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[Bobidy]

Hi all

Just listened to this great podcast by Dr Newson about surgical menopause (with or without ovaries), hrt, testosterone etc.

https://www.menopausedoctor.co.uk/podcasts/026-surgical-menopause-dr-rebecca-lewis-dr-louise-newson

Enjoy x 

[Sammiejane]

it would be nice if they touched upon tolerating hrt after surgical menopause and what to do then !

also it's mentioned that the contraceptive can be taken if under 51 yet my menopause said there's no way i can go on it yet my understanding is it's stronger then hrt so surely would be better for young women going through surgically induced menopause . yes there's risk but there is to with hrt !

[Bobidy]

You won't need contraception post surgical menopause? Only oestrogen and possibly testosterone, by either transdermal gel or patch. Sorry if I've missed your meaning.

Interesting to hear in the podcast that high levels of oestrogen (2 patches or 6-8 pumps) is safely used in younger ladies post surgery.

[Sammiejane]

yes your right u don't need contraception but combined pill isn't taken for that after surgical menopause it's for replacing hormones as we no longer have any and the pill has stronger dose !

hrt is is the preferred but it's intended use mainly is to supplement existing hormones natural menopause so may not offer enough dose for surgical menopause hence why some women have to use lots of pumps or patches to get relief and it's far safer surely to use the least amount for the least amount of time !

[Sammiejane]

hi all

just listen to the podcast

they mention women who are young need hrt and going through it naturally without hrt was not how are bodies were designed are body's were designed in our 20s 30s up intill 45 to have hormones , so being without hormones is not natural yet within that age group are bodies are designed to have all 3 hormones estrogen progesterone and testosterone so how can taking estrogen only hrt and possibly testosterone make us feel like we did ore menopausal as they are not supplementing one crucial hormkne whereby we have receptors for progesterone in our brains our heart are vagina are bones tissues etc not just endometrium . they never speak about this ! or if women don't agree with hrt what then do they do !

are u able to email dr louise newson ?

[Bobidy]

Yes the pill contains high levels of oestrogen, but most forms are synthetic. There are 2 (I think) types of pill that are body identical. I can't remember the names. Hurdity has mentioned them a couple of times. They may help?

I guess the problem is they are still going through the liver though.

I think with progesterone this is generally avoided post surgery as it has the small breast cancer risk. But it can be given if ladies want the calming feeling it can give (which I didn't realise). From what ladies say on here though it is the prog which causes most problems?

Dr Newson does instagram I think so you may be able to ask on there?

It's a tricky balancing act for sure.

[Sammiejane]

hi hurdity

could you possibly advise which types of combined pill are bio identical ?

[Hurdity]

Hi there - thanks for the link Bobody.

Sammiejane - I haven't time to listen to it all at the moment as it's quite long and chatty. However as Bobidy says in the title it talks about hysterectomy - including removal of ovaries (this would be surgical menopause) but also that even those who kept ovaries may find that they fail within 5 years - research has shown.

Re the contraceptive pill. This may have been touched on in the podcast? If so, is it suggesting that for those who have had a hysterectomy (and retained their ovaries), until they reach menopause ( which can be sooner than if they hadn't had their hyster) they will still get the huge mood swings of peri-menopause, and even if they don't need (large amounts of extra) progesterone ( as no womb), taking the COC can help with the mood swings as it will suppress the cycle just as in women with their uterus? If so that is interesting and obvious if you think about it - although very high doses of oestrogen are also a way of suppressing the cycle.

Also to add that our bodies do continue to make sufficient progesterone all our lives even post-menopause - via the adrenal glands - as do men. However it is only produced in very large amounts by the ovaries for pregnancy.

If you have had ovaries removed then you wouldn't take the COC - there is no indication for it at all.

Sammiejane those combi pills are QLAIRA and ZOELY  but there  would be no advantage to you in taking them as you have no ovaries and no cycle. You might just as well take oral oestrogen. QLAIRA in particular is tri-phasic so has different doses of oestrogen throughout the month.

Re the cancer risk from progestogns - I don't have the detailed stats in front of me but I understand that taking any HRT up to the natural age of menopause 51/52 does not increase BC risk - rather than the age of surgery, although not sure specifically about the synthetic progestogens? I think that is the general wisdom. If someone has more info that would be helpful but maybe not the subject of this thread?

Yes it's all a balancing act Bobody!

Hurdity x

[Bobidy]

Great, thanks as always Hurdity for clarifying x

[Sammiejane]

hi hurdity

yes the pill suppresses the cycle but also women with no ovaries don't have a cycle but they don't have any hormones either so surely higher doses would be better as hrt is designed to supplement existing hormones it is a replacement for the natural decline in hormones women without ovaries do not have a decline they don't have any and sometime depending on your make up hrt isn't sufficient in its doses to combat symtoms for a lot of women they are having to take 100mg plus patches or 4 pumps gel and hrt is designed to take the lowest amount for the shortest time . the aim is to bring levels back to pre menopausal ie child bearing years so the pill all be it synthetic would be better for some women ! my gynocologist advised i could take the pill but menopause said no as not advised of over 35 due to risk blot clot dvt but you take hrt in tablet u have same risk ! some women are on the pill till there 50 and then say they get moved on to hrt and feel awful because it's not strong enough ! to be honest if i hadn't of had my hysterectomy and ovary removal i would still be on the pill now !