Started spotting on Tamoxifen this normal??

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Hi all

My periods stopped after my 2nd chemo infusion last year. My treatment at the moment is adjuvent Target therapy (Trastuzumab) every 3 weeks and Tamoxifen taking that for 5 years. I've noticed I've been getting more discharge last few weeks  and I've started spotting last couple of days. I'm 46 and  gone 9 months of not having a period and did think I  was peri menopausal and chemo had brought it on. I was getting hot flushes but they stopped too within last month or so. Can your period  come back while still on Trastuzumab and Tamoxifen ?? Just worried as heard Tamoxifen can affect the womb or is this normal ??

  • Hi Mum45

    I am normally one of the Community Champs for the Womb group but just happened to notice your post.

    This is something that you need to discuss with your Doctor. 

    Tamoxifen is associated with a higher risk of hyperplasia (thickened endometrial lining) Any bleeding/spotting whilst on tamoxifen would warrant further investigation and possible hysteroscopy/biopsy procedure. 

    Its best to get this checked and hopefully get some reassurance. 

    Jane

           

    Macmillan Support Line - 0808 808 00 00, 7 days a week between 8am-8pm

  • OK thanks for replying.  I'm quite worried now but seeing my oncologist on Wed anyway so will speak to her about it 

  • That sounds a good plan. 

    Hopefully she will be able to give you some reassurance. 

    Tamoxifen can have an effect on the womb lining. If it becomes thickened that can lead to some spotting. I would expect a possible ultrasound as a first step to have a look in the first instance. They would likely want to measure the endometrial thickness. 

           

    Macmillan Support Line - 0808 808 00 00, 7 days a week between 8am-8pm

  • I only had a smear in January which came back clear and a full CT scan in April which was clear too so quite baffled to why this is happening 

  • I understand it is concerning. 

    The smear only tests the cervix and does not include anything that is connected with the womb/endometrium. 

    It is reassuring that your CT was clear 3 months ago.

    What I would expect to happen is that they offer you a TVS ultrasound (internal) and for them to measure the thickness of your endometrium. If the thickness is ok then it is likely to be left. If the thickness is higher than they would like, the next step would be to offer a hysteroscopy (camera) to take a closer look and to take a sample. This would be very much to rule out anything potentially serious. Sometimes tamoxifen can lead to changes in the endometrium and they would want to make sure that these changes are ok and perhaps monitor them. 

    Some changes would resolve by themselves (typical hyperplasia) whereas some (atypical hyperplasia) may need some treatment. For some ladies this would be a hormone coil. There can sometimes be other treatment suggested. 

    With any abnormal bleeding it is always advisable to check the cause to rule out anything potentially worrying and if there is something concerning happening for eg; the endometrium is thickened, then to be able to deal with it at the earliest signs. 

           

    Macmillan Support Line - 0808 808 00 00, 7 days a week between 8am-8pm

  • Thank you for getting back to me all I can do now Is see what my oncologist says and take it from there. Its one thing after another have one problem and when that ends another starts!!

  • Hi  

    I’m not for a moment suggesting that there is anything wrong, but a smear test is initially only a test for the hpv virus. If the virus is not identified, there is no testing of the cervical cells so a clear smear test only means that hpv has not been found in the test.

    Sarah xx


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  • Ok I never knew that. I've spoke to my breast care nurse today who has reassured me a little x 

  • I’m glad you’ve been reassured by your nurse. I often see ladies thinking that a smear is a check for cervical cancer, but it’s not, and a clear smear just means no hpv at the time of the test, nothing else. Not enough people seem to be aware of this-I know I wasn’t in the days when I had smear tests. I hope all will be ok for you.

    Sarah xx


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