Hystectomy with ovary left?

Hi everyone,
I was wandering if anyone is in the same boat as I am? I have had severe pain for years from endometriosis. I had 3 laprascopy's, uterine suspension, c-section, bladder pressure, pain and spasms. I had two miscarriages that led up to my hysterectomy leaving me with one ovary. I immediately had menopausal symptoms of anxiety, depression, loss of sex drive and hair. I finally got my doctor to run a hormonal test which showed my estadiol very low. I think if my doctor would have believed me that my hormones where off mabey I would never had suffered such bad symptoms and depression. But I did so I tried anti anxiety it didnt help and then anti depressants which helped get rid of panic attacks that I also gained but I stopped it because the anxiety never went away. I have found with the hormone replacement premarin did not help it made it worse. .05 patch was not enough & 1.0 patch seemed to be to much and both patches only seem to last 24 hours not 3 days as perscribed. The Estrace pill helped but I was given it only once a day for 2 years and I found out by another doctor that it is short lived. Estrace is only lasting about 6 hours for me. It does seem to help splitting the doses thruout the day but I still get estrogen surges and withdrawls when its almost burned out. Any suggestions on how to keep my hormones stable? Does anyone else have one ovary causing them bad PMS about 2 weeks a month?
Do you know anything about someone keeping 1 ovary as far as shutting that ovary down to stop symptoms? Any books? ERT, or HRT or BCP to help. I think some of the women with no uterus or ovaries do better than I any comments? I personally thought I was too strong to ever have these symptoms or feel depressed but Whamm! My hysterectomy changed my life and not for the better. Still praying someone has the answer. Thanks to all.
Vikki

(((((Vicki)))))
Don't ever think that you are not strong because of all this - look what you have endured so far. Hormones are powerful things and once they get out of whack we are surprised and thrown into the turmoil that you describe.
I know, because I had a similar situation (minus the endo thank goodness). 6 weeks post op hit me like a tornado, I kept both ovaries but they decided they didn't want to work very well anymore. The anxiety and lack of sleep were mind-bending. Like you, I tried a host of things and have had trouble finding a balance, at times nearly gave up and thought I was just plain crackers.
Time for some detective work. How long did you stay on each thing you tried? If your hot flashes were fairly frequent you should have seen an improvement within a few days (not total resolution though) but the anxiety and other symptoms take around a month to subside. Full effect is reached by about the 3 month mark - so patience is the key. In the first few weeks you may have sore breasts, headaches, some nausea etc but as long as it's not severe you should stick with it under the guidance of a doctor.
Are you ovulating at all? You can check this by taking your temperature before getting out of bed in the morning and keep a chart. A rise in temp signals ovulation and you will be able to see how long it is lasting cause the temp will drop at the time when you would have had a period. Also some ladies have trouble getting the patches to stick properly and maybe that's what happened with you. The estrogen won't absorb if the patch isn't adhered properly. Personally I found the transdermal method the best (with ovaries) because the turmoil is caused by the constant fluctuations. Transdermal gives you a more steady constant flow. Estrace sounds like it suited you but maybe you needed a higher dose or to take it twice a day. I'm on a gel and was applying it once a day but after 3 months found I had to double the dose, so I apply it AM and PM - helped with the fluctuations. If you are young then you may need a higher dose of estrogen. I'm 43 and have upped it to 2mg and feel much better.
You need to find a doctor who is knowledgable and sympathetic - not always easy to find. Ask at your compounding pharmacist who is good with HRT, they may be able to recommend someone. Otherwise a reproductive endocrine specialist could help. I recently saw one who reassured me that I needed to up my dosage whereas everyone else was saying I was getting sufficient. If I was getting enough then why was I feeling so crummy! If you are getting PMS 2 weeks out of 4 then you are probably not making enough progesterone or the balance of est to prog is out. A higher dose of estrogen may alleviate most of your problems, it won't stop your ovaries cycling but it will even out those highs and lows. I also take vitamin B6 - started 50mg (safe dose) but RE bumped it up to 100mg cos estrogen can make it lose it's effectiveness. It really helped me with the crying bouts.
With the right help and some more endurance you will be able to find that balance. If you have any questions don't hesitate to ask - I know how frustrating this can be but you can get there.
In the meantime if you haven't already check out all the info on the Hormone Jungle Home Page (especially the dropdowns
http://www.hormonejungle.com/
You also need a full examination to rule out cysts on that ovary . A cyst can cause imbalances and that will make it harder for you. Seeing as you had endo then it would be a good idea to investigate progesterone. Most ladies here have been advised to add progesterone if they suffered endo, it discourages it's growth should they have any remaining microscopic bits left.
Having said all that there are only short term solutions for shutting down the ovary - Gnrh agonists which can only be used for 6 months and put you into a menopausal state totally. Even though I have had a lot of trouble finding a balance I still believe at the moment that you are better off kepping the remaining ovary as long as it's healthy. Removal of ovaries means HRT for the rest of your life and some ladies have problems like blood clots or breast cancer and cannot take any hormones. Even after a 'natural' menopause ovaries still dribble small amounts and they also contribute some testosterone for an undefined period. Working with what you have left is a wiser decision.

