Post menopause bleed

[chocolatemonster]

Had my last period March 2019 and started bleeding yesterday. Light and not like a proper period.

I phoned the GP for an appt but they are only doing telephone triage first. The nurse called me. I explained that I am also experiencing lower back pain (last couple of months) and also pain in my left hip more recently. She thinks that's unrelated and general aches.

My smear is due so she has booked me in for that on Monday in the hope the bleeding has stopped and she said to kill 2 birds with one stone she can examine me then.

Should I be asking anything else? Everything I have read suggests it should be a 2 week referral so unsure what the nurse will be able to detect in an examination? Also the smear I assume is not sufficient on it's own to ascertain any issues? The nurse also said to cancel and rearrange appt if I am still bleeding Monday.

I am 51. Any advice greatly appreciated.

I've read it now @EleanorRising.

It's a very, very fine line with the word 'consider' [sending for a scan] and it's at odds with the up to date link from the RCOG which I posted.

The truth is there may be a very few occasions where there is possibly a reason for not scanning and a dr can make a judgment. However, I have not come across anyone on a forum being 'examined' by a nurse who then makes the decision. Yes, she may find a cervical issue BUT that doesn't exclude an endometrial issue as well.

It's a brave GP who considers and refuses to refer for a scan and they would be very sorry for making the wrong judgement.

I'm going through this currently too. I contacted my GP following a six day bleed. After a telephone consultation I was referred to a gynaecologist on the two week pathway.

I had a pipelle biopsy and bloods taken at my initial appointment followed a week or so later by a scan. Results from these meant that he wanted to do a hysteroscopy where he removed a polyp. Samples were also sent off for analysis and I'm seeing him this week for results.

I'm 52 but my mum died from endometrial cancer so I don't know if that was an additional factor.

I have been going through this. Am 56 and on HRT.

I was referred for an ultrasound in July followed by two hysteroscopies and biopsies plus a d&c. My case is a bit complicated, though, plus I don’t think they took enough tissue samples first time when I was biopsied.

Two-week referral applies for any post-menopausal bleeding. The nurse should know this but if she doesn’t you should remind her that this is the case. 🙂 It’s usually nothing to worry about but needs checking. Quite a few of my friends have had similar episodes.

I'd never heard of the 2 week referral. I wonder why I had to wait 7 weeks.

Such a difference in everyone's experience.

@Uptide - 7 weeks is a long time!

I should have said ahe to me to cancel and rebook if still bleeding but as the smear is not totally related I will definitely be insisting on the referral. I am sure it's all fine but I want that confirmed rather than assuming.

Thank you all for your input - very grateful. I will keep you updated.

Good luck

Had my appointment.

It was a bit confusing. I asked about scan and nurse said she would be expected to do investigations first so she would do the smear and also a couple of swabs and an examination.
When she did the smear she said there was still pink discharge - sorry tmi. Otherwise she said nothing looked untoward.

She examined me externally around the pelvis area and the left ovary side is tender. She said she would refer me for a scan at a local practice and results would come back to her. Hopefully in 2 to 3 weeks. Took her about 20 mins to figure out the booking process on the computer so she said she would do it later. Hope she does! I asked what the swabs were for and she said just routine and she would expect thrm to be negative?

I asked if she thought the bleeding was a period and she said it may be one of those things. She said she's had it once (looks over 50) and she would only be worried if it happened more than once and everything felt ok in her pelvic area?
She didn't seem concerned about the hip and back pain. Said the scan would show any thickening but not to worry as that can be normal?

All very confusing. Should I be asking anything else or is the scan enough? She was nice but very ditsy. I feel more confused than ever.

No, it's not good enough.

I'm sorry but even as a snr nurse or whatever she is, she's not qualified to make the call on something that could be serious.

The rule is you need a scan sooner rather than later and also the results should be sent to a gynaecologist or a radiologist to assess.

Obviously she can read the result of the thickness, but what you need to be sure of is that wherever you have the scan, the person doing it is qualified and not 'just' a technician.

I've had numerous scans and yes, I had private health cover, but they were all done by an experienced consultant radiologist who discussed what was there at the time and relayed the info back to the gynae.

It's not likely you have cancer, but at the same time they need to make sure you are scanned properly and someone who's a specialist looks at the images.

I think it's weird and unacceptable for her not to tell you what swabs were done. FGS it's your body! You need to chase that up and ask.

@JinglingHellsBells

I got the appointment through today for the 22nd December. It's signed by the Senior Sonographer. How do they normally give results for these things - there and then or at a separate appointment?

I am assuming the swabs were for things like STI's although why she couldn't just say that I have no idea!!!