Anti-depressants.....

I have read several posts about women going on anti-depressants after surgery for mood swings rather than hrt's. My question is "What if you are already on them?" I have been on them for several years now, and my mother had breast cancer in 1998, so what could my options be?

I am going to ask this at my pre-op but I would like some input before I talk to my Dr. about this.

Also I have been having hot flashes and night sweats for a couple of years now, so after I have my ovaries removed am I correct in expecting these to get worse?

Thank you for your time!

Take care!

Katie

Hi, Katie!

I wasn't on antidepressants at the time of my surgery, but have had occasional bouts of anxiety problems since childhood. I recently went through one that was treated successfully with Effexor, and it permitted me to cut down on my estrogen dosage. Effexor is reputed to help many women with hot flashes, and it did help me avoid them with less estrogen. Unfortunately, I couldn't stay on Effexor; one of its very common side effects is constipation, and I also have some really nasty problems with chronic anal fissures, so it wasn't a good long-term solution for me.

My mother has also had breast cancer, but I chose estrogen-only HRT and will probably stay on it for a few years. (Estrogen-only HRT is usually prescribed only for women who have had hysterectomies; it's less associated with breast cancer than estrogen-progestin HRT, but can increase the risk of cancer developing in an intact uterus.) Different physicians may have different and strong opinions on this, of course, so it's important to ask your doctor.

BTW, I was in early perimenopause when I had my TAH/BSO at age 46, and I'd describe my hot-flash experience after surgery as "moderate" rather than "severe". (That is to say: The flashes were annoying, but they didn't drench my clothing.) It may be more of a concern for younger women who go more abruptly from high to low estrogen. Of course, this is very subjective -- not to mention that there's lots of variation in our species and we don't all respond the same way.

You may want to make a list of questions to ask your doctor at your pre-op appointment. Antidepressant treatment (like HRT) seems to be something of an art, so you may have to work closely with your doctor(s) to get an answer. Be patient, and hang in there!

Best wishes,
Juliepede

Thank you for this information, but I have other questions now... If you have a hyst. for endo and you take estrogen do you still have the problems with the endo? Isn't that what "feeds" endo? And the second question is--If I am unable to take birth control pills, due to blood clots in my arms and legs, will that have any effect on hrt's?

The more I read, the more questions I have, sorry! lol.

Thanks,

Katie

Dear Katie,
You're bound to have a TON of questions! So keep asking!

I was on antidepressants for depression, long before my hysterectomy. Possibly this is a reason why I'm not having a bad time with the surgical menopause. I don't want to (won't) take estrogen because I had cancer. There are lots of alternative ways to deal with the symptoms, including herbs -- my gyn/onc and I will be discussing this soon so I'll know what's not "quackery," but I don't expect I'll be taking anything more than a calcium/magnesium/zinc/vit D/and B-complex combo, just to guard against osteoporosis.

It seems to me that people who can't take b/c pills due to clotting probably would be wise not to go the HRT route, but that's a question only your doctor should answer.

As juliepede said, our bodies all respond differently. Together, you and your doctor should be able to determine a safe and effective course of treatment for you.

Best wishes, and ask all the questions you think of!
=e