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[Nikki180515]

Hi I am a newbie in here, so this is my first post!

I had my hysterectomy in May this year, including the removal of my ovaries.  I am 43 so hadn't started the menopause so started HRT 4 weeks after my op.  I have been using 1mg of sandrena gel since and have been very happy with it, until now!

I have started full time teaching again after being part time for 5 years and am really struggling with feelings of stress, tiredness and just generally feeling totally overwhelmed.  I have broken down twice at work recently and yesterday was sent home as was so upset!!

I know you may be thinking it's the nature of the job, but these feelings and especially the tears are so unlike me.  Just wondered if I should up my HRT or not???  I also have an under active thyroid that doesn't help!

Would be lovely to hear from others who have been through surgical menopause like me!



Nikki xxx

[Dancinggirl]

Hi and welcome again
I responded to you on the other post which I hope was useful but hopefully others will be along with their thoughts and advice.  I think you need a higher dose of oestrogen.  DG x

[Nikki180515]

Hi Dancing girl

Yes thank you and did see your reply, thought I would start a new thread as you suggested.

I think you may be right re more oestrogen.  I requested my GP tested my oestrogen levels but she said they don't do that??  Not sure if anyone else has had theirs tested??
I am going to get my thyroxine levels tested in a couple of weeks so may ask the nurse about it.

My doctor was reluctant to up my HRT as she said I was doing so well before and feels it's the stress of going back to work full time, which she may be right, but I know I don't normally feel like this and am sure it's to do with hormones.  Will wait til I get thyroxine levels checked to see if that is affecting anything!

Nikki
Xxx

[CLKD]

HORMONES   

Do you get to see the Surgeon again to discuss further HRT requirements?

How do you feel generally about returning to full time work?  When did you decide?

[Nikki180515]

Hi CLKD

No never got to see the surgeon again, it was only of I had any problems with the surgery!

I was excited about returning to full time work, but maybe part if me misses meeting up with my friends, weekends are taken up with my sons football matches and catching up with washing, so think I miss not having a quality weekend in my eyes.  Miss being out in my garden etc!

I usually cope with this by being moody, then eventually accept the situation and get on with it!

But now just get so tired and just cry!   .    Which is not me!   Yesterday when I was off work- headteacher is great and sent me home the other afternoon as has a migraine and broke down in tears, she told me not to come back til Friday.  So went out for a walk which made me feel better being out in the sunshine!!!

Tried to research places around where I live for support. We don't seem to have any menopause clinics, even looked at private hospitals.   Also my GP said they don't check hormone levels, as it would be good to see what level my oestrogen levels are and testosterone???
I was feeling so well in the summer, but then again I wasn't officially at work, even though as a teacher was doing all my planning.

Hopefully it will sort itself out soon, love this site as only found it yestersday have been on another forum for a few months too.

Thanks for responding to me!
Nikki xx

[Pollie]

Welcome Nikki

I have no experience of hysterectomy I'm afraid but I can comment on blood tests.

Some GPs will test for FSH/LH to determine if they are rising which is useful to determine if symptoms related to menopause but some GPs will just 'treat the symptoms' and refuse to do blood tests.

I asked mine for tests recently and she agreed to FSH/LH and oestradiol.

But she refused testosterone saying there was no clinical need. I guess that she had no intention of giving me testosterone which is probably right as I still have uterus and ovaries and I think you can only get testosterone if you have had hysterectomy but someone else more experienced will be along to comment on that.

If you have given HRT long enough to work (3 months?) I think you would be entitled to ask GP to test oestradiol on the basis that you need to know if it is lack of hormones making you feel the way you do or something else?

HTH

Pollie

[CLKD]

A change of life-style can be a huge upheaval!  Give yourself some slack.  You are now working full time outside and inside the home 

[Briony]

Hi, can't help with the hysterectomy issue, but being the same age as you, I agree with what the others saying about needing more estrogen. I started on 50 mcg patches, but found I needed something stronger so now take 2mg in pill form. My fsh, when tested, was 'normal for age' but the consultant then requested day five estrogen tests and that came back indicating my estrogen was at a post menopause level . As a result, they suggested immediate estrogen therapy in the form of hrt or the pill.
Really hope you can get things sorted soon. Teaching is bloody hard  work even when you feel 100 %, so trying to manage whilst battling hormonal issues is no joke. You're lucky you have a supportive SLT .... sadly, quite a rarity these days x

[Nikki180515]

Thanks everyone for your support!

