I'm 6 months postop TVH-BSO for 5-month-size fibroid uterus. The surgery was absolutely necessary, but ovary removal was up to me. After many consults with surgeons and my migraine neurologist, I decided to remove my ovaries due to my age (47) and best chance of ridding myself of severe and frequent migraines and chronic headaches, for which I'm currently on disability. I was put on 0.05 estradiol patch after surgery and still no improvement in migraines 6 months postop. Even under a migraine specialist's care, they are so disabling they affect every aspect of my life.
I decided a few months back to go to a gyn who specializes in endocrinology to try to refine my patch dose to hopefully eliminate the migraines. Due to past history it was thought I might be sensitive to estrogen, so I was put on only 0.25 estradiol and was to stop completely after one month and revisit, with the thought of perhaps adding testosterone if things were better. The month I was on 0.025 estradiol was like living hell, with constant migraines so painful that I had to put myself back on 0.05. I'm due to see this same gyn in several days. He doesn't know I'm back on 0.05.
I do have a history of anxiety and mild depression at times, but for the last couple months this has really worsened. Yesterday my DH even asked if I needed to go to the hospital for depression, but I have no suicidal tendencies. My dose of Prozac from upped to 40 mg last month and this seems to coincide with when I was more depressed! I'm going to call my doctor this morning. I was severely depressed yesterday, the worst of all. My family is great--NO problems there, NO external problems. DH is a dream.
The psych who upped my Prozac last month told me that I should definitely see the gyn endocrinologist again because they will want to re-evaluate my patch dosage. The gyn's notes indicated if no estradiol didn't work, next step would be either adding testerone only OR tapering me up to 0.075 estradiol. It used to be that constant migraines were my "only symptom," now I'm having wild mood swings, periods of deep depression and always generally depressed, no motivation, NO energy, nap everyday, have mild hot flashes and sleepliness at night, don't socialize, etc. Is it "normal" to go through more fluctuations even 6 months postop? Now today I seem to be okay (no migraine, no depression)....for now.....what's up?
Newgal, Your symptoms sound awful and I hope you nail the cause very soon.
I became depressed after my surgery. My internist offered me antidepressants. I declined the offer. It seemed to me that hormonal was the more likely culprit as I had never suffered from depression before. I don't know if it was the estrogen, the testosterone or both that helped. The estrogen was increased and the testosterone was added at the same time. All I can say is that my view of the world went from black and white to color over a period of a few weeks. Each day got better! My sense of wellness, enthusiasm and zest for life were restored!
My current doctor told me that some women just do not produce much testostorone from their adrenal glands. Having your ovaries removed reduced your serum testosterone levels by approximately 50%. I would ask to have my Total and Bioavailable levels checked. Also, ERT can cause a relative low testosterone bioavailable level due to the increase in SHBG level. The total testosterone includes the free or bioavailable but does not tell you what it is.
A good book on Migraines is: Heal your Headache by David Buchholz, MD. He is from John Hopkins and offers the lastest in research and treatment. He does discuss hormonal influences also. This book is available from Amazon.com It may be a cheap second opinion for your migraine neurologist.
Just a side note and something to consider. I tried paxil and prozac and both gave me horrible heaches. How long have you taken the prozac? Have you considered trying a different form of estrogen besides just the patch? Also, not all patches are the same. There is alora, vivelle, estraderm, climara, esclim and of course the new menostar that only give a tiny dose of estragen. They all respond differently to each individual.
I haven't been here in a while. But when I had my LAVH in 2000 this website was a God send! I have been looking around for the last couple of weeks due to my hormones (which I thought was depression, but my husband kept saying "IT'S YOUR HORMONES!) He was right for once.
