this sometimes painful procedure that us women have to endure
I can’t remember if you said that you had a GA or Local for your Hystereoscopy

I didn't have either. I was offered the options long before the date of the procedure, during a discussion, and decided to try with nothing. A local was 'on standby' and a GA (obviously not on that day.) Mine took a while, but it wasn't painful.

Feel free to PM me if you want more info.

Normally the doctors delegate the holding to the nurses, while they push on with procedures. I too was shocked about some of things l heard initially, then when l start asking sensible and normal questions e.g. what pain relief options are there, can l see the consent form, what will the recovery be like etc. That’s when encountered them getting more pushy (and irritable!) in their responses. They are in a very production line mindset of: get people in and then get them gone ASAP. Rather than what is best for the patient or providing decent patient centered care

Like a lot things it’s a postcode lottery and some hospitals are more guilty of this than others. I held my ground about the general anaesthetic to be told “they were sure l would be fine”. Then at the pre op assesssment then staff told me of course a would need general, for all the procedures l was having!

I had a biopsy last year due to a thickened lining (which came back as all clear and I’m back within normal range again which is great). I said from the start that I wanted a GA. I also had C sections, I find smears uncomfortable. Yes I might have been ok with a LA but I was not taking the chance.
I was not questioned or made to feel like I was being difficult. I was told the choice was entirely mine so felt fully respected. The actual procedure was fine when it happened, no Iain afterwards.
It makes me so cross that there’s a post on here (maybe more but I’ve only skimmed the thread) that implies women are only making a fuss about the now because it’s fashionable to do so. Thankfully we are now in times where we are able to step up and say no to treatment that previously we would have just had to put up and shut up sbout. Hysteroscopies have caused pain and distress to many women since they began being used. But we no longer have to accept that, thank god.

Just to follow up. I had a general as an outpatient. They removed a polyp while I was under as well as doing the hysteroscopy and a biopsy.