Feeling a little better and have sorted out that Wednesday I technically don't teach! The morning is spent down at the local sports centre with the kids then my PPA time is in the afternoon, with the option of doing that at home, if I need too! 

am defiantly going to try and up my oestrogen gel and try and find out where I can get my levels checked as need this sorted for my sanity! 

Nikki xxx

[Dancinggirl]

Nikki
Your GP is talking rubbish about testing your hormones level.  They should do a blood test to get your oestrogen level - at your age your levels should probably be at least 500 so if it is below this your definitely need more oestrogen. I would go back and ask for the blood test so you know your current levels.
I am 59 and my gynae insisted my GP do a blood test after I had been on HRT for 4-5 weeks to see what my levels were - he wanted them at around 600!!!!!! DG x

[Hurdity]

Hi Nikki180515

If I haven't already done so I just wanted to welcome you  !

There is information on this site about menopause and HRT after hysterectomy here: http://www.menopausematters.co.uk/aftermeno.php when the different types are distinguished ie ovary removal or not ( and also cervix removal too).

My thoughts are as Dancinggirl - that is a very very low dose of oestrogen for someone of your age and who has had everything removed! Your doctor is wrong to presume that your feelings are to do with life events ie your returning to work full time rather than hormonal. It strikes me that your body is still adjusting to being plunged into menopause suddenly from the operation in May, and the hormonal shock this causes which is only a few months ago.

There are other women who have had similar operations and they are usually given much higher doses than this and it also seems to take some time to find the right dose that makes you feel good. I hope someone else will come along and give their experiences. Maybe start another thread with surgical menopause etc in the title so that it might catch someone's eye?

The new draft NICE guidelines for menopause ( hopefully soon to be approved) state that you should be offered access to someone with expertise in menopause which is not likely to be your GP

Offer women who are likely to go through menopause as a result of medical or surgical treatment (including women with cancer, at high risk of hormone-sensitive cancer or having gynaecological surgery)support and:

• information about menopause and fertility before they have their treatment
  referral to a healthcare professional with expertise in menopause.

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They also say this about testosterone - and this is for normal menopause not surgical as in your case:

Altered sexual function

1.3.8 Consider testosterone supplementation for menopausal women with low sexual desire if HRT alone is not effective

This is what it says on this site about testosterone and hysterectomy:

Role of testosterone after hysterectomy

If the ovaries are removed at the time of hysterectomy, as well as the estrogen level falling, there is also a 50% decrease in testosterone production. Some doctors recommend testosterone replacement along with estrogen replacement; testosterone helping energy levels, mood and libido. However testosterone replacement does not seem to be required by all and the ideal route and dose of testosterone for women is still being researched. It is therefore not routinely recommended following removal of the ovaries but can be considered for some women who do not fully benefit from estrogen replacement alone.

More info on testosterone supplemtation:

http://www.menopausematters.co.uk/testosterone.php

Do go to the doc and ask for a referral to a specialist - even if this is some distance away if you can manage to get there ( at half-term?). In the meantime do ask to be prescribed an increase in dose to see how this makes you feel over the next few weeks.

Hurdity x

[LW44]

Hi

This happened to a friend of mine, age 43 had hysterectomy and was put on very lose dose hrt. whilst she was recovering at home she felt ok, but as soon as worl was added into the mix she felt very overwhelmed and unable to cope.. tears low mood, anger etc... anyway dr then changed her hrt to a higher dose and different one (after being in floods of tears at her appointment) and she is now after a few months on higher dose feeling more able to cope and a lot better

[Nikki180515]

Hi

Thank you so much for that info will ring the doctors tomorrow and see if I can get an appointment.  If all else fails I think I will call my consultant who did the op and ask his advice as he may be able to point me to a specialist.  I don't mind paying to get in quicker!

Interesting about testosterone, as my libido is non existence at the moment, also I read low testosterone can affect your mood, which could be why I'm feeling like I am! 

Thanks again and will keep you posted how I get on!!

Nikki xxx

[Nikki180515]

Hi

This happened to a friend of mine, age 43 had hysterectomy and was put on very lose dose hrt. whilst she was recovering at home she felt ok, but as soon as worl was added into the mix she felt very overwhelmed and unable to cope.. tears low mood, anger etc... anyway dr then changed her hrt to a higher dose and different one (after being in floods of tears at her appointment) and she is now after a few months on higher dose feeling more able to cope and a lot better

This is reassuring! Thank you! 

Xxx