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[Annie Mouse]

Hi, I'm a new member who is struggling with surgical menopause.... I had a bilateral oopherectomy on Nov 14, roughly eight weeks ago.  The operation was undertaken due to a growing cyst on my left ovary and the fact that my mother died at 57 of ovarian cancer.  Operation went well laparascopically, and physically within a month I felt better. I went back to work after five weeks.  For the last three weeks I have felt truly awful- weepy, depressed, brain fog and massive insomnia.  Is this caused by my operation and the lack of hormones?  It's the lack of sleep that's worst for me.  My doctor initially prescribed Fluoxetine for depression, but this feels different from a previous depressive episode..... I would like to try HRT but do have a family history of breast cancer ( not first line relatives) - will this help me? Would be grateful for any advice on how to combat the terrible insomnia and the weepiness.
Thank you for listening!

[Joyce]

Hi & welcome.

Operations do take it out of you, but I think it's more likely to be lack of hormones. I had hysterectomy over 20 years ago. My GP put me on HRT so didn't have any problems. However, I took an HRT break a few years ago & suffered all the symptoms you are describing.

I'm sure there are others on here with a family history of cancer who can advise you better.

[CLKD]

   HORMONES       or lack of .  I'm sure other ladies will be along with suggestions.

Why didn't the Consultant discuss which HRT you might require before surgery?  Were the various blood tests performed before you opted for surgery to check for ovarian cancer risks?  There doesn't seem to be enough information given to potential patients  in what-ever speciality   â€¦â€¦   Ovacome, the dedicated O.cancer web-site, can be a place to look at too, it's how I arrived here    Sorry about your Mum, it's a wickedly hidden disease with it's presentation, often known as the 'silent killer' 

It was thought that there were risks of breast disease with HRT …… but recent Guidelines suggest that ladies can consider HRT more seriously even with a family history.  Quality of Life needs to be considered. 

Have you continued with the Fluoxetine?  It is now suggested that GPs should not be offering Anti-depression medication as a first line when ladies present with hormonal problems!!!!

You are in the right place!  You're symptoms sound 'within normal limits' to me ……….. and yes, there is help out there!

[Annie Mouse]

Thank you for your quick replies;) I am going to docs tomorrow to see if they will let me have HRT, - it's about my quality of life, and this is currently non- existent! I got told that I would go into surgical menopause but not what was available to help me.....I am sure that follow up care could have been better.... I basically had the op, one night in hospital ,then home - nil follow up whatsoever! I only went to the GP  cos I needed a sick note for work....my follow up consultant appt is not until end March - 4 months after the op!

The insomnia and tiredness is what drags me down...... I'm hoping HRT may help. X

[Hurdity]

Hi Annie Mouse

  from me too.

Sorry to hear about your problems.

As cubagirl says - you are feeling like this partly because of the operation and in a large part due to the sudden body shock of losing your ovaries and the associated hormonal upheaval. Did you keep your womb? If so you will need progestogen as part of your HRT but you could have a Mirena coil and then add in oestrogen as patch or gel (or tablet).

Having relatives who have had breast cancer - and especially not close ones - does not necessarily put you at high risk of breast cancer. Close would be mother, grandmother sister etc - even so with specialist advice some women are able to take it.

You haven't said how old you are but until the natural average age of menopause of 51/52 then you should have been given HRT to help protect your heart and bones - especially if not at high risk of breast cancer. Talking of this the best things you can do to minimise cancer risk is to improve your lifestyle where necessary - ie give up smoking ( if you do) limit alcohol, maintain weight within healthy BMI range, take more exercise, reduce stress and eat a healthy diet with lots of fresh ingredients. There is plenty of info on this site:
http://www.menopausematters.co.uk/diet.php
http://www.menopausematters.co.uk/weightgain.php

There is info on breast cancer risk here:
http://www.menopausematters.co.uk/risks.php

You may also find that reduction in testosterone also contributes to your symptoms - there is information here (scroll down): http://www.menopausematters.co.uk/aftermeno.php:
http://www.menopausematters.co.uk/testosterone.php

It is more difficult to get this on NHS although your specialist should be able to prescribe it as you have had your ovaries removed.

Hurdity x

[CLKD]

   Hurdity - missed you!

I think that the whole issue of what to expect following surgery should be discussed B4, it certainly was in 'my day'  in fact, I think it is negligent not to warn patients of what is required after.  Either your GP or Consultant should have discussed this, something you might like to suggest to your GP! explain that you had no information from the Consultant and perhaps he/she might like to take on board the need to warn patients what to expect.  Is there a patient group associated with your Surgery, might be worthwhile telling someone so that it can be discussed at their next meeting - patients meet with GPs and Practice Managers …….. it's about information, if the GPs aren't aware that patients are not being informed? and this goes for all Specialities.

