Hormone Hell after a Hysterectomy and Oophorectomy

I'm 6 weeks post op, and I'm very upset, because I'm going through a hormonal nightmare following my hysterectomy. I had a supracervical hysterectomy and an oophorectomy.

Before my hysterectomy, I was on bioidentical HRT made by a compounding pharmacy, which had 2.5 MG of estradiol, 150 MG progesterone, 6 MG of testosterone, and 30 MG DHEA. That worked wonders for me. I have PCOS (and diabetes) and PMDD and was in the late stages of perimenopause and the HRT brought back my sex drive, made me feel better, got my blood pressure and my diabetes under control, and greatly improved the quality of my life overall for the past year.

I continued taking this compound after my hysterectomy.

Well, about a week after my surgery, I started having horrible hot flashes, so my doctor supplemented my HRT with 1.25 mg of Enjuvia. I thought it odd that he added that instead of increasing the amount of estrogen in my compound, but he assured me that we need to experiment with how much I'll need now.

So I took both for the past several weeks and my mood continued to spiral downward into debilitating depression. I also began to get PMS type symptoms with mood swings, 10 pounds of water weight gain, etc. So, thinking the problem is likely progesterone, I quit the compound a few days ago and doubled up on the Enjuvia.

Sure enough, the water weight went away almost immediately and so did the PMS symtoms. My depression greatly improved. So the problem was progesterone, which I've never tolerated well. But now I'm having constant and unbearable hot flashes and no sex drive again (as I'm no longer on testosterone).

I saw my doctor again yesterday and told him about all of this. He wants to take me off of the compound entirely and give me synthetic estrogen tablets like Premarin with testosterone on the side.

He said that with the compound alone, I'm already on a very high dose of estrogen and he really can't go higher so it would be best to take me off of it entirely and put me on something else. Wow, this is a different story than he told me before. And he didn't seem to mind that I was on that high dose for a year when I had ovaries.

I told him that I don't want to be on anything but bioidentical hormones and that the pill has never worked well for me, that I've only had success with the compound and the patch--a few years ago I took the combi patch. It didn't work as well as the compound, but it helped a lot.

He didn't want to put me on a patch, because he doesn't think they're very effective. And he said there is no bioidentical patch or pill.

I really feel that he didn't hear a word I said.

I asked him about Vivelle and Climara, which I thought were bioidentical. He said they aren't.

Hmmm. that's funny. I looked them up today online and the sources I read said they are.

He said I probably don't absorb the estrogen well, which is why I'm having the hot flashes. Well, duh, I have PCOS, which means I have cellular resistance.

Anyway, he took some blood to test my hormone levels and he's going to get back to me in a few days. But I'm very frustrated with this. I'm not sure what to do as I'm miserable. I'm wondering if I should start doctor hunting again. I don't like that he's not listening to me and unwilling to put me on what I feel I need to be on.

I also don't see why he just can't take the progesterone out of the compound and increase the estradiol a bit--maybe to 3.0 MG and see if that works.

Any suggestions that might help? What has worked for you? Have you been where I am now?

I don't know what mix would work but I know how it is when Drs won't listen or at least explain themselves better. And I know the patches are bioidentical. So maybe if this next visit is no better, time to change Drs. Its frustrating, but sometimes better in the long run. You have some good points. I hope you get some relief soon.

I had an LSH 3/13/09. Even though i kept my ovaries i still needed to start HRT within 3 months. I finally settled into 1 mg divigel after trying a a few different methods including compounded. I then had an oophorectomy 17 months later. I began having headaches and hotflshes and was panicking that i was entering the hormone jungle as known on this website. It took my body a good month to 6 weeks to readjust, I still take my 1 mg of Divigel but now i feel like it works better than before my oophorectomy. I also can now tolerate small amts. of compounded progesterone.

My suggestion is to start from the beginning...with just estradiol, get that right than add P and T. Also sounds like you may need to find a new Dr. You may also want to try a gel vs. cream. My absorption is 10 times more effective with gel .

	Quote:
Originally Posted by greyown So maybe if this next visit is no better, time to change Drs.

Thanks for the well wishes. Yes, it's frustrating when they won't listen! I'll see what he says after the lab results are in, but if he still won't listen, I guess I'll have to hunt for another doctor. I feel like this OB/GYN caused my hysterectomy to begin with.

He'd talked me into having a Novasure ablation for DUB in January. That ruined my uterus and cervix. In June I started having severe pelvic pain, which I endured all summer due to an initial misdiagnosis of colitis. I was in and out of the ER. In July a doctor in the ER figured out that I had a hydrometra (fluid couldn't escape the uterus) endometritis, and cervical stenosis from the ablation. Consecutive sonograms confirmed the diagnosis. In August my OB/GYN, after denying that the ablation caused this, tried to fix the damage with another ablation and a DNC. That didn't work, and so I ended up with a hysterectomy on September 28.

