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[Louise2010]

I will be having a partial hysterectomy soon due to fibroids, painful heavy periods and prolapse. My womb is the size or a 16 week pregnancy. I’m 52 this year. I’ve been on oestrogel and micronised progesterone for over 5 years plus testosterone for the last yearish.
I’m not great on progesterone I find it makes me so grumpy and irritable but I’ve taken it to protect my womb. The oestrogel and testosterone I will continue with.
My question is should I be thinking about taking a small dose of progesterone at some time during the month after my op?
I have researched and found conflicting views. One says it’s safer to take oestrogen by itself anyway (without a womb) and the other view states that progesterone is necessary in small amounts for bone health, stopping hot flushes and mood regulation ( something that certainly didn’t work well for me when I take it 😆)
I’m willing to take a small amount occasionally if it’s going to be beneficial but wanted to see if anyone has been through this before or known anyone or has more knowledge on this particular thing?
I don’t think I’m really fully prepared for how having a hysterectomy will affect me. I know it will have many benefits for me in particular as every month is very painful and really debilitating and I’m trying to focus on those.

[CLKD]

Get some food into the freezer as you won't be able to lift - at least for 3 months  .........  best time of year for surgery, weather allowing you will be able to sit and chill.

Who prescribes your current regime?  MayB ask, or speak with a pharmacist if your Surgeon isn't 4coming.

Hopefully someone will be along with advice.

[Louise2010]

Eeek! I was told 6 weeks recovery. I’m pretty active and have a very physical job so I think the consultant based it on that.
My GP prescribes current regime however I never speak to the same GP twice and have to explain each time on the phone as my surgery has no physical appointments unless they deem it necessary. The practice seem very keen for me to stop taking HRT and always suggest me coming off it “now I’m 50 51 52 etc”
There doesn’t seem to be a GP at the practice for whom HRT is a specialty.
Digressed slightly there sorry 😆 I have in the past consulted a private doctor for testosterone and yes good shout re asking my consultant. I shall make a point of doing that. Thank you 🙏🏻
Just keen to see if anyone on here has first hand knowledge ❤️

[CLKD]

If you have supportive family you can extend the 6 weeks  ........

Don't take any notice of the age constraints that some GPs try to impose, sometimes on cost basis.  One can take HRT for life unless there are serious health issues ;-).

Give the secretary to the consultant a ring and ask the question, don't wait until operation day.  Let us know how you get on. 

[Louise2010]

Thanks CLKD I will do that.

I do like the sound of extending the 6 weeks 

[Taz2]

Hi Louise. I had a hysterectomy seven years ago at age 60. I use oestrogen only as I had a look at the good points of still using progesterone but considered these were outweighed by the increased risk of breast cancer when using a combined HRT. By partial hysterectomy do you mean you are retaining your cervix?

A 6 week recovery time can be achieved but I'd think more of 12 in total. If you have a physical job then I would think 6 weeks is too early to go back.  I was not allowed to drive by my insurance company for 8 weeks so you need to check that. I had 12 weeks off work in the end. You get one chance to heal and especially if you have vaginal procedure you have no outward signs at all of the major surgery which has been performed and it's easy to overdo it. You also need to begin your pelvic floor exercises as soon as the consultant instructs in order to avoid future prolapses. I'm sure it will make a big difference to your life but don't rush recovery.

Taz 

[CLKD]

 

[Kathleen]

Hello Louise 2010.

I don't have any experience of this I'm afraid but I wonder if your operation is being done laparoscopically? I believe that recovery time is much reduced if this is the case though I could be wrong of course.

Good luck and wishing you well.

K.

[Louise2010]

Hi Louise. I had a hysterectomy seven years ago at age 60. I use oestrogen only as I had a look at the good points of still using progesterone but considered these were outweighed by the increased risk of breast cancer when using a combined HRT. By partial hysterectomy do you mean you are retaining your cervix?

A 6 week recovery time can be achieved but I'd think more of 12 in total. If you have a physical job then I would think 6 weeks is too early to go back.  I was not allowed to drive by my insurance company for 8 weeks so you need to check that. I had 12 weeks off work in the end. You get one chance to heal and especially if you have vaginal procedure you have no outward signs at all of the major surgery which has been performed and it's easy to overdo it. You also need to begin your pelvic floor exercises as soon as the consultant instructs in order to avoid future prolapses. I'm sure it will make a big difference to your life but don't rush recovery.

Taz 

Thanks Taz that’s great advice. I  hear what you’re saying about increased breast cancer risk. I think possibly if my consultant finds endometriosis anywhere then I may have to consider continuing with the progesterone but I’d prefer not to.

In terms of recovery what you and CLKD have said I will take note of. I think I’m being optimistic if I think 6 weeks. You’re right about only having one chance to heal. Driving is a part of my job too so that will extend my time off. I’m self employed but my customers will understand I’m sure.
Thank you for your advice it’s invaluable. 🙏🏻

[Louise2010]

Hello Louise 2010.

I don't have any experience of this I'm afraid but I wonder if your operation is being done laparoscopically? I believe that recovery time is much reduced if this is the case though I could be wrong of course.

Good luck and wishing you well.

K.

Hi Kathleen it’s going to be an abdominal surgery sadly as my womb is pretty big with some whopping great fibroids!  I’m thinking a big old scar too.
I’m really grateful to you all who’ve replied it’s definitely helped me and I’ve decided I will make sure I take as long as I need to recover & contacting my surgeons secretary tomorrow re clarification on all these things.
Many thanks all 🤗😘

[Gnatty]

Hi Louise I had the same, very large fibroid. Last June I had total abdominal hysterectomy with oophorectomy as well. Do please feel free to DM me with any questions.

