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A question for younger sisters A question for younger sisters

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Unread 01-25-2004, 01:31 PM
A question for younger sisters

Have any of you who have had or have been informed about the process tell me if they will start a HRT the day of the surgery?

The reason I ask is cause I have been told about the hormones dropping from full to nothing and I am scared of the changes that might go on right away. I am only 18 so I figured they would wanna do a HRT. My surgery is this thursday and I will try to remember to ask my doctor tomorrow at the pr-op aptt. but I was just wondering what they did for others in my place.

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Unread 01-25-2004, 04:42 PM
A question for younger sisters

I haven't seen this mentioned anywhere, and kept thinking I'd ask if anyone else had experienced it.

I'm 50, so my situation is different from yours, of course! I asked my doctor about HRT before I got out of the hospital (I had my ovaries removed when he did my hysterectomy), and he said that he had given me an "injection," so I didn't need to worry about HRT "for awhile." I asked him again at my one-week post-op appointment, and he said that the hormone injection would last for about three weeks, then my hormone level would start dropping off and I would start on estrogen at that time.

He said I had several options--a patch, pills, or a new thing, a kind of rubber ring that you put into your vagina and replace it after a certain period of time (a month?). He said his wife uses the ring, and he showed me one.

I said I was already comfortable with taking pills (I had been on HRT for a couple of years already), so he said I should just start back on my estrogen (Cenestin) three weeks from the of my surgery.

I had never heard of a hormone injection, and thought that was interesting.

I'm so sorry you have to go through this at such a young age, but I'm sure you'll do fine. I had my surgery two weeks ago, and I feel great now. I'm starting back to work tomorrow.

Unread 01-25-2004, 04:45 PM
A question for younger sisters

Hi Crystal -- I'm 31, not quite as young as you. I was told that I'll get a patch the day after my surgery. Later on, when we're gauging my hormone level, I can decide if I want to keep using a patch or go to oral pill HRT. I'm having a TAH/BSO, with my tubes and cervix removed -- I guess you're going to have both ovaries removed as well, since you're worried about having no hormones.

Something that I did that helped during my pre-op was to take a big legal pad and write down all of my questions beforehand, and left a big space under each ques. so that I could take notes on what my gyn told me.

Good luck with your surgery -- if you need to ask any other questions or just need to talk, we're all here!
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Unread 01-25-2004, 08:43 PM
A question for younger sisters


I am 38 and 4 mo. post op. I had a TAH/BSO and the patch was slapped on the day after my surgery. Some wake up in recovery with thier's while others don't start for a few weeks. Pretty much it is up to each doc and patient, don't be afraid to talk to you doc, honesty and openess are very important especially at a time like this.


Unread 01-25-2004, 09:27 PM
A question for younger sisters

You didn't say if they are leaving you ovaries or not. I am 27 and 4 months post op and I still have my ovaries and have never been on HRT. I'm not a dr but I would think that they would only put you on HRT if you did not have your ovaries. Just because you have a hyster does not mean that they take your ovaries unless there is a problem with them as well.
Unread 01-26-2004, 03:55 AM
A question for younger sisters

Hi Crystal Gosh you are so young to have to go through this surgery

I see from your signature that you have endo... endo is fed by estrogen, so many DRs will not allow their endo patients to have HRT for a time after surgery (weeks.... months... they all have their opinions on what works best). You definitely need to discuss this at your pre op with your DR... the last thing you need is a surprise after it's too late to turn back.

As far as the onset of symptoms goes, it varies a lot by individual. Women store estrogen in fat cells, so those of us who are 'fluffy' may have more stored estrogen than those who are very thin. Some women wake up from surgery already having hot flashes (I was one of those), and others may go several days or even weeks before starting to have them. And a few lucky gals don't have them at all!

Given your age, I would hope that if your DR does not start you on HRT right away, he/she has a plan for handling your symptoms. Please make sure to quiz him/her thoroughly about what your options are, OK? And let us know?

Good luck with your surgery, I'll look for you over in Post Op!
Unread 01-26-2004, 05:20 AM
A question for younger sisters

Hi Crystal

You poor thing having to go through all of this at 18! I am 33 and having TAH on 29th Jan for endo.

