I have been having regular intermittent abnormal uterine bleeding since May 2020 when I was almost 3 years menopausal. I get bloating, cramping, fatigue, breast tenderness and all the other hormonal symptoms I used to associate with periods. Despite being  monitored, scanned, having repeated blood tests,  2 hysteroscopies and a polypectomy the consultant has been unable to confirm the cause suggesting simply ovarian activity triggered by hormone fluctuations. I get seriously frightened on occasions by it now but take my mind off it with a lot of exercise and a busy lifestyle. My last smear was 2017 (age means I'm now on 5 year screening) but have been assured that regular smear tests would have picked an abnormality up before now. I've forged a good relationship now with the team in our local gynae department and they have been very patient in answering all my questions (I've asked a lot) however absurd. 
Like you I thought I'd got through menopause lightly (no hot flashes) and no HRT. However, it does seem that despite blood serum tests confirming menopause, I also have higher levels of oestradiol than would have been expected which with hindsight probably explains the lack of menopausal symptoms and although I do have atrophy it's  not believed to be the cause of the bleeding.

Jumid, I am so sorry to hear what you have been through over the last 15 months. It must be so frustrating to not know what is causing the bleeding. I honestly think that if I was in your shoes I would have begged for a hysterectomy by now. Would HRT help you or would you prefer not to go down that route? I have always told myself I would do my upmost to avoid having HRT but I guess it depends how bad the symptoms get. Can I ask, have you had any urinary problems at all? Also, when you had your hysteroscopies, how did you find them? In my letter, it says to take Ibruprofen beforehand but if I find it too painful to tell them at the time and I can have a local anaesthetic or, I can request a general anaesthetic beforehand if I wish. So, it appears that I have 3 options. I would be tempted to go for local anaesthetic  as I have read on this forum that the procedure is painful, however, that would involve an injection in the cervix so I am not sure what is worse. Generally I am fine with injections but guess it would be a bit unpleasant in the cervix! So I would welcome advice from anyone about the best option. Jumid, I do hope that you find some answers and that your symptoms improve over time. Thank you for your response x

Hi,

I hope it all goes well for you. I had a hysteroscopy last week. I had been so anxious about it having read so many things on the internet and various threads on this site. In addition that gynaecologist had tried to do a biopsy the week before which was excruciatingly painful and unsuccessful. On the day I had the hysteroscopy I was the second patient of the day. I could hear the lady before screaming in agony which did not alleviate my fears.  As it turned out it was completely painless. I had taken ibruprofen and parecetamol before hand.  I did not have a local anaesthetic as the nurse said often that was more painful than the procedure. I think everyone's anatomy is different and if you find it is too painful without anaesthetic you can opt for a general. You just don't know how it will go on the day. There are pluses to being able to do it without the additional pain relief but there are times you need it and that's ok. There are not simple choices and often we don't know what will be manageable until the day. 
the worst thing about all of this is the waiting. Waiting for appointments, waiting for results, waiting to find out what the next steps will be. 
Currently I am waiting for the histology results from biopsies taken last week. I am not too concerned on some levels. I will either end up having a procedure to removed a womb full of polyps (there were too many to take out last week) or a hysterectomy if the results are not great. Either way I am ok. It's just the waiting in between I find challenging.

I hope it all works out well for you and you get answers soon. 

Thanks for your reply Crazynut. I can't have HRT because I appear to be producing oestradiol and more oestrogen could exacerbate the situation. The nursing lead has given me the heads up that the consultant is likely to discuss a hysterectomy with me and it's reached the point the sooner the better.

I found the hysteroscopies uncomfortable rather than painful and took maximum dose of painkillers an hour beforehand and then during the procedure just breathed deeply - you get a lot of cramping and my atrophic vagina made it a bit sore. First time, she did a polypectomy ( with my consent) at the same time but I honestly didn't feel that at all. On the second occasion she did a full swoop to gather tissue from all over for analysis and that really cramped but I was offered gas and air which I was grateful for. If you think you might need that, make sure you are not driving yourself home; my husband was picking me up and otherwise I wouldn't have been given it. Might be the same for an actual local anaesthetic too.

I was able to watch the whole procedure on the screen and the hysteroscopist gave a full commentary with one of the nurses pointing to where she was referring but none of that was obligatory although I found it intriguing. They assured me at all times I was in control and could stop the procedure at any time if it was painful.

Apart from more bleeding afterwards there were no side effects and I felt much better than when I had one a few years ago under general anaesthetic, where I assume because I was unconscious they were significantly rougher.

Hi, not sure if can help but any questions u might have I may be able to offer some words of comfort.

im 57 menapause for 5 years, I’d had bloating for bout a year and suffered constipation so put that part down to some sort of ibs, then couple of months before my lst bleed I noticed funny smell when went a wee and some watery discharge, so after my 1 bleed I went gp who put  me for appointment at ladies clinic, had vaginal scan and 2 weeks after a hysterescopy then 10 days later results and 2 weeks after this full hysterectomy, yes cancer but till you have all your results and mri scans don’t let anxiety take over. I googled the life out of my phone and all it did was fuel my fear and my fear 6 months on still not good. Please no google until u have a diagnosis good or bad it don’t help xx

Thank you Frances123 for your response. I am sorry to hear of all that you have been through. You seem to be very positive though and that is good. Thank you for your tips re: the hysteroscopy. I think I will try and do the same as you but will ask for gas and air if it is too painful. You are right about the waiting, it's difficult. I have been trying to keep myself busy with the kids etc. but my head is all over the place and I am imagining all sorts. The dull achiness has gone but I still don't feel 100%, needing to wee a bit too often and I have had a few little episodes of light headed-ness over the last few days, they only lasted for a few minutes. I hope that isn't a bad sign, it might just be the result of me being so anxious as it seems to happen when I am thinking bad things and I get all hot and panicky. I am hoping the ultrasound on Tuesday will provide some answers but am bricking it . I know I am a bit of a hypochondriac though and always think the worst - I am really hoping it will be something simple.  Good luck with your histology results. Fingers crossed all down to benign polyps that can be removed easily. Take care and stay positive ️

Thank you Mario11 for your advice re: googling, I am my own worst enemy! So sorry to hear your story. I do hope that you are doing okay after your hysterectomy xx

Thank you Jumid for your response and advice regarding the hysteroscopy. It's good to know what to expect. Have you suffered with any urinary issues at all or has it been mainly cramping and spotting? x

I'm afraid I've always been the kind of person who hears running water or sees a sign that says Ladies and has to go, so to be honest I've not noticed anything untoward in that connection.

Ha ha, I know what you mean . I am a bit the same to be honest. Maybe I am reading into things too much - over thinking. I wonder sometimes if I am imagining all these symptoms as I am so anxious.