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DiscussionPost Menopausal bleeding-Benign Hysteroscopy
Menopause | Last Active: Jul 17 4:58pm | Replies (40)Comment receiving replies
Replies to "I am 55 and began menopause in April of 2021. I have been on continuous HRT..."
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Did your D&C show hyperplasia or estrogen stimulated tissue?
It is not unusual for estradiol of any kind when used, especially vaginally, to cause hyperplasia or bleeding from estrogen stimulated tissue or to stimulate polyps with resulting bleeds.
Of course you have had a uterine polyp and uterine polyps are a common cause of abnormal uterine bleeding, An elevated estrogen (estradiol) levels may cause or stimulate their growth. These, often benign, growths on the inner uterine lining frequently cause spotting, heavy periods, or postmenopausal bleeding.
You might be better served with an estriol vaginal cream. Estriol is 10 times less strong than estradiol and not tied to polyps or hyperplasia.
Scientific literature generally suggests that estriol is "endometritically silent." This means that at standard doses for vaginal atrophy, it typically does not cause the uterine lining to thicken.
In contrast, while Yuvafem is also considered very safe, its more potent nature means that in a small percentage of women—particularly those who are highly sensitive or using the product more frequently than prescribed—the estradiol can trigger spotting or localized growth like polyps.
Estriol works in the vaginal area but generally does not significantly thicken the uterine lining (endometrium) because of its short duration of action on receptors. It is a weak estrogen that binds to vaginal receptors long enough to treat dryness and atrophy, but dissociates too quickly from endometrial receptors to cause proliferation.
Also, with a system like yours which is sensitve to estrogen it is safest to use progesterone systemically and maybe vaginally to counteract any estrogen over reaction. Please ask your doctor; there is a ratio of progesterone to estrogen which is considered safe which you doctor should be able to maintain for you.
Your story is one that I hear over and over again. It seems that doctors have grown used to prescribing estradiol for women, women that were for years predominately without a uterus or ovaries.
That is less and less the case nowdays, and doctors are seeing that women with a uterus/ovaries are more senstitive to estrogens and do better on estriol, whereas women without a uterus/ovaries seem to need the stronger estradiol. At this point this is all self reporting and doctors speaking out on line, but hopefully a research or population study will clarify this better in the future.
Now though we are left with our own bodies' speaking to us and us having to listen very carefully.
personal example: I have bled twice in my around 28 years in menopause and both times I was taking estradiol systemically. Seems, I was making my own estradiol and was basically overdosing on estradiol when I used the topical estradiol cream. I found a doctor that uses hormone testing and the tests showed that I made plenty of estradiol naturally. I have not used estradiol again until just recently when at the age of 73 my estradiol levels have begun to fall; we will see how I do on this tiny amount of estradiol skin cream balanced by progesterone which I am now taking, plus upping my estriol vaginally.