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[ardee]

Hi All
Almost a year ago I had a total hysterectomy with ovaries removed. I tried various oestrogen only HRTs and eventually settled on Premarin 125mg. I also came off Citalopram anti-depressants after things stabilised on the HRT. Coming off the Citalopram was hell but things got better after a few months. However, I am now having really bad mood swings again that have gradually got worse again and it is over 7 months since I stopped the Citalopram so I don't think it is likely to still be that.

Before I had my hysterectomy I was on the Zoladex implant to stop my ovaries working and was on Tibolone HRT. Having this alongside the citalopram this was the best I had felt for years, mood-wise. Anyway, sorry for the long and waffly background info but my question is this:

Is anyone else on Tibolone (aka Livial) after a total hysterectomy?

I want to ask my doctor if I can go back on the Tibolone instead of the Premarin but I cannot find out if Progestrogen is not given because they believe it is simply not needed after the ovaries and womb have gone, or if it is actively a problem to take it without having a womb? If I can tell my doctor that others are taking it who are in the same situation as me I think he is more likely to let me try it.

(I have also posted the same in the hysterectomy association forum.  Apologies for the cross-posting but would like to get as many views as possible)

[Dancinggirl]

I think Tibolone is an option post hyster.  It's not actually hormones like HRT so isn't progesterone. If it suited you before then it's likely to suit you again.  some women do need HRT together with an SRRI to really keep everything under control - I wouldn't rule out going back on the Citalopram again either.  DG x

[Annie0710]

Yes you can take Tibolone after hysterectomy, from what I've read it isn't hormones as such it's more the starter to produce the necessary hormones from my understanding of reading it up.  I am 18 years post hysterectomy and it's assumed I now have no ovaries and Tibolone has been offered to me so I read up about it and there's lots of women post hysterectomy on it x

[ardee]

My GP has now agreed that I can try Tibolone again so I have just taken the first one.  Will keep people updated on progress as I think these forums provide an invaluable resource for us all.

[Dancinggirl]

Fab news ardee - hope Tibolone works for you as it did before - there's a good chance it will. DG x

[Annie0710]

Aw glad you got it x

[Tempest]

That's great news, Ardee!

[ardee]

Hello Ladies.  I'm popping back in to let you know how I am getting on.  I managed to persuade my GP to let me try Tibolone and I have been on it for 1.5 weeks now.  I am pleased to say that I am feeling SO much better.  The mood swings/anger have all but gone and the stomach bloating that I was getting on and off also appears to have more or less gone away.  I am going to continue with Tibolone (as long as my GP agrees, and I see no reason why they shouldn't) and see if things continue to go well for me.

I think that I am quite lucky because my GP surgery is at the University where I used to work and is there to serve the university community so I guess the GPs are perhaps more used to having patients who have done their research than a practice serving the general population so are more inclined to listen to someone who goes in with a specific suggestion to their problem.  All I would say is don't give up and don't let your GP fob you off.  If you are not happy see a different GP or even change your surgery and keep going back until they let you try what you think will help you.

[Dancinggirl]

ardee - Hoora   DG x

[Annie0710]

Aw it's lovely to hear you're feeling better on your chosen plan :-)


X

[Tempest]

I'm so glad that you're starting to feel good again, Ardee!

[Leahjay]

Hey Ardee,
I wanted to say thanks so much for posting about your progress- might sound crazy but it really helped calm me down tonight.

Did you ever get an answer to your question about the progesterone-like component? I've been wondering the same.

I was on zoladex and livial prior to a total hysterectomy and ovaries out also. Like you, I felt great pre-surgery, my mood was stable for the first time in my life. So amazing.

I've stayed on the livial after my surgery, I'm 2 weeks post and starting to feel pretty depressed, I'm so disappointed and scared. I read something about how livial can sometimes cause depression because of its progesterone effect and I wondered if this could somehow be more of a factor after surgery if the uterus is gone.

So many factors I guess, it's hard when none of the doctors seem to really understand the factors either. I'm just trying to remind myself that when I first went on the zoladex and livial, there were a few hellish weeks before things settled down. Hopefully this will be similar.

I hope you've stayed feeling well, thanks again for posting your story.

[Tempest]

Hi, Leah! I hope things progress well for you on Tibolone, but my experience over time was that it was just too weak in its actions to help me after TAH/BSO. I was desperate at the time, so I'd try anything!

I think the best way forward if it doesn't pan out for you is to use a transdermal estrogen, and then add in testosterone replacement as this really can help mood/sleep/libido amongst other things.

Give the Tibolone a good go though - I wish you the best of luck! xxxxx

[Leahjay]

Thanks Tempest, I really appreciate the support (I'm crying in a good way) and it's so helpful to hear about your experience. Did you ever try 5mg of tibolone? I've read some places that it can be prescribed and they did research on 5mg also.

Can I ask why you like transdermal?

Thanks again x

[Tempest]

Oh bless your heart, Leahjay {{{{passes hankie and a hug}}}}}.

Transdermal is good for us TAH/BSO  ladies as we may need HRT long term, and it bypasses the liver and doesn't raise clotting risk. Tibolone does neither of these things either - but other oral HRT'S do potentially carry that risk.

It can be tricky to get right (trust me, you don't want to read my saga - but I'm an unusual case as I had no HRT for a year post surgery).

I'd give it at least 2 packs of Tibolone on its own at 2.5mg initially to see if you settle - if not, you have plenty of other options to try.

Hugs! xxxxx