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[Shelly2000]

Hi. I'm 43. I had a TAH BSO (Total Abdominal Hysterectomy with both ovaries and tubes with cervix) in 2012 due to extensive endometriosis, which I know was wrong. Unfortunately no going back so am trying to move forward and need all the help and advice please. Since 2012, I've been suffering really bad with anxiety, insomnia, itchy skin etc etc. I've seen every specialist available but have just discovered myself this is surgical menopause. I was on premique .625, evorel conti patch and activelle. I have finally found an endrocrinologist who was surprised how low my oestrogen intake was, so I'm now on Evorel 100 patch and Uterogestan 100 mg. I feel the evorel is really helping but I'm only on day 6 of the progesterone and unsure of same. My anxiety has lessened and I have stopped anxiety meds because of this. But when I take the Uterogestan, I feel drunk and giddy. Is this right? Plus hot flashes and night sweats are back. My doc said only to take 2 weeks of progesterone. Is this right? Also can anybody recommend a specialist that can measure and balance hormones? Appreciate any advice please. Thank you.

[CLKD]

Your Surgeon was wrong not to explain to your prior to your operation about the consequences.  I don't think that many realise or are bothered about the effects that hormones can have!! 

As oestrogen levels drop the muscles may become lax = aches and pains.  Also the body may become dry, inside and out: skin, nostrils, deep in the ears, vagina, scalp .........

Many ladies find problems with progesterone ............

Browse round.  Make notes.  Put your products into the search box and read the threads, might give you an idea whether you need to change/not.

[Shelly2000]

CLKD, thank you for your reply. I think many surgeons are/were like mine. He was a good surgeon and I was naive. Anyway I need to fix this now. Surgical Menopause is a killer. Thank you for the tips. Will I ever feel like myself again. 

[walkingthedog]

Hi shelly200

I don't understand why you have been prescribed progesterone if you have had a total hysterectomy as you only need estrogen. Progesterone is used to give you a bleed to prevent your womb lining becoming too thick but in your case you don't have a womb!
I had a total hysterectomy last year and only use estrogen for hot flushes.
I would be asking why you have been prescribed progesterone

Hopefully what I have said is correct. Perhaps one of the other more knowlegable members will comment

[Hurdity]

Hi Shelly2000

 

What walkingthedog says is normally correct but you will have been precsribed progesterone I imagine due to the extensive endometriosis. I presume there were residual depoists ( or the possibility of these) outside the womb so the progesterone is necessary to prevent these growing as a result of stimulation from oestrogen you are taking?

If that is the case then you should take the progestogen continuously and your doctor is wrong. Taken continuously it prevents oestrogen acting on any womb lining ( or endometrial deposits if you have them) so the endometriosis should not increase. Also 100 mg utrogestan is the dose for every day use. Here is the info on 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.

https://www.menopausematters.co.uk/atoz.php#GlossE

I suggest your hot flushes are back because the dose of oestrogen you are taking is now much less than before which was a 50 mcg patch, a medium dose equine ( horse) oestrogen combined HRT pill together with a low dose combined oestrogen HRT pill. Is there any reason why you can't continue to take a tablet as well as what you are currently taking? However if there is concern about endometriosis you might also need to increase your progestogen dose ( if you increased oestrogen). Is your endometriosis being monitored or was it all completely removed?

Yes some women do find side effects from utrogestan and these can be mitigated to some extent by taking it at night, otherwise vaginally - although I doubt you would want to take it like this all the time. A Mirena coil could also be fitted although not sure if this would work if you have no cervix or uterus?

Not sure what you are wanting to balance - in your situation it might be more a case of taking as high a dose of oestrogen as will deal with your symptoms but also to take into account the extra prog you might need ( and the downside of higher doses of this) due to the endo.

One other hormones you might like to think about is testosterone as your production of this will be very low since removal of ovaries and you should be able to get some precribed on NHS through your specialist hopefully?

Hope this helps

Hurdity x

[chillybiscuits]

Hi Shelly2000,

I'm new here too.

 I had the sub total hysterectomy and ovaries out (aged 41) 14 months ago due to complex Endometriosis, large ovarian cysts, fibroids and polyps.

Due to the Endo, I was terrified to start any sort of HRT and the surgeon was a bit vague and just recommended I take Tibolone. I was so confused, I went hormone 'cold turkey' for over a year which was really, really tough. In desperation I started reading around (especially on here) and found out about Nick Panay's menopause clinic at the Chelsea and Westminster hospital. I asked my GP for a referral, even though I live in Somerset! It took 3 months to get the appointment, but I'm so very glad for it! I have been on the continuous HRT (prescibed by the clinic) for 6 weeks now and I'm feeling lots of improvements already. I take Utrogestan vaginally every night (due to the Endo it's important to take it continually to counteract the Estrogen) and Vagifem twice a week internally. I take 2 pumps of Estrogel a day and 1 pump of Testosterone gel twice a week. I'm sure the doses will need tweaking at some point as I get a feel for how they are working but I will have a follow up chat by phone with the clinic soon and the option of repeat visits to them. I can't stress how knowledgable they were and how generous with their time. I saw a lovely lady called Patricia, who had a particular interest in surgical meno and Panay himself too. I would highly recommend getting your doctor to refer you there (there are other meno clinics, but few and far between sadly!).

A wealthy friend attends the London Hormone Clinic for bespoke prescriptions, and finds them very helpful, but it is very pricey!

Chilly B x

[Taz2]

Hi Chillybiscuits. A really informative post for women facing the same problems. It's good to read that your HRT regime is working especially at your young age where it is so important to replace hormones lost from surgical menopause. I'm so sorry you were let down by your consultant originally. How many other women are in the same position I wonder.

Taz x