Uterine Polyps and HRT

Hi Rosalinda,

Its quite a few years ago now that they tried to give me HRT and I flatly refused. 

I'd had a late miscarriage at 20 weeks and my hormones went all over the place. I had some very queer feelings for 3 months, until my body righted itself. So, when I was offered HRT I refused it. I did not want another round of hormone imbalance. I was told I risked Osteoporosis without it. I am now approaching my 80th birthday, do my own gardening and housework and still can walk 5 miles or so with no ill effects. So, I am quite happy with my decision. I think you know your own body better than a doctor at times.

I don't know about your particular case. I have no experience of polyps. Could you get a second opinion?

Interesting that when I had my hysterectomy I was asked if I had ever been on HRT. I think the theory is that the longer you have hormones working, the more likely you can get womb cancer. In my case the theory didn't fit!!!!

Good luck xx

Thank you for sharing this NannyAnny! So sorry you had to go through all the pain of a late miscarriage. That's hard. My miscarriage was a lot earlier and I still remember hormones going all over the shop.

I'm a lot younger than you but my GP been trying to put me on HRT for years (even before I was post-menopausal as she didn't believe I could have such a late menopause LOL).  Every time I go for a smear I get The Chat. Good idea to get a second opinion. Might do that if my results come back all clear.

I just don't get about the HRT when I'm not having any symptoms that would require it and everything I read says I'm not a good candidate re co-morbidities. But my GP says vaginal HRT would be okay even though I could never have oral HRT...

I should add here that I am talking about oral HRT. I'm obviously behind the times. Never heard of vaginal HRT. I think I would need more information on this!!!

Hi Rose

This is my understanding as I discussed HRT with my CNS.

Endometrial cancer, hyperplasia and PMB can occur when there is an imbalance in the hormones. Progestogen offers some protection which is why some ladies are offered it as a hormonal treatment, if they have very early stage cancer or if they can not have a hysterectomy for some reason. 

My understanding with HRT is that the side effects are greatly reduced if it is not taken orally so it may be that by offering it vaginally then it can give the greatest protection for much lower risks. Because of your medical history and your bleeding and the atrophy in the womb lining perhaps they think it is worth using the HRT to stabilise everything. 

But it is very much your decision- I understand your concerns about more polyps growing. I wonder if it would be worth calling the Support Line and asking one of the nurses?

I would also consider making a list of questions to put to your doctor and then if you are still having concerns perhaps consider a second opinion?

Perhaps some questions like these.........

-What are they hoping the HRT will do?

-What are the risks of not taking it?

-What do they hope it will do to the endometrium?

-Will it improve the atrophy?

-Would it increase the risk of more polyps growing?

- once the results are back- would there be an alternative treatment eg; hysterectomy, monitoring with repeat scans

-With your family history of cancer, is there an issue with taking HRT

-What is causing the polyps to grow in your case?

........................................and anything else that you want to ask.

I have previously done this and took a list to my radiotherapy consents appointment and the consultant was happy to go through them 1 by 1. Within a couple of minutes I had the answers I wanted. 

Just a suggestion.

Jane

Hi Jane,

That is just brilliant! So, so helpful. Huge thanks.

I think my GP wanted to make all the investigations easier – smears, TVS, etc. Plus, it might help with incontinence? I'm going to wait and see what pathology shows then ask all your brilliant questions.

From my reading (NHS link) I do have several contra-indications re personal history even for vaginal HRT (clots, migraine with aura, family cancer history, etc). But, I also understand that progesterone might help reduce some risks. It's a tricky one. I certainly don't want to take anything that might help grow more polyps and necessitate more procedures!

Again, thank you so much for your input. It's really helping to be able to talk things aloud and process things.

Rose xx

Hi again Jane,

I decided to check the patient information leaflet as GP had told me the name of the cream.Turned out it was an oestrogen cream!! According to the PIL I have one absolute "Do not use" two possible "Do not use" – polyps would have to be benign and I would have to speak to a non-gynae consultant about another risk – plus there 6 other potential contraindications where it says "discuss with your doctor".

Mind-boggling or what? 

Rose xx

I think that's a good plan, to wait for the pathology to come back and then have an appointment and ask your questions- and then once you have all the information you can make the decision that is right for you. 

I find preparing the questions in advance helps as my mind can go a bit blank when I am in front of the consultant. Most of my questions could be answered with a quick yes or no and I got far more from the appointment than I had previously. I find otherwise sometimes the consultant can talk about what they think is helpful rather than what is actually important to you. Mine never minded and I think it made the appointments easier for both of us. 

Let me know how you get on and if you need anything else, then let me know. 

Jane