I would also be writing a strong letter to my Consultant, but then, that's me.  4 months before follow-up    - what happened to the week after Discharge and then 6 weeks  .      (steps off Soap Box ).

[Annie Mouse]

Thank you for all of your kind words and honest replies.  I agree that more information should have been available to me prior to the operation and that follow up care has been poor. I work in the health sector myself, so know the trials and tribulations of trying to get staff to work here on the Isle of Man, - it's a hard slog and staff shortages are ongoing.
I am 52 now, don't know if that makes any difference to whether I should get HRT? I'm convinced that it is my lack of hormones that is causing my symptoms post operatively...... Just need some confirmation and reassurance!

[Hurdity]

Were you menopausal before the operation ie had reached menopause with 12 months since last period? Even if so removal of ovaries will still be a shock to your system as they continue to produce some hormones in post-menopause. There is some information here too and testosterone is mentioned:
http://www.nhs.uk/Conditions/Hysterectomy/Pages/Considerations.aspx

Let us know how you get on

Hurdity x

 

[CLKD]

Do you feel Island-locked?  I would love to visit but it's the journey that puts me off 

Hopefully the Forum will get you pointers as to which way to go …… let us know how you get on!

[SarahMcComish]

Sorry to hear how difficult things have been for you!

You are absolutely right to go back to your Doctor- first port of call should always be your GP.  However, your 'non existent quality of life' worries me too.  It must be very hard to return to work feeling like you do, so maybe you need advice on work life balance as well.  Is there anyone at work who is in charge of wellbeing?  Support of family and friends is key too, although as capable women, we sometimes find this hard to ask for.

Hope this helps.

[Worrywart]

Hi Annie Mouse

I had a total hysterectomy at 52 and my GP was very keen to get me back on HRT afterwards as it protects against other things. I too felt awful although I had it done the long way round so wasn't able to go back to work for six weeks so although tiredness was a problem it wasn't so terrible as I was not having to do much.

HRT helped enormously - I have no ovaries, womb, tubes or cervix and I would not like to have to manage without it. I was on it before the op but I do think that having everything taken out right in the midst of the meno is difficult for one's body to adjust to! I really do think it would help you, and your GP should be able to discuss the new findings regarding the risks with you.

I'm on Evorel estrogen only patches - which I was on before, but combined with Utrogestan. I did try estrogel but found, for me, my wellbeing sort of fluctuated with it. Many women love it though.

I hope you get sorted and start to feel better really soon. Do be aware that even a laparoscopic op takes a lot of recovery as I'm sure you know - your body still has to do all that internal knitting! And I was warned by some lovely nurses that the anaesthetic hangs around in your system for quite a while and can make you feel very weary all of a sudden.

X

[CLKD]

 

[Annie Mouse]

Quick update for you all, - went to GP and she has put me on HRT (estradiol) tablets.  My blood tests showed levels of <10, which is incredibly low.  She agreed follow up had been poor......I'm off on holiday to Lanzarote tomorrow so hopefully by the time I return will be feeling a bit better!  My work have been marvellous with me - can't really fault them. I've been a " wreck" since returning to work and they have been supportive.

Yes, living on the Isle of Man you can feel island locked - I've only been here one year ( came with my husbands job) but try to return home every four weeks ..... It's a very pretty place- but incredibly small and island living brings its own challenges....

I will update on my return from holiday..... Thank you all for your replies and support x

[Ju Ju]

Have a wonderful holiday in the sun!

Follow up is poor. I had a hysterectomy 7 weeks ago. I was told I had had a hysterectomy as well as the repair I went in for. I wasn't told whether it was full or partial, though on discharge I asked a nurse, who said I still had my ovaries, which were healthy. As I only spent one night in hospital, I didn't question further. My GP hasn't been given much info either, but we need to know whether my cervix is in place still, as I need to know whether I still need progesterone added. My GP is contacting the consultant as I don't have a follow up appointment for weeks.

[katiep1959]

Thank you for all of your kind words and honest replies.  I agree that more information should have been available to me prior to the operation and that follow up care has been poor. I work in the health sector myself, so know the trials and tribulations of trying to get staff to work here on the Isle of Man, - it's a hard slog and staff shortages are ongoing.
I am 52 now, don't know if that makes any difference to whether I should get HRT? I'm convinced that it is my lack of hormones that is causing my symptoms post operatively...... Just need some confirmation and reassurance!

I had removal of a large cyst and BSO on Tuesday and feel the same, totally left to get on with it I have no follow up unless the histology results show something and haven't been told how long it will take to recover. I was already on HRT but think I may need my dosage changed as my sweats are back already. I am almost 57 and no period for several years so consider myself post menopausal. We are due to go on holiday in 2 months 1st May and just hope I feel better by then. How are you doing now?