ERT-When to start

Hello Ladies,

I'm sooooooooooo happy I found this site. What a blessing and a comfort you all have been as I decided what to do. I'll be having a TAH/BSO on July 1st, for fibroids (16wk ute) and the ovaries are coming out due to cysts.
One of my many questions is about ERT. When is a good time to start? I know I'll be starting sometime after the castle visit, but want to know what some of you did in regards to this.
My pre-op visit is next week & I would like to know something more before I see the Dr. I took the pre-op question list I found on this site to the last visit to his office. He answered everything & didn't try to rush or ignore or make light of any of the questions.
It was great.

Thanks so much : ) ( :
Cooksalot

(((((((Cooksalot))))))))),

This is one of the topics you will need to discuss with your Dr. Everybody has different needs and desires about hrt or no hrt.

I started at 3 days post op . I didn't want any flashes while recovering. I quit hrt 2 months ago.

It is all a personal choice that you make while consulting with your Dr. Not everybody should use hrt or wants hrt.

So please do ask your Dr. what he thinks.

You can get alot more hrt info. at

http://www.hormonejungle.com/

Best wishes,

Pamcat

I started HRT 24 hours post op. I had a consultation with a compounding pharmacist before surgery. I also had hormone levels drawn before surgery as I wanted a baseline on my hormone levels (as I was premenopausal before surgery). My doctor did not recommend this, I asked for it. I was very proactive with my HRT - some docs don't start HRT for 6-8 weeks, which I do not think works best. Hormone levels begin to drop as soon as your ovaries are gone - so it seemed logical to me to start HRT as soon as possible.

I researched all I could on HRT, and chose the one I thought best for me - Vivelle Dot .1 and 3% progesterone cream to start off. It has done well so far - and am four weeks post op this Thrs.

Since you have some lead time (up to Jul 1), you have lots of time to research HRT and find a GOOD compounder, get the blood tests for hormone levels (many will tell you this does not help - but I felt better knowing what I was BEFORE surgery, and then I feel I am better prepared to align my body back to pre-surgery levels, or better), and study this issue...it is a VERY important one!

My compounding pharmacist said I was the first woman he'd had come to him BEFORE surgery for a consult, and he was thrilled women seem to be taking a more proactive stance in their HRT therapy...because "there are so many ways a woman can go with this, to make it individual to her needs" he said.

I am of the mind that HRT hormones are specific for each woman. HRT is as important as INSULIN to the body, and JUST as individual. People all take different doses of insulin, and the same is true for HRT! I would not take insulin lightly and without really researching it, so I feel the same way about HRT.

The symptoms of HRT problems are many, and the proper therapy is VERY important for QUALITY of life. I would recommend getting a good book or two, (Women, Weight and Hormones by Vliet is a good one) a good compounder, and a take charge of my HRT attitude. It also works to be pretty informed when you DO talk to the doc, or compounder....they like someone who seems pretty "up" and studied on what they are talking about. Worked for me so far.

Good luck. PM if you like. Am not a professional but have studied HRT at length, and I do know endocrinology (study of body hormones).

Cooks

I too started ERT 24 hours after surgery (after the Castle Pharmacist payed me a bed side consult) . As Pam said your HRT is determined by you and your Physician.

When I went in for pre-op, ERT was one of those Q's I has pre faxed to my Doc- our choice was made and it was added to the Docs post-op instructions.

Best of luck on the 1st.

Hi ladies: Dumb question but I'll ask anyway...are Vivelle Dot or other compounded bio-identical hormones classified as hrt, or are just the synthetic hormones classified as hrt?

Also, if you ask dr to put you on Vivelle Dot or Climara patch after surgery, do you have to specify dosage or do they calculate based on your weight, etc.?

Thanks for your knowledge.

I too will be having a TAH/BSO & the info on getting a baseline hormone level pre-op makes a lot of sense. I still have time before my surgery -- and am gathering a list of questions to go back & ask about.

Thanks for your "words of wisdom."

Quite often the reasons leading us to a hyst have been wreaking havoc on our hormones, so it is quite possible that getting a baseline level could be pointless.

I know in my case, between the Provera I was taking to control the bleeding, the frequent cysts on my ovaries (not PCOS however) and the fact that when I wasn't taking BCP's or something to control the bleeding my periods were always pretty irregular, and add in the PMS - those levels were not something that I particularly cared for.

My DR starts HRT about 2 weeks after surgery - the body stores it in the fat cells and she believes that you need to use up the stores before you start HRT otherwise you can get a high level and then it drops.

I am taking Estradiol 1mg/day, and have been since 2 weeks after my surgery. I have never had a hot flash (including the 2 weeks after surgery) and it seems to be working fine.

Best wishes.

I chose to have my ovaries out after my Dr. giving me that option. A patch was put on the day following surgery and then I went into oral harmones and have had no problems. The one thing I have noticed, no more PMS and no more migraines. Hope these thoughts will help you in making your decision.

pianolover