Menopause Matters Forum
General Discussion => New Members => Topic started by: Hetty2018 on January 24, 2018, 05:36:10 PM
-
Hello Ladies
I am hoping for a little advice please. I underwent a total hysterectomy in March last year (age 37) for endometriosis. I tried 6 months of Tibolone and it made me feel terrible so stopped taking it and have tried the last 3 months on more homeopathic tablets which frankly haven't done a thing 🙈 I now find I am struggling massively each day.. usual menopause symptoms like exhausting hot flushes and brain fog etc,, super dry skin and sleepless nights, no libido at all, but what u can't deal with is the absolute exhaustion and fatigue that is so debilitating I can't get out of bed a lot of days. I have two small children and a job so lounging about is not really an option lol... I feel like I'm slowly losing the person I am/was.
I have asked since June last year for blood work to check my hormones and my Gp flat out refused and instead offered the standard concoction of sleeping tablets and anti depressants 😡 which I politely declined.. I have been doing lots and lots of research and found lots of very useful links on here (thankyou). I have had a battle with my GP to let me try bio identical hormones and have more or less tried to get the right combination of what I think I may need from research papers and reading what lots of ladies that have seen Prof Studd are using.
I asked the doctor for
UtroGestan progesterone 100mg daily continuous use
Testosterone gel testim 1/10 tube a day
Oestrogel 2 pumps each day
She agreed finally and has asked if she could use all my research to do a clinical/training meeting with the other practice doctors...
I just wondered if anyone else out there uses this combination after a hysterectomy as I understand that a lot of ladies use UtroGestan for only 7 days if they still have their uterus.
It's all a little trial and error for me as I'm essentially self medicating.
I have no problem in going to see Prof Studd but his receptionist told me Monday the first appt in the start of April and I can't wait till then I may throw myself under a bus before then 😫😫🤦♀️
-
Hi hetty why not spend £25 and email dr currie before you do anything else.i wouldn't rush to see private specialists just yet as your gp should be more clued up and not be costing you money like that if she doesn't have the expertise you need she should be referring you to a consultant not picking your brain.
I'm not sure but I think you may NOT be on the right tracks and need the help of a professional or the more experienced ladies on here.if you've had a full hysterectomy then you should only be on oestrogen.some of the other ladies will come along and help you soon but meantime email dr currie you usually get a response in a day or two and she's great.just be patient I'm sure help will be here soon.good luck xx
-
Many thanks Daisydot for your reply.. am very grateful for any suggestions or help seen as though my GP has been next to useless x
-
Hi that sounds fine, you may want to try the Utrogestan cyclically say for 12 days per mth instead of every day if you find its not agreeing with you. I am now down to just 1 pump per day of the gel and I have never had any symptoms whatsoever, it really is great and transdermal is definitely the right way to go.
-
Hi Hetty - do you want to use the utrogestan because you find without progesterone you don't function very well? You do need some kind of HRT obviously in order to protect your heart and bones let alone alleviate the horrible symptoms. The best thing I found about a hysterectomy (although I am much older than you) is the fact that I can use oestrogen only.
I am on Evorel 50 patches which are bio-identical as are most HRT's apart from the ones with Prem in the name.
Taz x
-
Hi Taz
I haven't tried Just the oestrogel on it's own yet and thought that the 3 different hormones were the best way forward,
The reason for the progesterone was that I read that Oestrogen should always be balanced in the body with progesterone to prevent the unwanted effects of oestrogen such as weight gain, fluid retention, depression and many others.
that while protecting the uterus ( which I don't have ) it also protects the breast and balances other unwanted effects that oestrogen on its own will produce.
Progesterone is vital to oppose excess oestrogen because oestrogen dominance needs addressing because of the risks.
-
Hi Cassie
Thanks for the info.. did you use Utrogestan following a hysterectomy? X x x
-
Hi Hetty. I thought that combined HRT is linked to higher breast cancer risk but this might be for older ladies such as myself? I was just pleased to swap to oestrogen only after my hyster as it was the progesterone in my bio-identical HRT which caused a certain amount of fluid retention and depression for me.
Everyone is different and I'm sure you will get lots of help on here to enable you to access the treatment you need.
