Endometrial Concerns

Just wanted to say firstly that I'm very grateful for this forum and have spent some time reading about other members concerns that are quite similar to my own, and have been amazed at all the support and responses people have been given during such worrying times. You are all amazing!

I too am going through something that is causing me sleepless nights and am hoping for some support as I have very little family to confide in.

I am 44 and just been diagnosed as peri-menopausal and started combi HRT (Elleste Duet) nearly 2 weeks ago. Symptoms were severe mood swings and irregular periods so the doctor recommended HRT, and I declined a hormone blood test as I didn't think there was any need for it at that point. I have always had heavy periods so to me, they were normal, but over the last year or two, I have some very slight blood tinged marks on the toilet roll when I wipe. No other symptoms.

In March 2021, I had pelvic floor surgery under GA due to prolapse. During the surgery, I was fitted with a Mirena coil which I was unaware of until after surgery. When i asked, the consultant said he fitted it because of my past issues with heavy periods. This concerned me as I already had the Implanon contraceptive in my arm. I started with bad cramps during my periods so I had the Mirena removed in November 22.

Anyway, September last year, I had my routine smear test. The nurse noticed some bleeding from my cervix when touched and some redness. She asked me to come in the next day so the doctor could look. I attended the appointment and the doctor confirmed that there appeared to be what she thought was a large ectropian and referred me to a gynaecologist. She ordered a full blood count and they came back as 'satisfactory' showing a raised white cell count but no further action.

In the meantime, my smear came back negative, so I wasn't concerned and have related the slight blood tinge when wiping to the ectropian. Anyway, Gynaecology made me an appointment around 2 weeks later which I have cancelled and re-booked a few times due to travelling and looking after my elderly father who is in palliative care. My next appointment, that I intend to go to, is tomorrow.

I have recently been given my medical records due to an insurance claim and as expected, have had a look through them and found out more information that wasnt relayed to me during my smear and the doctor visit the next day. The doctor noted that a large ectropian? was seen and possibly numerous nabothian cysts? Now I was aware of the possible ectropian but nothing was said about the cysts.

Nurse report says:

medium spec used, cx fully visualised, ?large etropion with nabothian follicles. not previously documented before. bleed on contact when sample taken, therefore GP not got to check as unable to see cervix after sample taken, has drs tomorrow to visualise cervix to confirm. - task to Dr.

Dr report: 

Examination Looks well and comfortable Examination
done with Dr Porcas as Chaperone Abdomen: soft and
non-tender Pelvic exam: mulitple bumpy swellings around
the cervix Speculum: cervical ectropion? with some
nabothian follicles? seen
Comment Plan Bloods - FBC, ferritin Gynaecology referral swab mcs. 

I continued looking back through my notes and saw that I had an ultrasound scan on my pelvis back in 2016 that appears showed some concerns but were filed as normal.

Here is the report:

US Pelvis : Transabdominal and
transvaginal scans done with pt consent. LMP= 10 da ys
ago. Normal sized anteverted uterus, 37mm AP diameter.
Endometrial borders are poorly-defined but the
endometrium appears thi ckened measuring 19mm at the
fundus, a polyp is not excluded. Normal ultrasound
appearances to both ovaries.

So here I am today, concerned that there may be something more sinister going on down below. I have had a feel about this morning and was able to feel my cervix which does indeed, feel very lumpy which is something new, as previous checks over the years were smooth. I am also having extremely bad period pain since last night, which I am putting down to my starting HRT nearly 2 weeks ago.

My worries are that if the ultrasound in 2016 showed endometrial thickening, that has progressed to the cells and lumps found on my cervix today. And now I am taking HRT, which also adds to the risks of endometrial cancer? Wouldn't any endometrial/cervical concerns have been picked up during my pelvic floor surgery also?

I'm really sorry about the long post but thought that it best to add as much as I can. I don't think much sleep will be on the cards for me again tonight as I anticipate what tomorrow may bring xxx