[Eviepf]

Hi Louise

I can't help with your progesterone question, but just wanted to say that I had an abdominal hysterectomy at age 54 because of fibroids (ovaries retained) and was pleasantly surprised at how 'not-unwell' I felt afterwards. I obviously didn't lift anything heavy for the required period afterwards (my husband bought me a 'mini-kettle' for use when on my own at home!) and didn't drive or return to work for 6 weeks, but as for pain and discomfort, I didn't really have any after the first day or two. I second pp who've advised you to take as much recovery time as you need, though. My job was a desk job, so very little exertion required as long as I could get there and back each day.

My womb was apparently the size of a 28-week pregnancy, which I mention not to play fibroid top trumps , but really just in case it might be somewhat reassuring as you're in a similar situation. The scar is quite large, I suppose, but healed pretty fast and rapidly became less and less noticeable (I'm now 10 years on) although the abdominal numbness at first was very disconcerting and did seem to last for ages.

Wishing you all the best.

[Hurdity]

Hi there

If you have a partial hysterectomy ie retain your cervix then some authorities recommend using progesterone for 3 months in case some womb tissue has been left behind. If there is no bleed when you stop then all OK to continue without prog. It is mentioned here: https://www.menopausematters.co.uk/aftermeno.php Scroll down to sub-total hysterectomy.

Otherwise yes if you have endometriosis deposits outside the womb then you will need to take it continuously to prevent these growing when you take oestrogen.

As to benefits of taking progesterone - I think there are very few women who actually feel the benefit and as far as I know there is no medical benefit from taking it re bone health for example although I am not well up on recent research if new evidence has been found. The (commercial) progesterone cream lobby will have you believe it is essential for just about everything from libido to bones and well-being! Hot flushes and mood regulation post-menopause - as far as I know, no evidence at all except with large doses of synthetic progestogens ( re hot flushes apparently). If you are taking continuous oestrogen after your op,  and not yet menopausal then you will be cushioning any extreme flucuations and preventing the oestrogen crashes that occur in peri-menopause and throughout the menstrual cycle.

Also I agree with Taz re the breast cancer risk though the studies have been carried out mainly with synthetic progestogens in this regard I think? I wouldn't want to take it all the time and keep it to the absolute minimum I need to get a bleed, that is medically advised.

All the best for your op!

Hurdity x

[Louise2010]

Hi Louise

I can't help with your progesterone question, but just wanted to say that I had an abdominal hysterectomy at age 54 because of fibroids (ovaries retained) and was pleasantly surprised at how 'not-unwell' I felt afterwards. I obviously didn't lift anything heavy for the required period afterwards (my husband bought me a 'mini-kettle' for use when on my own at home!) and didn't drive or return to work for 6 weeks, but as for pain and discomfort, I didn't really have any after the first day or two. I second pp who've advised you to take as much recovery time as you need, though. My job was a desk job, so very little exertion required as long as I could get there and back each day.

My womb was apparently the size of a 28-week pregnancy, which I mention not to play fibroid top trumps , but really just in case it might be somewhat reassuring as you're in a similar situation. The scar is quite large, I suppose, but healed pretty fast and rapidly became less and less noticeable (I'm now 10 years on) although the abdominal numbness at first was very disconcerting and did seem to last for ages.

Wishing you all the best.

Thanks Eviepf
Top trumps 🤣🤣🤣 I think you win though in any case 😂😂
That’s great to hear that you didn’t feel too bad after all considering. Did you feel or have you felt any different in terms of meno symptoms coming back for example hot flushes etc? Did you have to up your oestrogen?
I’m hoping my scar will be horizontal and not vertical however really that’s just vanity on my part! 😁
I’m thinking big comfy Bridget Jones pants will be my friend whilst it’s healing.

[Louise2010]

Hi there

If you have a partial hysterectomy ie retain your cervix then some authorities recommend using progesterone for 3 months in case some womb tissue has been left behind. If there is no bleed when you stop then all OK to continue without prog. It is mentioned here: https://www.menopausematters.co.uk/aftermeno.php Scroll down to sub-total hysterectomy.

Otherwise yes if you have endometriosis deposits outside the womb then you will need to take it continuously to prevent these growing when you take oestrogen.

As to benefits of taking progesterone - I think there are very few women who actually feel the benefit and as far as I know there is no medical benefit from taking it re bone health for example although I am not well up on recent research if new evidence has been found. The (commercial) progesterone cream lobby will have you believe it is essential for just about everything from libido to bones and well-being! Hot flushes and mood regulation post-menopause - as far as I know, no evidence at all except with large doses of synthetic progestogens ( re hot flushes apparently). If you are taking continuous oestrogen after your op,  and not yet menopausal then you will be cushioning any extreme flucuations and preventing the oestrogen crashes that occur in peri-menopause and throughout the menstrual cycle.

Also I agree with Taz re the breast cancer risk though the studies have been carried out mainly with synthetic progestogens in this regard I think? I wouldn't want to take it all the time and keep it to the absolute minimum I need to get a bleed, that is medically advised.

All the best for your op!

Hurdity x

Thank you Hurdity. I am having a partial hysterectomy yes leaving ovaries and cervix hopefully.
So I’m hoping no endometriosis is found. I’d rather not have to take progesterone really 🤞🏻
A gp who issued my last prescription wrote to me to say she’d included the utrogestan despite me not asking for it, as she thought I may need it. This makes sense now reading the first bit of your reply.
Many thanks for the wishes! Just feeling so grateful we live in an age where this type of discussion and medical expertise and surgery is available to us.