Endometrial Atrophy

Try not to worry sharon

all been checked and all okay.. Maybe just a blip ... 

I havent ( touch wood ) bled or spotted, i am about 17 months post meno, 

no HRT .. Just the Ovestin vaginal Ovules, which i prefer to the ovestin cream .. Thats Estriol and the weakest of the oestrogens ..

Good luck hun, hope all calms for you 

jay x

 

Thank you x

Thank you.  I have talked the Vagifem through with my GP and she explained that the risks (albeit low) only seem to be when you use the Vagifem for a long time.  She said 6 months (which the gynaecologist prescribed) was just to coat the womb.  I think I will try them, as the bleeding this time happened after 7 weeks.  I'm assured it isn't really a period by 2 different gynaecologists a year apart, so I should really believe them.  They have been thorough with checking with biopsies, pelvic and vaginal scans etc.  I am quite overweight, and that also is a risk factor.  I have joined weightwatchers and have lost 7lbs in the last 2 weeks and am committed this year to getting back my fitness!  Interestingly, I read an article that Clomid (a drug used in infertility treatment) can cause thinning of the lining of the womb, and I did use this drug for about 18 months when I was about 24!  Thanks for your positive comments.

hi Sharon 

good luck with it all, and well done losing the weight 😀

back to vagifem ( i also use vaginal Estriol ) 

it only assists the vaginal area up to the cervix ( neck of womb) .. not the womb ..

you dont want your womb lining thickening up, when its thick its of concern.

thin is what happens and suppose to happen..

after menopause the lining must be thin, this means its not thick and will not cause bleeds ( shedding of the womb) 

vaginal vagifem and ovestin and gynest vaginally prevents vaginal dryness, and helps plump and replenish only the thinning vaginal walls its said to help with possible uti feelings too, and relief prolapse discomfort ..

i am confused with you saying your gyno said it coats your womb, it shouldnt even be entering the womb, thats the idea. its safer ..

jay x

Hi Jay,

My letter (and phone call) from the gynae confirmed all the tests and biopsy were clear. They said the lining of the womb was smooth with no lumps, fibroids, masses or any worrisome feature.  The ovaries were fine, shrunk but normal and the lining was thin consistent with post-menopause.  They then concluded with the fact the bleeding was due to probable atrophy and prescribed me Vagifem for 6 months maximum.  I am so confused at the moment, the bleeding is subsiding (and hopefully will continue to do so) just like a period again. It is bright red and not as much as last November, but then I guess it is only 7 weeks.  My doctors have the results of the swab, but as it is with the doctor I will find out tomorrow.  Another GP I saw a couple of weeks ago said she still considered me perimenopausal and wouldn't refer me back to gynaecologist if I bled again within this year.  The gynae and other GP seemed to think I couldn't be anything but post-menopausal because of the length of time between bleeds (14 months first time, 11.5 months second time), and I guess because of the thin lining.  Next time I'm coming back as a man!!!

Hi Sharon

oh bless you its confusing for you, you go all those months and then bleed , maybe thats why that lady said she thinks your still in peri and its not stopped completely..

12 months is a guide but may bot be a golden rule so dont worry ..

all is okay inside you .. Thats great news .l

thin lining happens post menopause, thats what happens, the lining thins right down, and the ovaries become non functioning and no follicles ..

i had these trans vaginal scans in august and that was my outcome..

lining was thin and normal for post menopause, but may thin abit more .

this is good, thickened uterine lining is when they get concerned.

so rest assured on that.

i saw and was shown my ovaries, non functioning and no follicles ..

post menopause confirmed .. 

maybe you have vaginal atrophy like me, vaginal dryness.. Hence me using ovestin ovules, but i too dont like the thought, and i actually split my ovule and use half twice a week for abit then use non hormonal premeno duo ovules from stress no more uk .. They are good too.

pity they didnt tell you if you had any follicles.. 

My gyno showed me all my bits on the screen, explained the lot and i went home with the photos 😳 even measured my uterine lining .. Was 4.1 mm 

but i live in southern spain and they give you your results to take home..

i had blood tests yesterday at the doctors, and ten minutes later i had the results back, all explained and put in my personal take home file 

You try and relax my sweetie, try not to worry as that doesnt help..

big hugs 

jay x

 

Sharon, I'm in gynecological hell too.  

One doc did everything to me, including D&C, polypectomy,  hysteroscopy, endo ablation...everything she could think of doing to me.  I've had 4 biopsies in 5 years, 2 sonohysterograms and so many ultrasounds I can't count them anymore.  If there was a test or a procedure, she did it...INSISTING that I "had to be in menopause" because of my age but, I still kept bleeding in spite of all of that so, she said, "hysterectomy" and I had enough of her.  

I finally switched gynecologists 2 more times.  (I'm on my 3rd now).  The 2nd one said, "I don't think you're menopausal yet and I'm not touching you".  I kept on spotting and bleeding.  

The 3rd said "no" to the hysterectomy and did yet another biopsy.  

