Menopause Matters Forum

Menopause Discussion => Postmenopause => Topic started by: Katejo on September 15, 2023, 01:34:11 PM

Title: Requirement to stop patches before minor day surgery
Post by: Katejo on September 15, 2023, 01:34:11 PM
Hi All

I have a minor op (removal of a neck cyst) coming up and I had a pre op yesterday. The nurse tried to tell me that I would have to stop HRT beforehand. I told her that I was sure that this only applied to tablet HRT not transdermal which doesn't have the same blood clotting risks because it doesn't get processed in the liver. I don't think I convinced her. Since then I have found the following   which agrees with me. https://www.balance-menopause.com/menopause-library/do-i-need-to-stop-hrt-before-surgery-factsheet/#:~:text=If%20you%20take%20estrogen%20through%20the%20skin%20%28transdermal%29,carry%20an%20increased%20risk%20of%20clot%20or%20stroke.

Has anyone had surgery while using  HRT patches and been allowed to continue with them? I am very reluctant to stop them just for a minor procedure.
Title: Re: Requirement to stop patches before minor day surgery
Post by: CLKD on September 15, 2023, 02:44:01 PM
Add to your worried, if the procedure is cancelled  :-\

I would want to know exactly why any treatment needs to be stopped. 
Title: Re: Requirement to stop patches before minor day surgery
Post by: Katejo on September 15, 2023, 02:57:32 PM
Add to your worried, if the procedure is cancelled  :-\

I would want to know exactly why any treatment needs to be stopped.
  Yes exactly plus I don't have a date yet. Only approx early November and the consultant said it could be delayed if there are more NHS strikes.
Title: Re: Requirement to stop patches before minor day surgery
Post by: CLKD on September 15, 2023, 03:17:09 PM
Will the procedure be performed under GA or a local injection?  If there is a risk of strikes ........ what's your gut instinct?  Perhaps Dr Currie is available to ask the question via e-mail on here?  Or perhaps ring Dr Newson's Clinic for advice? 

My instinct if confronted with this is a firm 'nope'.  After all, I don't have to stop any medication for dental surgery etc..
Title: Re: Requirement to stop patches before minor day surgery
Post by: Katejo on September 15, 2023, 03:29:02 PM
Will the procedure be performed under GA or a local injection?  If there is a risk of strikes ........ what's your gut instinct?  Perhaps Dr Currie is available to ask the question via e-mail on here?  Or perhaps ring Dr Newson's Clinic for advice? 

My instinct if confronted with this is a firm 'nope'.  After all, I don't have to stop any medication for dental surgery etc..

Definitely GA or the issue wouldn't arise.
Title: Re: Requirement to stop patches before minor day surgery
Post by: CLKD on September 15, 2023, 03:34:19 PM
That's a little different but if you have to stop medication - would they if 1 was diabetic - then U need to make the Consultant aware that the date IS the date that the operation should take place.  I wonder if you offered to pay whether the situation would be different  :-\ ?  Cynic?  Moi? 

R U very worried?
Title: Re: Requirement to stop patches before minor day surgery
Post by: Taz2 on September 15, 2023, 04:17:15 PM
I had to stop my patches but that was for a hysterectomy which is considered major surgery where clotting may be more of a risk. I discovered afterwards that only one surgeon at my hospital insisted on this though. I wouldn't have thought minor surgery would need HRT to be stopped.

