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[FiGo]

Hello. I've been on Evorel 50 and Utrogestan 100mg since entering perimenopause (signalled by IBS and migraine)  so I guess, at 55, I'm maybe mid meno. Currently I have brain fog, am listless, wake up in the early hours on fire (no sweats). I have huge fibroids (18weeks, if you know what that means) so the dilemma should be - stop oestrogen and shrink fibroids or get a hysterectomy. For me there is no dilemma; I want it all out. Lugging this heavy womb and its contents around is draining enough but I cannot now fasten my jeans and now I'm bleeding heavily and have been for days. It has been agreed that I need hrt to cope or deal with my life and job but I am also told that “surgeons won't do hysterectomies these days”. So, the Utrogestan has been replaced by Noriday (norethisterone) to stop the fibroids bleeding. Reviews are scary and I feel helpless and condemned to be miserable until I am in a position to give up on hrt. Can this be right when a hysterectomy might drastically improve my quality of life?  Any similar experiences or advice/views most welcome.

[Dancinggirl]

What about having a Mirena fitted. The Mirena will usually shrink fibroids and stop problematic bleeding and you can then use Oestrogel or oestrogen patches alongside.
You could possibly have an ablation and the fibroids removed?  A hysterectomy is quite drastic and can result in prolapses and other issues so not always ideal - this is why it's the last resort.
Utrogestan is possibly not the best progesterone to use either as it's not as powerful as synthetic progesterones so doesn't protect the womb lining so well - give the norithisterone a try as it may help.

DG x

[NorthArm]

It's true that surgeons don't do hysterectomies routinely these days. However, if there is a reason, ie problematic bleeding, fibroids, adenomyosis etc....they will. Please ask for a referral, insist on it, you should not have to live like that!

[FiGo]

Thank you both, Dancinggirl and NorthArm, for some really helpful information and support. It is quite uplifting to have all of this experience applied to my problem. I think I will give the norithisterone a go but at the same time press my GP for a referral. I will also look into Mirena as I have not heard of this before. What I do know is that my fibroids are so big that a biopsy whilst conscious is impossible and with a retroverted uterus, smears are a trial. Thanks so much both.

[Dancinggirl]

FiGo - if you have fibroids then I am very surprised they have not offered you a Mirena - it's often a favourite with many gynaes as it will usually shrink fibroids. Heavy bleeding can be very debilitating and to put you on HRT without addressing the problem of the fibroids was very unwise. DG x

[FiGo]

Thanks Dancinggirl. Having “researched” this now, I will raise with GP as a prospective next step but will give the norithisterone a go. What scares me is the feeling that I'm sort of having to project manage all this myself. The diversity of views in the medical profession is unreal; even within my GP practice there are different views on taking hrt with migraine yet it was a consultant neurologist who recommended oestrogen as a potential solution (it was). Also, I developed mild hypertension so have been exposed to another range of views: come off hrt, stay on hrt and take mild “water  tablets”, change hrt. I stayed on with water tablets. The inconsistency of views astounds and frightens me; who should I believe? Now I have horrendous gastritis; it came from nowhere. I've never had acid/stomach issues and can eat and drink anything. It seems that this too is fairly common at this stage of life. What with the thinning hair, thick middle, low mood and physical pain, I hate to think what might be next!

[Dancinggirl]

You are so right - sadly there is rarely an holistic approach to us as patients - each doctor has their own view and I'm afraid we do have to ‘project manage' our health.  Getting really clued up on everything is vital so you can ask the right questions and ensure you are getting what is needed.  This site is great fro giving the info you need and many of us on the this forum have long and varied experience of HRT and the challenges of the menopause so we learn from each other.  Good luck and keep us posted. DG x

[paisley]

I had a total hysterectomy 7 years ago because I was so intolerant to the progesterone side of HRT. I don't remember having to argue my case much. The gynae said it was my decision. Before the hysterectomy I was 18 months into perimenopause

[Mary G]

FiGo, I would definitely get another opinion on this.  Have a look at Professor Studd's website where he talks extensively about the benefits of a hysterectomy and he thinks that for many women, it does improve quality of life - he recommended I have one due to severe progesterone intolerance. 

I'm afraid I didn't get any meaningful input from my GP and was left to work it all out for myself.  She didn't have a clue about HRT and would not prescribe it anyway so I bought it myself in Spain.  After struggling on patches I ended up consulting Professor Studd privately but it was the best £300 I ever spent. 

If it comes to it, you might have to pay for a consultation with a private gynaecologist to speed things up.  I know you should not have to but your quality of life is important.

[NorthArm]

‘Project Manage' is right DG!! Best description so far....

[FiGo]

Thanks to all who have given advice so far. I'm really beginning to believe that I actually have options. They say hindsight is a wonderful thing; when I first was referred to a gynaecologist on an unrelated matter (little lump) seven years ago  I got a young man who had just transferred to my big city hospital from one in a rural area. He said that if I kept taking oestrogen (it was for migraine back then) with my monster fibroids I'd be “heading for a hysterectomy”  and asked how I'd feel about that. Back then I remember being terrified at the prospect - the risks of the operation, the time off work, weight gain, loss of libido and another hundred things on top. Today, I'd say “where do I sign?”  That said, I'm going to start the norithisterone, get a double appointment with my GP and ask for a referral. If I get one in 6-8 weeks (fat chance) then I should have an idea of how well I'm tolerating the norithisterone. I'll definitely raise the Mirena point and ask to explore all options including a private second opinion if necessary. I'll use the money set aside for my first Botox  for that Feeling hopeful for the first time in ages. Off to investigate Prof Studd now. Thanks so much.

[Dancinggirl]

Sounds like a good plan FiGo.

This forum can be a good sounding board that allows you to look at your problems from different angles.

I know a hysterectomy seems such a good idea and for some it is necessary but this op is not without consequences so leave this as a final Option.
The NHS will only do a hysterectomy if it's absolutely necessary as it is costly. if you do seek private advice which supports the hysterectomy choice you may have to pay for the operation - which will not be cheap.
Keep us posted. DG x

[FiGo]

Thanks Dancinggirl. I wonder, can I or should I, ask for blood tests to check oestrogen levels? Is that a GP area or gynaecologist? Off now to research if I should be wearing my patches on my buttocks rather than on my thigh. I've always gone for the thigh but a friend says she moved from buttock to thigh and didn't get “the effect” so moved back to buttock... I'll update idc 

[Dancinggirl]

The GP could and should do blood tests as this should show  whether you are absorbing the hormones properly or not. If you have large fibroids then a scan would also be advisable.
I never got on with patches so I'm not sure it matters where you stick them as long as they are below the waist.
I find writing symptoms and questions down for a doctors appointment really helps the focus - nothing is misunderstood and the doctor has to address all the issues and questions. DG x
Do keep us posted.

[Mary G]

FiGo, have you thought about using Oestrogel instead of patches?   It's much nicer to use (you just rub it on your skin) it absorbs very easily and it's far more dose flexible.