I’m 50 and in peri (I think) on 4 pumps of oestrogel and Slynd (synthetic progesterone, micronised P intolerant).
I recently had an ultrasound for some pelvic pain and bleeding that I thought was another ovarian cyst. Scan showed no cyst, a small 1cm fibroid and an ovary that was close to my uterus (inconclusive but adhesion not ruled out). My lining was 4.1mm - the guidance wants 4mm on continuous HRT. Solely because of the lining, I’ve been referred for a hysteroscopy.
Interesting context, I’ve had two very similar experiences a year apart: start gel then a month later develop pelvic pain, bloating and bleeding. The first time this happened, a year ago, the symptoms were attributed to a large ovarian cyst and a slipped mirena coil. The investigations and mirena coil removal (and a 2nd failed coil) took several months to solve by which time I had started to trial the patch. On the patch, my pelvic pain, bloating and bleeding all went away, though most of my perimenopause symptoms came back (wasn’t absorb it it well). At the time, I thought the pelvic pain and bleeding went away because I no longer had the coil and cyst (absorbed itself). But in hindsight, the picture is unclear and perhaps the change to the patch caused the improvement in pelvic symptoms.
I know that changing HRT seems like the most logical and least invasive option. However, 4 pumps of gel is the only estrogen that has come even close to treating my debilitating perimenopause symptoms (all over flu feeling, intense anxiety and suicidal thoughts). In an ideal world, I’d keep the gel (now resettled for 3 months) and figure out and treat why it seems to be causing pain (if it’s the gel). Part of me wonders whether it might be some endometriosis that would benefit from treatment but I’m self diagnosing based on google!.
I’m not sure whether to push back on the hysteroscopy since I had these symptoms a year ago and suggest moving HRT first. But I’m very nervous that I’ve tried most oestrogen and apart from the oral pill, the only thing I have left to try is the Divigel.
The other option is to have the hysteroscopy, but I don’t see that that will fix my pelvic pain as it’s really just designed to check my lining isn’t cancerous. I don’t believe I have polyps or fibroids that would be causing this amount of pain. Should I just get the hysteroscopy and see what it says? I surely should be able to take four pumps of gel without pelvic pain? In case it’s relevant, I’ve been offered complete sedation for the hysteroscopy. Because of that, I’m leaning towards having it done. But I’m not sure it’s going to get me any further forward.
Other information: I’ve been on Slynd for 5 months and another progestin mini pill for 4 months before that so don’t think that’s the cause of the bleeding. I’m unable to add micronised P to solve the bleeding due to intolerance (I really did try it orally and vaginally for 3 hideous months)
Edited to add: I do think there’s something wrong with my pelvis. I can no longer take vaginal localised oestrogen without getting cramps (after a bowel movement) that are so strong I have to lie down for 20 to 30 minutes. Neither the tabs or the cream.
Any thoughts?