Taz x
Title: Re: Requirement to stop patches before minor day surgery
Post by: Sage 🍃 on September 15, 2023, 04:27:20 PM
This is from the The Handbook of Perioperative Medicines

https://www.ukcpa-periophandbook.co.uk/medicine-monographs/hormone-replacement-therapy-hrt

NICE guidelines aren't very clear on the subject though

https://bnf.nice.org.uk/treatment-summaries/sex-hormones/
Title: Re: Requirement to stop patches before minor day surgery
Post by: CLKD on September 15, 2023, 06:23:49 PM
What's the general consensus ........ ask more questions about the risks?
Title: Re: Requirement to stop patches before minor day surgery
Post by: Katejo on September 16, 2023, 12:12:06 PM
This is from the The Handbook of Perioperative Medicines

https://www.ukcpa-periophandbook.co.uk/medicine-monographs/hormone-replacement-therapy-hrt

NICE guidelines aren't very clear on the subject though

https://bnf.nice.org.uk/treatment-summaries/sex-hormones/
  The NICE guidelines are referring to women having major surgery and immobile for some time plus it talks about blood clotting problems which are irrelevant to transdermal. I posted the same question on another forum and got replies from women who had had a hysterectomy (not cancer related) and were allowed to continue HRT.
Title: Re: Requirement to stop patches before minor day surgery
Post by: CLKD on September 16, 2023, 12:14:51 PM
Difficult to decide? 
Title: Re: Requirement to stop patches before minor day surgery
Post by: Katejo on September 16, 2023, 12:15:45 PM
This is from the The Handbook of Perioperative Medicines

https://www.ukcpa-periophandbook.co.uk/medicine-monographs/hormone-replacement-therapy-hrt

NICE guidelines aren't very clear on the subject though

https://bnf.nice.org.uk/treatment-summaries/sex-hormones/
  The other link is pretty clear. I will print it out to show them if they continue to insist.
Title: Re: Requirement to stop patches before minor day surgery
Post by: GraceM on September 18, 2023, 03:10:16 PM
I had a recent hysteroscopy, D&C and polyp removal under general anaesthetic.  I was told at some point that I would need to stop HRT a month prior to the procedure - I finally got an appointment with about 2 weeks notice.  I didn't stop HRT and arrived on the day and mentioned it.  Nobody batted an eyelid.  I was fine to have the procedure with my patch still attached.  Some doctors just aren't up to date on the types of HRT.  If on tablet form there is a higher risk, but many are on transdermal oestrogen nowadays.
Title: Re: Requirement to stop patches before minor day surgery
Post by: CLKD on September 18, 2023, 04:18:24 PM
Tnx GraceM - how is your recovery ?
Title: Re: Requirement to stop patches before minor day surgery
Post by: Rumbaba on September 22, 2023, 04:56:13 PM
Will the procedure be performed under GA or a local injection?  If there is a risk of strikes ........ what's your gut instinct?  Perhaps Dr Currie is available to ask the question via e-mail on here?  Or perhaps ring Dr Newson's Clinic for advice? 

My instinct if confronted with this is a firm 'nope'.  After all, I don't have to stop any medication for dental surgery etc..


That's not quite true. My partner is a dentist, and there are certain medications which have to be paused for some dental procedures.
Title: Re: Requirement to stop patches before minor day surgery
Post by: Grheliz1 on September 24, 2023, 04:19:43 PM
I didn't have to stop my HRT gel when I had a total hysterectomy--fairly major surgery. If they're worried, there are injections for preventing blood clots that are routinely given. I had them when I had a hysteroscopy under GA, as well.
Title: Re: Requirement to stop patches before minor day surgery
Post by: Katejo on September 27, 2023, 04:50:46 PM
Here is an update on this. I rang the pre op centre today and queried it. I don't have to worry because my HRT is transdermal. However, there does appear to be a total misunderstanding/illogical reasoning regarding  HRT tablets. They are telling patients on tablets to stop taking them just 1 day before the planned surgery!
That surely can't make any difference!
Title: Re: Requirement to stop patches before minor day surgery
Post by: flossie fiddler on September 28, 2023, 01:58:41 PM
I had major spine surgery whilst on Evorel Sequi patches, and wasn’t required to stop using them. I think it’s to do with the risk of blood clots, but I had those boots on during surgery that massage your calves, and 2 hours after having my spine screwed together, they had me out of my bed and walking carefully to the loo for a wee.

Surgical stockings for 6 weeks, (those ones designed to set pulses racing) and that was that. I would be asking if it’s necessary.