I guess, after all of this, I don't completely trust him. I feel that if I'd never had that first ablation, I wouldn't have ended up with a hysterectomy. And looking back, I feel the second ablation was completely unnecessary. I think he did it to make money off of me.

After my hysterectomy, he claimed I also had several fibroids, but they were small and "extensive adenomyosis" (which was probably caused from the ablation) and he tried to blame those conditions for everything. But I don't buy it. I think he was just making excuses in fear of a lawsuit.

But I've stuck with him in desperation over the hormones as he's the only doctor nearby who gives bioidentical hormones, including testosterone. I don't make my own testosterone and without it, I have no sex drive, no energy, and the colors are all dulled in my life, including my creativity, which is important as I'm a writer and artist.

And now, he's talking about taking me off of the hormones that I went to him for to begin with. I feel like I've gone through this nightmare for nothing and am now back at square one.

P.S. Some woman wrote on a doctor review site that he'd given her several surgeries for endometriosis. Well, for some reason she became suspicious of him and finally went to another doctor. The new doctor said she'd never had endometriosis. Highly suspicious! I also learned that he's known locally as the "surgery doctor."

	Quote:
Originally Posted by NJ2CA You may also want to try a gel vs. cream. My absorption is 10 times more effective with gel .

NJ2CA,

So, I'm curious, why did they need to go back in 17 months later and remove your ovaries? That must have been hard to go through two surgeries. One is bad enough. LOL!

After the fact, I was upset that I'd had my doctor remove my ovaries, though I know that they fail about 40% of the time afterward anyway. But I was hoping that, since I've suffered PCOS all of my life, that removing them would make me more stable hormonally. So far, it appears that I was wrong. It didn't help that at all. And I've since learned that the ovaries produce other chemicals that help protect us all of our lives. So I greatly regret getting them removed.
I'm 46 and they were about ready to shut down anyway.

I'm glad you found something that works for you. That Divigel sounds promising. Thanks for telling me about it. The only issue I have with it is the dosage. It appears to be a lower dose hormone. I'm already at 2.5 MG and that doesn't work. If the max is 1 MG, I'm not sure it will do it for me--though I'd love to try it if my doctor would be willing to prescribe it.

I'll let you all know what transpires. :-)

	Quote:
Originally Posted by NJ2CA I had an LSH 3/13/09. Even though i kept my ovaries i still needed to start HRT within 3 months. I finally settled into 1 mg divigel after trying a a few different methods including compounded. I then had an oophorectomy 17 months later. I began having headaches and hotflshes and was panicking that i was entering the hormone jungle as known on this website. It took my body a good month to 6 weeks to readjust, I still take my 1 mg of Divigel but now i feel like it works better than before my oophorectomy. I also can now tolerate small amts. of compounded progesterone. My suggestion is to start from the beginning...with just estradiol, get that right than add P and T. Also sounds like you may need to find a new Dr. You may also want to try a gel vs. cream. My absorption is 10 times more effective with gel .

Do you need a prescription for the hormone skin creams and hormone vaginal creams?? I was looking in stores for a vaginal cream with hormornes but couldn't seem to find any? Anyone know? I just want to get that good feeling back again in my vagina. Everything does work, but it takes so long to get there and not as strong. Sorry if ths is TMI, here.

	Quote:
Originally Posted by chanel Do you need a prescription for the hormone skin creams and hormone vaginal creams?? I was looking in stores for a vaginal cream with hormornes but couldn't seem to find any? Anyone know? I just want to get that good feeling back again in my vagina. Everything does work, but it takes so long to get there and not as strong. Sorry if ths is TMI, here.

Yes, you need a prescription for the strengths that are effective. You can buy some over the counter, but the dose of estrogen wouldn't really help, and I think a lot of the over the counter products are scams. You can call a compounding pharmacy in your area and find out what doctors are prescribing bioidentical HRT.

Good luck!

	Quote:
Originally Posted by writer99 Yes, you need a prescription for the strengths that are effective. You can buy some over the counter, but the dose of estrogen wouldn't really help, and I think a lot of the over the counter products are scams. You can call a compounding pharmacy in your area and find out what doctors are prescribing bioidentical HRT. Good luck!

Thanks for your response.

I went back in surgery 17 months later for continued pelvic pain. i couldn't stand it anymore. Dr. thought i had adhesions...as it turned out i did not and just had a few small cycts on the ovaries..nothing that would have caused pain. However removing my ovaries, pain is now gone and my hormones work better...so i am really happy i feel like a new person. Also, when i swiched from compounded cream to Divigel i was able to take a lower dose of estradiol. With compounded 1.5 mg of estradiol was barely enough. With Divigel 1 mg is perfect. Plus its cheaper....yeah !!!!! Good luck