Lily,
Thanks so much for your response. I am 37 and my hysterectomy was about 4 years ago. I first tried premarin
YUK! for about 6 weeks. Then the .05 patch for 1 month, it did not seem to be enough. 1.0 patch seem like it made me over stimulated a constant nervous feeling. I was on this for about 1 year. I then tried Estrace 1mg 1x a day
which left the evenings feeling hot and more nervous. After about a year of this I finally found a Doctor that said split the dose which did help. I do seem to prefer the patch for a more even feeling but the patch seems to burn up for me within 24 hours top. I think the vivelle patch stays on fine, I just dont think it works for three days as perscribed. I know the climara patch came off to easy. The estrace pill only seems to last in my body for about 6 hours. I am afraid to add progestrone pill, creme, natural or synthetic progestin because I have heard it does cause a more depressed mood. I sure dont want to feel more gloom and doom than now. Have you found this to be true? And if so which one is worse or better? How do you know for sure that your side effects are from to much estrogen or not enough? Is there anyone that can explain the severe breast tenderness that just started a few months ago ? I have been on ERT for 3+ years now, so why now. This is also when the PMS symptoms hit me on a regular basis starting at mid month to the end of every month. I know mid month is the time I would be ovulating when I get migraines and palpitations. Not to mention the wonderful mood swings and tears. I have been told this is because this is the part of the cycle when progesterone is rising. That is why I did not know if the one ovary I had left is helping or hurting. I think possibly when the estrogen wears of to quick all I am getting is the uneven balance of the one ovary. I had never had PMS before my hysterectomy and I didnt start getting it until 3 1/2 years after surgery. Strange to me. Thanks to any great advice that you might have in this area.

Vicki,
What estrogen are you on now? It's a fine line between working out what is too much and too little. At 37 your needs for estrogen would be fairly high but with the migraines, palpitations mid month could be when your ovary is producing the most estrogen and you may be overloaded. True, that's when progesterone kicks in but the level of est is also at it's highest then. With the breast tenderness, pre hyst I was the same as you are now, and had PMS mildly in the second half. In my case it was a progesterone deficiency I think. My estrogen was very high but my progest was spasmodic. This led to the heavy bleeding, flooding and fibroids I believe. Natural progesterone as in Prometrium (oral) or a prescribed progest cream may be what you need in the second half of your cycle. Still, I'd be doing the temp method to try and find out what's really going on, it can give you clues when nothing else will. If ovulation is present but short lived then a trial on progesterone cream might be just the ticket. Have you got a compounding pharmacist near you? If so I'd speak to them they will be able to help you sort it out. Keep a diary with temps and symptoms and it will make it easier for your doctor or pharmacist. It gets very confusing and everyone is different but this can help a lot.

Lilly,
I am taking estrace 1mg a.m 1/2 at 2 p.m. & 1/2 mg at bed time. Today I went to Doctor and he said try Cenestin which is a synthetic conjugate estrogens, 1.25 2x a day.
He believes my ovary is producing to my progesterone and not enough estrogen. He also want me to try Sarafem for pms. I have never tried these. Cenestin although is synthetic is still made from plants and I was told was bio-identical. Do you or does anyone have any experience with this medicine or the Sarafem? I will keep trying to hang in there, I know the right replacement balance for me isnt far off. Thanks Again lily about the advise on the natural progestone just wandering what balance of estrogen, progesterone have you found works best for most women
any idea? I will check other things you suggested.

http://www.hormonejungle.com/estrogen.php
This will give you some info about estrogen. Cenestin is NOT bio-identical or natural, it doesn't match the estrogen our bodies make. Still, some women do well on it, some get too many side effects.
I don't know a great deal about Sarafem but it's an antidepressant and he probably wants to use it in the second half of your cycle? You could do a search on the site because I know some have used it around here. There have been some trials using Prozac 20mg( lower dose for PMS) when symptoms occur. Unlike a normal antidepressant the effects are quick (you don't have to wait 4 weeks to see relief). However it can kill your libido even at this lower dose and I posted a while ago about it and lots of women said it wasn't any substitute for hormonal balance and gave them weight gain, no libido as I have mentioned. Some even said they reacted very badly with it (the ones taking estrogen).I really think addressing the hormonal imbalance is the best way to go. Also have you tried Vitamin B6 (it helps release Serotonin in the brain) 50mg is a safe dose, but I'm now on 100mg which I'm assued should be OK. Without it I turn on the waterworks often Taking estrogen can block the absorption of B6, folic acid, magnesium (you could also try that) and zinc.
If you go to http://www.hormonejungle and read everything there it gives you a lot of info, esp. the dropdown box. Also Hystersisters store has some books which may be helpful. It's not going to be easy but if you are well informed you can make the best decisions. Have you had your progesterone levels checked several times after ovulation? If not I would, because in menopause progesterone production is usually the first to go haywire and then the estrogen is shaky because you either produced a poor quality egg or you didn't ovulate at all. That's why the temp method along with tests and symptoms is really the only way to figure out what's going on. The tests can be inacurrate without additional info because your hormones (as you have discovered are up and down and change wthin the hour). Some tests to consider are Estrogen, Progesterone, DHEA (an adrenal hormone), FSH & LH, testosterone, and sex hormone binding globulin cos if you have too much of this you may be taking hormones but not enough is available to be actively used. Maybe your best bet would be to see a reproductive endocrine specialist because of your young age you really need to sort this out properly, not just stab in the dark about what's out of whack. Good luck.