NO ONE did a simple blood test in all of that. 

Upon my insistence, this one FINALLY agreed to doing one.  Guess what?  The levels came back as PERIMENOPAUSAL....NOT menopausal.  

So, I had all of this done to me for what????  

The fact that your lining is thin, seems to me to indicate that you're almost there.  

Have you had a blood test done?  I mean FSH, Estradiol, progesterone etc., including thyroid?  That might tell them a story or two.  They tend to go with the gold standards...no bleeding for 12 months...thin lining...age....you're post menopausal.  But, that's not necessarily so!  

Try asking them to do a full hormone blood panel to see where your levels are going/are at.  They fluctuate greatly so, it could be that one time won't be enough but...since they haven't found anything of any consequence to explain this bleeding....it's worth having done.  

The only other thing that I can think of is a polyp (usually...99% benign).  A regular pelvic and transvaginal ultrasound will not show that up.  I had to have a Sonohystergram done (not bad at all to go through) to find the polyps.  I'm not certain in my case that was the cause as I am now being told that I just wasn't done....but, it *may* be a cause for YOU with such thin walls.  

One thing for sure...you know it's not cancer causing this and is more of a pain in the rear than anything else but, like me, I'm sure you want answers!  

And, I'll join you in coming back as a man next time! 

 

Thank you Jay. Maybe it is vaginal atrophy, although the letter does say endometrial. My lining measured 5mm which i understand is the top of how they like it, but when I questioned this the gynaecologist said it was the histology of the biopsy that was most important and that was scant and thin and normal. At the time of biopsy, she ran off with the sample to speak to the senior gynaecologist consultant and told me then she was sure it was atrophy. I used to be very dry but can't say I have noticed that in the last year because of the discharge. It's the bleeding that bothers me and I am confused too about vagifem for endometrial atrophy?? I can't understand the hot flushes disappearing with the episodes of bleeding either?

Yes  as jamie says 

have you had a FSH blood test, mine was menopausal in 2011 

and post meno now ..

i have full bloods done every year too, i insist on it ..

i had ten year natural peri, and my periods just declined gradually eadh year i got less ..

I am age 50 now and 17 months post meno ..

not had a blees or spot nothing ... And confirmed by Gyno 

jay x

I just don't think you're truly menopausal yet, Sharon.  

Like Jay and I have both said...get a blood test done.  Your GP can do it.  

Test your FSH and all of your hormones...especially Estradiol.  

If we lived closer...I'd bet you a coffee that you're just not quite there yet!  

LOL, thanks Jamie.

I have asked the Gynae, and 2 GP's for blood tests.  No, they said, it won't show anything, you are post-menopausal!!  Like you said they confirmed that the blood tests are only as good as on the day!  So, performing blood tests every 2 weeks for about  6 weeks seems to make sense to me, but this is the NHS and I'm guessing it's the cost!!  Weigh that up against visiting gynaes, biopsies and scans, and I know what makes more economic sense to me!  I saw my GP last Thursday, when she took a swab (for which I still await the outcome), and I ASKED for a hysterectomy LOL!!!  I said I figured if I didn't have a uterus I couldn't bleed any more, it couldn't turn nasty any more and let's face it I don't need it anymore!!!  She looked a bit shocked, but said she could see my logic, however, having had the tests come back normal I would not be considered for a hysterectomy.  I know it's a bit drastic, but I get quite anxious (no doubt another menopause symptom) about this, and I would rather get rid of the womb and have peace of mind than go through all this every year!!!  I have even considered buying an ovulation kit to test myself!

Sharon I get where you're coming from and why.  LIke you, I've been through the mill and I'm still there.  (And, I'm 58!!!)

I went into this 3rd gynecologist with a resounding..."TAKE IT OUT NOW!" and she sat, stunned, looking at me as though I had 3 heads! 

She then proceeded to read me the riot act on what can happen during a hysterectomy that's likely un-needed as well as post hysterectomy and many years down the road.  That scared the living daylights out of me!  

She said that I AM a candidate for one...but, ONLY because I am moderately prolapsed...otherwise, she wouldn't have grounds to do it and 2 gynecologists have refused to do it.

She is urging me to continue just taking progesterone and wait it out because (I'm in Canada), they are on a quest to cut down on the number of unnecessary hysterectomies due to long-term potential side effects.  

Her reasoning was that once you remove an organ such as the uterus, you have weakened the entire pelvic structure and believe it or not, the uterus DOES still serve a purpose.  Though our ovaries are not still producing much of anything, our uteruses do produce some hormone or something.  You also can have bowel/bladder prolapse later on and the list is endless as to what can happen.  

Two gynecologists have said that they are now reserving hysterectomies for those who have pre-cancer, cancer or larger fibroids or distortions of the uterus that cannot be corrected via other means.  They mean business now in NOT doing hysterectomies...though...in the U.S., it's still one of the most done surgeries.  Even there...it's declining.  

So, I'm with you on hearing how upsetting (I panic over it all too.  You're not alone on this!  Trust me!) this all is and no one being able to explain it all to you.  I am in the same boat.  It all feels like no one really knows and is just "guessing".  

