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[shally0318]

Hi had my hysterectomy 14/1 with ovaries  removed. I was put on Tibolone right away in hospital but I am feeling a bit flat. Is there anything else I can ask for to list my mood?
I have not had my post op follow up yet due to C Virus so will have to ring my Doctor.
I have a stash of Sandrena gel can I add that?

[Hurdity]

Hi shally0318

I agree with Avalon. If you have no uterus then there is no danger of womb thickening from adding oestrogen to the Tibolone. The other alternative is to stop the Tibolone and just take the oestrogen gel but ask to be prescribed testosterone. However as this is off-licence there may be a reluctance by the GP to do this?

Hurdity x

[shally0318]

Thanks for your replies Ladies. I was on Femoston before OP the Surgeon said that I could straight onto tibolone after OP as it would be the best one for me?
I have been ok no major side effects I just feel a bit flat mood wise. I know it's a hard time for everyone and I am thankful I had my OP but I just need a mood lift if that makes sense.

[shally0318]

Gosh I am confused. I have just had my post op consultation via phone. Doc said I can come of Tibolone and go back onto sandrena gel and utrogesten as I have no uterus but kept my cervix. Utrogesten made me bleed heavily due to fibroids before op. She said I could still have womb cells on cervix so it is ok to take both forms of HRT. any thoughts?

[Yorkshire Girl]

Tibolone didn't work for me, so ended up back on Evorel 100mg patches and testogel.
Shally you shouldn't need to take utrogesten as you have no uterus.

[shally0318]

YG That's what I said to her but she said because I had subtotal hysterectomy and left cervix cells from uterus can still be on cervix so that's why she said I will need progesterone. I am so confused. Maybe I should stick with Tiboleone.

[Hurdity]

Hi shally0318

Yes your doc is partly correct about the cells if you've had a sub-total hysterectomy. Here is the information on this site:

https://www.menopausematters.co.uk/aftermeno.php

"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 only need to use an HRT type with progestogen of some sort, initially for 3 months but then stop the progestogen part to see if there is a bleed. If there is not then you are safe to take oestrogen only according to the info.

This does mean until you have tested this on yourself, addition of oestrogen to the Tibolone could theoretically cause these cells to be stimulated excessively. It sounds like the option to go onto estradiol gel and Utrogestan might be a good idea at least temporarily on a cyclical basis as per the above. Then if no bleeding you are safe on oestrogen alone. You doc should know this I would have thought? It sounds like it is not definite that the cells will be there?

Maybe go for the new prescription and try it out as per the above (ie cyclically at first) and then take it from there?

Hurdity x

[shally0318]

Thank you for your replies. I will try the new prescription and see how I get on.