One of the best things about menopause (yes, there are more than one) is the end of your periods. But bleeding has been a major part of my menopause journey this year and it’s lead to a worrying couple of months.
It began with a GP appointment. It had been almost six months since I’d been given Evorel Conti as a make-do hormone replacement therapy (HRT) after Covid-19 precautions stopped me getting a coil fitted and I needed a new prescription.
However, I was a bit concerned because I was bleeding. Often. Every couple of weeks I would have a “period”, sometimes as heavy (and almost as painful) as my true ones, and in between I would rarely go more than a couple of days without spotting. I’d had to put away my nice knickers and wear the old faithfuls, the sort your mam would warn you about not having a road accident in.
Obviously I did what everyone in this situation does and turned to Google and read:
Most women do not have a regular monthly period with Evorel Conti. However, bleeding or spotting does often occur in the first few months until treatment settles down.
Closer googling unearthed forums on Mumsnet where other women were also having bleeding, so I took a deep breath and accepted it.
But then Mr 50Sense said: “Again?” when I told him about a new round and I realised I was bleeding or spotting more days than not. And six months did seem more than “the first few months”.
Fast-track to Worryville
When I told the doctor – a locum, covering during the pandemic – he said he would recommend I changed over to the coil and inform Dr B, who does the fitting.
However, Dr B was not so happy and before I knew it, she was talking about getting me fast-tracked for ultrasounds and seeing gynaecologists and checking for cancer.
I’d been brushing my teeth when she called and I sank down onto the edge of bath in disbelief. No one on Mumsnet had mentioned cancer.
Dr B was wonderful, calmly discussing her concerns and why she thought this was the best action. We needed to get anything serious ruled out, she said. But then she called back straight away and said: “I’ve been thinking and perhaps you should stop taking your HRT,” and my heart did a little flutter. (We compromised on a half as I was scared of going cold turkey.)
Sitting there, I came to a decision: cancer has struck several members of my family and my in-laws, so I wouldn’t tell them about this until there was something to tell, either good or bad. I didn’t even want to tell Mr 50Sense, but then he was off ill when I had to go for the scan and I had to explain why I was suddenly drinking gallons of water!
Ah, yes. The great How Much Water to Drink for an Ultrasound debate! The clinic told me to drink two litres, but a quick chat on Twitter found this was a much-disputed number. Some women had been told a pint, others that they’d drank too much and had to wee some of it off… In the end, I compromised on a pint and a half and crossed my legs and fingers.
Medical procedures fascinate me and I lay there enthralled as she read off numbers and discussed my “fast asleep” left ovary compared to my “very young-looking” right, where a follicle was “11”.
I raced back home to tell Mr 50Sense. “What does all that mean?” he asked. “Haven’t the foggiest,” I replied, and then promptly took to social media to boast about my “young-looking” right ovary.
As time went on, however, that C word kept coming back to my mind and I googled facts about ovaries and follicles, looking for reassurance that the internet couldn’t provide.
Off to the women’s health centre
A couple of weeks later, I found myself sitting in the nearest women’s health centre to see the gynaecologist. Why they call it a “women’s health centre”, however, I have no idea as there wasn’t one piece of literature or poster or pamphlet for women’s health that didn’t relate to pregnancy and childcare. Images of babies and happy families were spread wall to ceiling. “Motherhood health centre” would be a more appropriate term.
My internal rant waylaid some of my fears.
You see, I’d been blasé when talking about the tests, saying it was nothing to be concerned about, but a niggling part of my brain kept saying: “What if…?” After all, I’d started bleeding yet again that morning…
In fact, I was so nervous that when they told me to undress and wrap a paper blanket around me “like a sarong”, I did a full strip and walked out tightly holding on to as much decency as possible.
“Noooo,” laughed the gynaecologist. “Just your bottom half!”
Well, it broke the ice.
Next, I was stirruped up, discussing the weather in a very British way as bits and pieces were stuck up my vagina and wiggled around.
“Your cervix is a bit…”
“Wonky?” I proffered. “That’s what they told me in Spain during a smear test once. They said it was more difficult because my cervix was wonky.”
Well,” said the gynaecologist. “I wouldn’t be so rude. It’s… playful. Likes to hide.”
See? That’s the difference between the Spanish and the British NHS.
Wonky or not, it turns out I have a cervix that really doesn’t like people poking around in it. Especially people trying to do smears or biopsies. I closed my eyes and concentrated on mindfulness techniques, focussing on my breathing and trying not to imagine John Hurt with a Baby Alien moving around his stomach.
After what felt like an age, the gynaecologist said: “You’ve done really well. I’m waiting for your scans to come through, but I’m getting the biopsy sent off straight away. I think it’s HRT related, but if it is cancer, we can hit it running.”
I thought I would feel more nervous after the gynae appointment, but her words made me feel much, much better. The matter-of-fact way she explained what she was doing and why brought about an almost Zen-like calmness: if there was something there, I was in the best hands so better to find out.
Not long later, I coincidentally received a DM on Twitter from someone going through a similar situation. Through our conversation, I explained what was happening to me – she was the only person apart from Mr 50Sense and my Pausitivity colleague Clare that I had told.
And it felt good.
By telling her what I had gone through, I was not only able to prepare her a little more, but also reassure myself. There was a process here and experts behind it.
More importantly, though, I was able to lift a little of the load I’d been mentally carrying by keeping it secret. By shining a light on it, I could put things into perspective and look at the facts, which were that it was more likely to be the HRT than anything else.
I still had a huge sigh of relief when my letter came through agreeing with me and saying everything looked good. It also gave me lots of medical details to geek out on and I know fine well my new party piece will be telling people the size of my uterus.
I also heard from my DM Pal, telling me she had fistulas.
“Fistula fistbump,” I proudly replied!
Wonder if she knows the size of hers…
Looking to the future
So now it looks as if I may finally get to my holy grail of HRT – a Mirena coil and oestrogen gel – 20 months after I was recommended it by the now-head of the British Menopause Society.
The ironic thing is, emotionally, I’m actually feeling really well on the Evorel Conti! I’m taking it with Sertraline, which seems to be counter-acting the effects of progesterone on me, and except for one bad episode of menopause depression, I’ve been more emotionally stable than for a long time. I’ve still had a few bleeds, however.
Finally, if you are experiencing bleeding after menopause, please go see your GP straight away. In fact, let’s make that an order – GO AND SEE YOUR GP.
And share your medical facts with me afterwards.
What are your experiences of Evorel Conti? Has it made you bleed? Please let me know in the comments below and tell me what happened to you.