I had my hysterectomy in 2000 and did fine for a while (I kept my right ovary). And then in July of 2002 my world feel apart (or so I thought). I was depressed, anxious, wanted to leave my husband...it was horrible. My husband and I have always had a great relationship. Thank God for him! He TOOK me to my gyn himself and told him what was going on. My gyn was convinced it was depression but my husband persisted and demanded he do a hormone level test before he prescribed anti-depressants. The gyn said okay but wasn't convinced. When my test came back my level was 11!!! (Should be between 100 and 200) They put me on several different pills and patches and finally found relief in a compound of estrogen and testostorone. I did well until September of this year when I went in for my yearly exam. I had been having some trouble "Peeing" (can I say that) but wasn't really concerned but when my gyn examined me he discovered I had a cyst on my only ovary I had left. When they did a sonogram they found that my ovary had actually shifted on to the top of my bladder and that I had a "grapefruit" sized cyst on my ovary. I had surgery to remove the ovary and that's when my hormones went crazy and my migraines that I had had 3 or 4 times a month became unbearable. They took my hormone level again in October and this time it was 15! They put me on the CombiPatch and I did well until about 3 weeks ago. And just like Gail is describing I began to feel depressed and exhausted. I really thought I was going crazy! I had struggled with depression in my late teens and early twenties and I just resorted to the fact that this was it, I'M DEPRESSED! I was miserable...when I finally told my husband how I was feeling and that I though I might be suffering from depression, he convinced my to call my gyn. I didn't want to because I really thought I was just depressed and that the gyn would think I was crazy (again) well I guess he learned after the first incident and ordered a hormone level test and once again my level was low, it was 36! I went in yesterday and got a hormone injection and all I can say is that I feel better today and hope it lasts! I can really relate to the depression you feel. It is so scary. But please don't give up! My husband THANK GOD is always on top of it even when I just think I must be psycho. Hormones can really mess with you so please talk to your doctor about trying a different hormone. My doctor has been great and told me yesterday that everyone is different and he would work with me until we found the right one for me. Has anyone else had luck with the injections and can anyone tell me what to expect? I don't even know the name of the injection...
Also, on the subject of migraines...has anyone tried the progestrone for them? Saw a few posts about it and am thinking of trying it? Sorry this is so long...I'm a motor mouth. lucydarlene
I would hug your husband if I saw him--how sweet and caring he is! The whole "female hormone" issue is so foreign to most men (in terms of dealing with it), that I applaud your husband in helping you in such a loving way.
I know that many hormones are life-sustaining and other hormones, such as the estrogens (estradiol, estrone, estriol), progesterone, and testosterone are absolutely essential to our sense of well-being. That's why so many women here (myself included) will often feel that something is wrong above and beyond the actual symptoms of surgical menopause we can pinpoint---it's that wonderful sense of well-being.
One disappointment I have had post hyst is how quick even the very best doctors have been to want to prescribe antidepressants when hormones are SO clearly the cause. When my estradiol patch was reduced to 0.25 from 0.50, within a week and a half I was living in pure hell, but was told to stay with it for a month. I was so sick that month, so hideously depressed for "no reason". When I told my family doctor, he asked me "What was different this past month?" I said decidedly, "Hormones, the patch dosage reduction." Nothing at ALL had been different that month with the exception of the patch reduction; I had been so sick with migraine exacerbation that month that there was no other news to even convey! Still, he didn't think it was the hormones and referred me to psychiatry!Luckily I scheduled a followup with my gyn endocrinologist and see him in the next few days. I suspect from our first conversation that he will work with estradiol and/or testosterone.
As for progesterone for headaches and migraines, I can offer no help there. I have been seen by a top migraine specialist at a prominent teaching hospital for several years and he never advocated progesterone.
In summary, let's all think about. Take out our ovaries, fallopian tubes, cervix, and uterus, and with it ALL of our sexual and reproduction hormones, and tell me how you think we might feel! God made our bodies in a wondrous way. Sure, I needed the hyst, no doubt about it, but don't tell me it isn't my hormones.
Great book.....Screaming To Be Heard: Hormone Connections Women Suspect...and Doctors Still Ignore, by Elizabeth Lee Vliet, M.D. (2001), over 600 pages, $29 but worth every penny for women with and without ovaries, at any age.
newgal, Doctors make me so mad in that they immediately prescribe anti-depressants! Not that I don't think anti-depressants are necessary because I have taken them and still do to try to ward off my migraines (by the way they only help when my hormones are on an even keel!) I love my gyn but I wonder if he would have beeen as understanding if my husband hadn't gone to the doctor with me and told him that I WASN'T DEPRESSED!
I just looked up the book "Screaming to be Heard..." today on amazon.com and saw that you could get a used copy fairly cheap so I placed my order. What about the book "What You Doctor May NOT Tell You About Menopause"? Has anybody read it? I ordered it too.
newgal, how are you feeling today? I'm feeling better since they gave me that injection yesterday. I actually put clothes on (warm up suit, but hey it's a start) and not only picked up my kids from school but went to the nursing home to see my DH grandmother. Thanks for listening. It's so nice to have others that can relate. I am only 35 and none of my friends have had a hyst. They just don't understand the menopause thing. The only one who I can talk to that understands is the girls here and my MOTHER!