Taz x
-
Hi Taz
Yes I think the combined HRT did attribute to a rise in breast cancer figures but that's the synthetic route rather than these bio identicals? It's all very confusing lol x
The Tibolone definitely don't suit me and still had all the hot flushes etc plus put on about 18lbs in about 6 months which I'm finding hard to shift now x x x
-
Hi Hetty2018
:welcomemm:
There are all sorts of theories on the internet telling you that you need progesterone to balance oestrogen but this has mostly been discredited, and are designed to sell progesterone cream! If it was needed per se then it would be prescribed on NHS even for women who have had hysterectomies. You do only need progesterone in large amounts to protect the womb when taking HRT (ie oestrogen) or during pregnancy. If you had your ovaries removed as well as your total hysterectomy then you don't need it - I agree with the others! Oestrogen does not need to be balanced as such, as far as is known, because if you go through menopause you are just replacing what has become deficient.
The role of progesterone (as well as oestrogen) in breast cancer development is complex and controversial in that there is no established causal relationship - except for the figures in the WHI study from combined HRT using synthetic progestogens as you pointed out which could indicate a connection, as I understand.
Unfortunately weight gain around the time of menopause is common and we need to eat less and exercise more just to stay the same weight - really annoying!
If your doctor has agreed to the combo you want include the testosterone, then I would go for it! Definitely no need to see a private specialist and yes good idea to write to Dr Currie (facility on home page of website).
Like Taz I would prefer to take oestrogen only - my progesterone cycle is coming up soon and I never look forward to it.
Let us know what you decide and how you get on :)
Hurdity x
-
Thanks for the info Huridity it's all a bit of a minefield isn't it 🙈🙈 I think I've just got that fed up with feeling totally yuk that I have done so much reading and research and that triple combo keep cropping up in a lot of different research papers that I thought it was the best way forward..
I'm really hoping it does work out and the the testosterone doesn't just give me a full beard 🧔🏻 🙈🤣
-
Huridity
Just out of interest why do you not like the progesterone? X x
-
Hi Hetty
I replied to you in another thread but now reading your story and seeing how young you are (envious much !) you do need a combo. I'd say because you suffered endo you should take progesterone as there could still be fragments left inside, from my understanding it's a possibility some remains so you need protection in progesterone, I'd research this further if I were you. Plus you need testosterone and the minute you have issues down below with dryness, UTIs etc get some vagifem too. I pop mine in daily halfway up towards tummy and it sorts internal and external issues for me x
-
Thanks Annie I really appreciate your help.. I had read elsewhere that the progesterone can act as a protection against being oestrogen dominance with regards to my endo.. hopefully this will be the solution i was looking for.. 1st night tonight with the new regime so fingers crossed 🤞 thanks again x x ❤️
-
Good luck Hetty, I really hope you've found the right regime for you x
-
Hi Taz
Yes I think the combined HRT did attribute to a rise in breast cancer figures but that's the synthetic route rather than these bio identicals? It's all very confusing lol x
The Tibolone definitely don't suit me and still had all the hot flushes etc plus put on about 18lbs in about 6 months which I'm finding hard to shift now x x x
You're right about it being confusing especially since I've been looking at the sites dealing with HRT after hysterectomy for endo! I now know why you were prescribed Tibolone though :). I managed to find this in my bookmarks - takes me a while - which gives the BMS take on combined HRT and breast cancer https://thebms.org.uk/2016/08/breast-cancer-now-study-finds-effect-combined-hrt-breast-cancer-risk-likely-underestimated/ again.. confusing!
Taz x :)
-
Taz I'm sure by the end of all this we will all be a lot more educated and informed on all things menopause related than a lot of our gps 🙈
I totally appreciated my GP not having the answers I desperately needed it was the blanket approach of Just take this and have some sleeping tablets and anti depressants... 😞 one of the gps actually said to me.... “you may just have to accept this is your life now and you will never feel any better†which I thought was encouraging 🙀🙄
They should just refer to a menopause clinic if they are not sure.. but then again anti depressants are super cheap to prescribe and try and shut us up 🤔
-
Thanks Annie I really appreciate your help.. I had read elsewhere that the progesterone can act as a protection against being oestrogen dominance with regards to my endo.. hopefully this will be the solution i was looking for.. 1st night tonight with the new regime so fingers crossed 🤞 thanks again x x ❤️
Hi again Hetty
Of course - Annie0710 is absolutely right! I had missed the bit about endometriosis and latched onto the progesterone issue and oestrogen dominance. Was in too much of a hurry as I always am these days - sorry! That is exactly it re residual depoits - here is the info from this website:
Endometriosis
There is a small risk of reactivation of endometriosis with HRT use and any recurrence of symptoms should be reported. If a hysterectomy has been performed for endometriosis, the choice of HRT use thereafter should be influenced by the extent of endometriosis at the time of the operation. Since hysterectomy often causes a premature menopause, it is often advised to take HRT until the average age of the menopause; 51 years. HRT after hysterectomy usually consists of estrogen only. However, in the presence of endometriosis, estrogen may cause stimulation of residual deposits and consideration should be given to using continuous combined (estrogen plus daily progestogen) therapy, or tibolone, though little research has been done on the effect of different types and duration of therapy. Medical treatment of endometriosis often involves ovarian suppression which, along with ovarian removal, may increase the risk of osteoporosis.
