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[ladybird52]

Hello everyone.  I posted a few months back about having some tests as I was suffering due to having multi fibroids.  Well I've bit the bullet and I am booked in for abdominal sub total hysterectomy 4th March (keeping the cervix).  During last consultation the consultant confused me as he said I would have to stop HRT (combined) before the op to guard against blood clots (perfectly understandable) and then wait several weeks after to see if I had a "bleed" before starting on oestrogen only HRT.  What does he mean by a bleed?  I haven't actually had a period since 2012. I have been taking low dose Premique for about a year now and it has changed my life so I also wondered how soon the horrible meno symptoms would come back when I stop taking the HRT as I dread trying to cope with them as well as getting over the op at the same time. Would appreciate any advice from any other ladies who have been through this. Thanks. 

[Sarah2]

I hope you get on okay.

I am no expert on this and others will be along soon...but I think as you are keeping your cervix there may be some lining left just above the cervix, which has to come away and your dr is not wanting to start you on HRT unless you have no lining anywhere left, because the oestrogen only HRT would 'feed 'it.

If though you are almost 2 years post meno it's unlikely but depends on whether you have had a combined or sequential HRT to date.

You could get round the waiting to start HRT by taking a short course of progesterone after a few weeks to see if you bleed.

[Rowan]

If you have a sub total leaving cervix and ovaries, this means that part of the lip of the womb will be left behind, this can cause light bleeding if you have not finished your periods for good, it is harmless. Most women don't experience bleeding after a hyst and as you have not had a period since 2012 I don't expect you will.

You will be having an abdominal hysterectomy if the cervix is left.

I had subtotal hyst when I was 53 and did from time to time have a very light bleed sometimes not much more then a couple of drops but it did coincide with tender breasts, until I was 56 when I finally was post menopause, the age my mother finished her periods.

I put a patch on at about a month after my op when I had a dip, but many women  start using the as patch after they come out of hospital. I really can't see why you can't start using estrogen as soon as you feel you need to.

[ladybird52]

Thanks Silverlady and Sarah52.  I will talk to consultant again at pre-assessment op appointment.  As I haven't had a period for nearly two years and have been taking combined HRT hopefully I can start on oestrogen as soon as possible.  I know it would probably be simpler to let him take away everything as he's also removing the ovaries but I just feel I want to keep a little piece of me especially as I have read that it can affect sexual response after the op and I've never had any problems with smears etc.  Also he said the sub total op is easier than also taking the cervix but it is so difficult when they try and explain everything as a lot doesn't sink in at the time!  Silverlady how were you after the op?  I am expecting it to take some time to get over it?

[Rowan]

It took almost a year to forget I had had the op, mostly it was tiredness and fatigue, its major surgery and your body and mind has to recover, my advise is not to not rush things.

I remember in hospital I felt OK and on about the forth day I went for a walk as I was getting restless in the ward, I experienced an almighty hot flush all through my body almost icy hot, I never really had another one after that, I did have an increase in my sexual response in sleep!!! which was pleasant and I thought I should have done this sooner, but it was short-lived and only lasted about a month. Many ladies report this.

While in hospital the ladies who had had an hysterectomy were given Voltorol suppositories because the cramping can be quite bad, I was given some to take home with me, the first night the cramping was very painful, I used a suppository which calmed it down and I never had it again after that..

Gas can be a problem too but the nurses will explain about this. You will be given instructions about wound care and a leaflet about any symptoms that would need you to get in touch with the hospital or GP.

Hope this helps.

[Hurdity]

Hi ladybird

Just to add to the information about oestrogen after sub-total hysterectomy, here is the information on this site:
http://www.menopausematters.co.uk/aftermeno.php  (scroll down)

Sub-total hysterectomy

If the main part of the uterus has been removed but the cervix retained, it is currently uncertain whether HRT can be given in the form of estrogen only or estrogen combined with progestogen. The slight concern of using estrogen only, is that there may be some of the cells of the lining of the uterus in the cervical canal which could become thickened from the estrogen. This thickening can be prevented by adding in progestogen. To find out if progestogen is required, it may be suggested to use estrogen combined with cyclical progestogen for 3 months after your operation. If there is monthly bleeding in this time, it means that cells are present which are responding to the hormones so estrogen and progestogen should be used thereafter. (These hormones can however be given together continuously to avoid monthly bleeding). If there is no bleeding in the first 3 months, then estrogen can be given on its own thereafter.

Therefore you can be given oestrogen straight away - but for the first 3 months a cyclical progestogen is recommended in addition.

Hurdity x

[ladybird52]

Thanks Silverlady for your advice.  Everyone is telling me I will need to take my time to get over it as it is such a major op.  I've hardly ever had to be in hospital so I find it all so daunting but I am trying not to dwell on it too much yet.  My hubby is talking about putting a day bed downstairs so I can just hop on and off when I need to...how decadent! (well probably not hop more like hobble) Hopefully the nurses will just knock me out with something whilst I'm there!  Thanks Hurdity for the link and info, I understand it much better now....you are a mine of information.  To be honest the consultant was pressing me to have the cervix out  too but I just couldn't get my head around taking something away which is not the cause of the problem.

[Joyce]

Make sure you discuss fully with consultant regarding cervix. I had a total hysterectomy in my mid 30s. Ovaries then needed removing 10 years later. Was only supposed to be my left one being removed, but after discussion it was decided to remove right one too as with my history, it would more than likely need done within a couple of years. I'd had more than enough problems TBH & agreed with consultant's reasoning.

Guess what I'm trying to say is, maybe the consultant feels that you would just be delaying the inevitable by leaving the cervix.

[ladybird52]

Thanks Cubagirl.  The cervix isn't actually the problem so that's why I've decided to keep it and I didn't like the idea of them reconstructing a "cuff".  My mum also had hers taken away when she was about my age and she said she never felt the same again!  No fun being a women is it!

[mamakaren]

Hi ladies,

I'm finding this thread quite interesting! Thank you! It does take some time for a body to recover from this surgery.

The part I am finding most suprising is how long Silverlady said she was kept in hospital!  :oYou were kept in the hopsital more than 4 days? I had a complete hysterectomy last January. I had the surgery Tuesday morning and was discharged late Thursday afternoon! Way to soon in my opinion! Just wondering, how long was everyone else kept in after surgery?

Karen

[Rowan]

I had my hyst 13 years ago, things have changed since then, they want the beds I suspect. As for HRT I was on it before hyst and afterwards went onto the estrogen patch only even though I kept my ovaries and cervix.

I can't imagine why if you had a full hysterectomy you did not have a patch as son as possible, you have gone to zero hormones in your body and its crying out for them.

I would see your GP as soon as possible. Think I have replied to your other thread too here.

[mamakaren]

I guess things have changed quite a bit! To much in some cases! I had to wait to start HRT because I had problems with cyst growth and hormones aide in their growth. It's weird because they took everything, but apparently they can attach themselves to the pelvic wall!