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[Mazza27]

Hi Ladies,

Not been on for a while, have been going through the peri journey since 39 yrs old. Changed my job to take stress out of my life and still do  not  know what to do for  the future.

Lap and hystosocpy done no problems, suffer from the period of ovulation through to period with pain/hempligic type migraines/tinnitus/sore boobs/bloating/mood swings/depression/loss of confidence/tiredness/no energy/brain fog the list is endless and changes all the time.
My GP would not prescribe HRT scared of stroke risks due to migraines(these have only started in last two years), paid private to meno specialist. Advised severe PMS and to try zoladex and if all good full hysterectomy.

GP referred and now under Gynae private, first two injections fabulous the brain fog lifted and the migraines none existent but but the night sweats/flushes kicked in but I did feel great till the 3 rd one, this seemed to plunge me in to a depression with no energy whatsoever and night sweats bad. Got an appointment with Gynae and gave me Elleste solo, said this will what you will be on post op so try it, gave me tablets but said best to have gel/patches if all ok.  Felt fab within 48 hrs mood great and no sweats at night and thats what he said but then a nausea hit me thought it was a bug as I was vomiting and I didnt take one Tuesday night felt ok all day weds, seen gynae again and he said was prob bug keep with it, I took one last night  and agin feel nauseus and want to be sick but its in waves,  the migraines are underlying not full blown but looming not flooring me.

I am now in situation of what to do?
Full Hysto or just ovaries removed(this is what gynae recommends but meno spec says full hysto) or just forget it all and go back to the woman I was post injections, that I don't  want as the brain fog was horrible. That was a horrible feeling along with the migraines down the right side of my body.

Anyone got any advice?

Thanks ladies
Mazza xx

[Mary G]

Mazza, I'm sorry to hear that you have been having a rough time.  Having read your post, I would say that if you are going to have an operation and you suffer with migraines and/or progesterone intolerance then have the whole lot removed.  There's no point in being progesterone intolerant, having your ovaries removed only to keep the womb which needs progesterone, it would be a short sighted move that would not solve the problem and would subject you to hormone fluctuations - assuming you would be taking oestrogen of course. 

Presumably the zoladex shut down your cycle and gave you an idea of how you would feel without ovaries and a womb.  From what you have said, you need oestrogen at a steady dose all the time without any hormone fluctuations.  If that is the case then a full hysterectomy and an oestrogen implant would be the way to go but you would need to know what dose of oestrogen you need before having the implant and the best way to find the right dose would be via Oestrogel.  A steady dose of oestrogen should mean no more migraines. 

I hope that helps.

[paisley]

Before I had my total hysterectomy 7 years ago I had the injections as well. I didn't get on with the injections at all. I was also on oestrogel at the same time. I don't think the injections give a true picture of how you will feel after the hysterectomy. They didn't for me.

[Mazza27]

Thanks Mary g and paisley can i ask how were you for hysterectomy?

I am reading that it may not help with the migraines but i am thinking mine are defo hornonal so removel would solve it! Then the horrors of dementia as you not got your own hormones. My dad has dementia and i am frightened i may put myself at more risk to it

Scary stuff

Mazza xx

[Mary G]

I haven't had a hysterectomy but I have been told that I should have one because of my severe progesterone intolerance.   I can only take a very small amount of progesterone and have to have regular scans.   It's difficult for me to have a lot of down time at the moment so I've been putting it off.  That said, if I found I had to have a gynaecological procedure that would be the catalyst and I would have the whole lot taken away.

Do you know what your migraine trigger is?   If it is either hormone fluctuations or progesterone related then a hysterectomy would be the answer and you could then benefit from a constant dose of oestrogen.   Obviously if they are oestrogen related then you would get rid of the migraines but still have menopause symptoms because presumably you would not want to induce migraines by taking oestrogen.

[Mazza27]

Hi Mary g,

How do you know whether it's progesterone or the oestrogen that causes the migraines?