But, the bottom line is that they look at bleeding like this as "cancer until proven not to be".  In your case...they have proven it to NOT be that.  So, you can rest assured that you're not in any danger and this is more of a pain in the rear than it is dangerous by any means of the word.  

My take:  at 5 mms thickness...I wouldn't guess "atrophic endometrium/endometrial tissues"...though there could be spots that are and causing the bleeding and that was captured on the biopsy (remember...it's such a tiny portion that they take)

Honestly, if you're afraid of the pessaries...don't do them.  Wait it out and see where you go with losing weight for a bit and put up with the bleeding the best that you can.  I know...easier said than done.  But, really...they seem to be "guessing".  They really don't know for sure.  

And, if you can't get at least one blood test to just get a fair idea of where you are...I'd try another doc.  Here, we have walk-in clinics where anyone can go in and they will order blood tests.  I don't know what it's like where you are though.  If they're going to do blood work for something else...what's another vial for hormones at the same time?  I know it's money with the types of healthcare that aren't insurance driven but, a general rule of thumb reading might give them and you a clue???  Perhaps, just INSIST like I had to do over and over again until I broke them down and they finally wanted to shut me up.  Surprise!  That made a difference in how they approached things and helped me to understand a bit better.  

Anyways, bottom line is to NOT panic or worry about this so much.  Yes..it's a pain and yes it's annoying but, it's NOT dangerous.  Try to relax with it even though you don't understand.  Sooner or later, this will all level off and hormonal levels will balance out if you're not done.  If you are and this is atrophic bleeding...well...then the body will adjust eventually too.  But, as Jay has said...at 4.1 mms...she is NOT bleeding so, at 5 mms for you...I rather doubt it's atrophic endometrium.  I think you're just at the tail end of things and your body just isn't quite ready to give up on the bleeding just yet.  Wait it out and keep on trying to lose the weight for that reason as well as your own wellbeing in general (plus you'll look great in that little black dress )

Hang in there!  XO

 

Hi Jamie,  Thanks so much for your comments (and Jay).  Until you get on a forum like this you do feel like the only one!  Strangely the lining measured 3mm last year which is why they put it down to an oestrogen blip.  I did read that sometimes the measurements on a scan may not always be completely accurate, but if the lining had increased slightly this year then I can't understand how the biopsy showed it as too thin!  I guess as you say it could be pockets of thinning thats making them think I'm post meno or perhaps the bleeding is down to ulceration which I think happens when the lining is too thin.  All the episodes of bleeding have followed the pattern of a period, lasting for 5-6 days.  Two weeks before the current bleed, I had sore breasts that after a couple of days disappeared.  Strangely the hot flushes disappeared too.  After the first bleed they returned after about 6 weeks and disappeared again after the second bleed and as I have now bled again after 7 weeks they haven't returned yet! Oh the bliss of not waking in the night and literally walking around in a bikini in the middle of winter!! Not to mention the fact that my husband is cock-a-hoop about not having to sleep in a woolly hat because I had the window open when it was -5!!!  LOL - the joys of hormones!  Thank you so much ladies for all your help and comments.  I will insist on some blood tests.  Sadly there are budget restraints on the good old NHS, but if necessary I will get some done privately!

Hi sharon and jamie 

well its nice to share .. Lining thickness and all 😃

i had hot flushes return this summer gone, hadnt had any for years, but OMG in the spanish heat in summer i was having up to 20 a day, and still get one or two.. They say the first year post menopause theres still some oestrogen activity going on and likely to be the cause ..

jamie taught me a new thing too.. I hadnt heard of endometrial atrophy until she talked about it, then i had to have a look on google, they say you learn something new every day 😊 thanks for sharing that, it baffled me at first as you probably guessed.. 

I then found this snippet of info 😳 so its good to be aware and get checked as you have, and know all is okay in there ..

Post-menopausal bleeding is vaginal bleeding that happens at least 12 months after your periods have stopped.

Although it's a common problem, it's not normal to bleed at this time – even if it's just spotting – so don't ignore it.

Make an appointment to see your GP as soon as possible.

The cause is usually something minor, such as inflammation of the womb lining, but cancer is always a possibility that must be ruled out.

Most likely causes

There can be several reasons for bleeding after the menopause.

The most common causes are:

inflammation and thinning of the vaginal lining (atrophic vaginitis) or womb lining (endometrial atrophy) – caused by lower oestrogen levels

cervical or womb polyps – growths, which are usually non-cancerous, that can form in the cervix (neck of the womb) or the womb itself

a thickened womb lining (endometrial hyperplasia) – which can be caused by hormone replacement therapy (HRT), high levels of oestrogen or by being overweight;

if left untreated this can lead to development of womb cancer (also known as endometrial cancer)

About 1 in every 10 women with post-menopausal bleeding will have womb cancer, and in a few cases bleeding may be a sign of another type of cancer such as vulval, vaginal or cervical cancer.