When to start Premarin after TAH/BSO?

I had a TAH/BSO w/appendectomy (ready to rupture) June 30,08. Before leaving the hospital I had a Provera injection. I went for my 6 week appointment and had a prescription for Premarin (estrogen only). I can't remember whether she said start it three months from the surgery date or three months after my six week appt. I tried to call the DR but she was on vacation. I haven't slept normal since surgery (lucky to get 4-6 hours) and have mild to moderate hot flashes. Dr said that would get worse once the Provera was running out. She is more concerned about ORS (ovarian remnant syndrome) which I am clueless about. I know estrogen shouldn't be taken to soon after surgery because it helps the endometriosis grow.

Any suggestions/advice appreciated :-)

Brenda
34 yrs.

You need to talk to your doctor about when she wants you to start the Premarin. All doctors have different orders. Some have patients start it right away figuring that if there is endo left behind it is going to grow no matter when you start the Premarin and/or your overall health indicates that the pros of taking the estrogen outweigh the cons. Some doctors feel that if you use something such as Provera then the remaining endo will dry up and then when you start the estrogen you will be fine. Others want a space of time no matter what before you start any estrogen hoping that any remaining endo will dry up. So, there is no perfect answer here as it all depends on you and your doctor. Who is on call for your doctor? Can s/he help you? Can your doctor's nurse look and see what your doctor noted in your file about starting the Premarin?

The issue with ORS is that if a tiny bit of ovarian tissue remains it can produce hormones which can then feed endo. If you have ORS and are taking Premarin then you could definitely have an issue with too much estrogen.

You may want to also talk to your doctor about taking progesterone along with the Premarin as the progesterone can help keep any remaining endo from growing.

Best wishes to you! s