I remember you saying you have not had a hysterectomy.
Paisley You hadone 7 years ago. I was wondering how old you was and did it help?

I think i am going to ask consultant to book me in for full. Ive stopped the hrt and my last injection was 28th Feb



Mazza x

[Hurdity]

Hi Mazza27

I am sorry to hear about your problems with pms. As the doctor said - transdermal HRT would be better, and oral HRT is not recommended for those who have digestive problems.

Here is what it says on this site:
https://www.menopausematters.co.uk/route.php

 Indications for non-tablet route.

    Individual preference.
    Poor symptom control with tablet HRT.
    Side effects such as nausea with tablet.
    Bowel disorder which may affect absorption of tablet therapy.
    History of migraine (when steadier hormone levels which may be achieved with a patch may be beneficial).
    Lactose sensitivity (all tablet preparations of HRT contain lactose).
    History of gallstones.
    Current use of medications such as anti-epileptic medication which may interfere with the break-down of tablet HRT.
    Variable blood pressure.
    High triglyceride levels.
    Risk factors including Body Mass Index greater than 30, family history or past history of deep vein thrombosis or pulmonary embolus, after full discussion and specialist advice when necessary.

Personally I feel you have not yet given the replacement HRT a chance to work yet - after all from what I understand the injections plunge you into chemical menopause which is quite drastic and is giving you what you would experience after full hysterectomy with ovary removal. You haven't yet achieved the right level of oestrogen and presumably have not yet tried to introduce a progestogen either?  You may or may not be severely progesterone intolerant and the only way to find out is to get the right dose of oestrogen and then introduce a short course of progesterone to trigger a bleed.

Hormonal migraines have a variety of caues - usually due to the extreme fluctuations of peri-menopause. If you settle onto HRT then at least your oestrogen levels will be constant and it remains to be seen whether the progesterone will cause migraines. In addition there is the issue of testosterone - if your ovaries have been shut down then the major source of the body's production of T has also gone and most women in your position need replacement T. Only when you have got the right balance will you know what works for you - having everything removed is such a drastic step with other health implications, and I really would want to try all routes before deciding.

Did you ever try the route of high oestrogen doses to suppress ovulation as per John Studd regime - which may also be beneficial and avoid the need for injections too. You would still need progesterone but under medical supervision if you are intolerant then the licesned dose can be reduced - and maybe would limit migraines? I always got monthly migraines from progesterone withdrawal in the early days of hRT and also in late reproductive stage before my period. I didn't know they were migraines and glad of that otherwise doc might have said no to HRT even though HRT is NOT contra-indicated for migraineurs and especially not for hormonal migraines.

Here is the info on this site:

Migraine   
    Migraine is often triggered by hormonal fluctuations and therefore may occur around the time of a period. Such migraine may improve at the time of the menopause. Some women find that migraine may be triggered by the daily hormone fluctuations which can occur with oral (tablet) HRT so the transdermal (patch or gel) route is usually preferred with a history of migraine.

Hope this helps and that you manage to arrive at a solution that works for you and enables you to feel better for most of the time

Hurdity x

[paisley]

I had my total hysterectomy because I was Progesterone intolerant.

[Mary G]

Mazza, in my case migraines are very definitely caused by all types of progesterone used in HRT preparations, nothing else, not even my own progesterone.  I can only tolerate a low dose of Utrogestan and have to maintain high levels of oestrogen to keep the migraines away. 

Can you remember at what time of the month your migraines usually occur?  If you are progesterone intolerant a hysterectomy is the only real solution, I wish it wasn't but it is.  Professor Studd recommended I have one. 

[paisley]

I was 46 when I had my hysterectomy. It helped me because I had no need to worry about progesterone anymore. Before hysterectomy I really couldn't take it so I had the extra worry about my uterine lining getting thicker with unopposed oestrogen but for you it is different, it is the migraines