That being the case you will need to take a progestogen all the time - unless it can be established that you are free from deposits? If so best to take one of the synthetic ones unless you feel OK on 100 mg daily progesterone? It's not a question of oestrogen dominance - it needs to be taken by women with endometriosis for the same reason that it is taken to protect the womb ie oestrogen stimulates the womb lining - and the endometrial deposits are the same tissue ie the progesterone spcifically targets thes tissues - so not a question of general balance nor oestrogen dominance - but a specific clinical reason if you see what I mean?
Did you keep your ovaries or were these removed? If you kept them then you may not need testosterone yet as you are still young but be guided by symptoms such as low libido, muscle aches and pains, fatigue etc with no other cause.
Hurdityx
-
As always, sensible words from Hurdity. Her science background gives well informed advice - I have learned so much from her posts.
If only we were all given good lessons on not just puberty but also the menopause, as part of our biology lessons, this time in our lives would not be such a mine field. Boys need to know all this as well!!!???
Of course there is a place for ADs/SSRIs but I , like many others, am extremely worried that GPs rush to prescribe these as a first line treatment, without fully informing the patient of the side effects or fully assessing whether this is the right route to take. It's the old fashioned approach of ‘let's cosh them, to keep them quiet'.
As a short term trial to help someone get over a difficult time with a true depression, crippling anxiety or for pain management, then fine, but how many people are sent away with a prescription for an AD having been given the full implications explained to them? Initial side effects can be severe, withdrawal symptoms take many weeks or months and I am particularly worried about the long term effects for those that find they become dependent on these drugs?
I know that the right SSRI can be very helpful for those poor women who can't take HRT for health reasons but it is about time they did some research to find some other alternatives.
I was prescribed Prozac in my mid 30s (going through very difficult time with my son being diagnosed with developmental problems) but my local pharmacist was very responsible and, knowing I had small children, told me he thought it unwise for me to take them due to the side effects - I was doing busy school runs carrying both my children and friends children to and from various schools and he said I might not be fit to drive. I opted not to take the Prozac and stuck with the counselling - I will be eternally grateful to that pharmacist.
I was then advised, last year, to use Amitriptyline (just the lowest dose of 10mg) to ease pain in my lower back, hips and sciatica. It did reduce the nerve pain but, by week three, I was a hyper wreck, with a horrid dry mouth and awful headaches - it took 3-4 weeks for these side effects to wear off when I stopped them. I dread to think what is would be like to come off a higher dose!!!!!
In the end I paid to see a rheumatologist privately, I had scan and X Ray and the problem was identified - he gave me a steroid injection in my spine which has worked wonders (injection took 10 mins). It will never be perfect as I have deterioration of L3-L4 vertebrae but the GP should have referred me, not dished out drugs that were just to keep me quiet. I now know what the problem is and I can manage it better - if it gets worse again I know I can have another injection that will relieve the pain for quite some time and won't give me side effects. Why did I have to pay for the appropriate treatment???
I know ADS/SSRIs are trial and error, before you find something that works well for you, and for many people they are a life line, BUT - the GPs really must explain why they prescribe them and what effects they may have both short and long term.
RANT OVER. DG x
-
Thanks Huridity
I had my ovaries removed ... will give the T gel a go when I can get my hands on some as all the pharmacies locally are out of stock and there is a delay from the manufacturer 😫 I've asked my GP for an alternative to the Testim so am awaiting a reply.
I've started with the 100mg of Progesterone of an evening.. what adverse affects to ladies complain of with the Progesterone so I can watch out for them... I do feel like a bit of a guinea pig really so any advice is greatly appreciated xxxx
-
I slept really well on progesterone but did have vivid dreams , no other side effects x