I have been told that I must wait (if possible) 6 months before having HRT because endo is estrogen fed so if you have HRT straight away the cycle of endo will continue and you will be no better off.

I will keep you in my thoughts and pray that your surgery is successful.

Unread 01-26-2004, 10:15 AM
A question for younger sisters


Like you, I've had severe endo since I was 18; had my first laparoscopy (one of the first done at that particular hospital, thirty years ago) for severe, unrelenting pelvic pain. In those days, there was no real understanding of endo, and if a hyst had been offered me at that point, I would have jumped at the chance -- anything to end that pain.

I went on to various kinds of treatment (including months of antibiotics, thinking that some infection was causing the problem) but finally found some small measure of relief with BCPs. Twenty-eight years later, I finally had my hyst -- and it turned out to be for endo, though it didn't look like it at the time.

We have had a couple of younger ladies around here; take a look, particularly, for posts by cg_bubbles. She was 19 when she had her surgery, and wrote quite eloquently about the particular problems that you younger endo sisters share.

Was your endo and adeno proven by laparoscopy? Whenever I see a story like yours, I worry that you've not been given options to attempt to delay what may wind up being inevitable. Losing your ovaries early has far more implications than just hot flashes. Bone density, in particular, is critical, especially at your age when you are still producing new bone mass. I also find myself quite uncomfortable reading your post, since it would appear that your doctors (you did get a second or even third opinion, didn't you???) haven't really discussed the implications of surgical menopause at your age. Although I wouldn't necessarily urge you to cancel, if you should have any questions about what the surgery means for you, or what your doctor plans for you, it is NOT too late. You have the right to make sure that this is the right path for you, as it cannot be undone. Sometimes, a hyst can lead to more trouble, unfortunately.

If you do have adeno, it is true that only a hyst will resolve it. I won't say you're too young for adeno, but it is uncommon at your age. Some women have been able to have pain mapping or laser excision procedures, which don't lead to the profound lifelong changes that surgical menopause does, and can buy you some time to really research the whole thing.

I know that you probably are feeling that it's impossible to postpone, or to cancel, but it's not. We have had ladies who cancelled on the day of surgery -- it's not unheard of. We find, around here, that the women who have the best outcomes are the ladies who really did their homework and were sure that there was no other option -- having tried all the options available to them. The ones who felt pressured by their doctors and/or families to have the surgery ("the hyst will solve everything for you, dear") seem to have a harder time of the process. The change IS profound, and although it may be still the only option you have left (as it was for Candida, the young woman I referred to earlier), you would have that assurance that you'd tried EVERYTHING first.

As far as "HRT" goes: most of us with endo have spent some time off estrogen, but have been able to use other types of hormone replacement. Progesterone (such as Prometrium, which is made of the same molecule your body makes) helps suppress any remaining endo for many of us -- part of the plan for your hyst should be to excise or remove ANY endo that is found, wherever it is, but there's always "scraps" left behind. Many of us also take testosterone; it's also a hormone manufactured in your ovaries (not as much as the guys but enough to impact strength and energy levels). These are hormones that can make the transition easier.

Those of us with endo often have too much estrogen prior to surgery -- that's what helps the endo to flourish. I'm not particularly "fluffy" (at least, I hope that extra 8 lbs doesn't count ), but it was still a good six weeks before my menopausal symptoms really kicked in. I am very glad that my doctor waited until my symptoms began before adding anything other than the Prometrium into my mix. I should also mention that I do use a small dose of vaginal estrogen to keep those tissues healthy; it doesn't pass into the bloodstream for most of us, and nearly all of us seem to need some sort of vaginal treatment to keep those tissues healthy.

You have a lot of thinking, reading, and, if you're so inclined, ing to do in these 24 hours. If it's the right choice for you, then good luck tomorrow. But if you have ANY questions, remember that it's forever, having a hyst. Make sure, in your heart, that it's the right choice for YOU, not just what everyone else is urging you to do. If it just doesn't feel right, PLEASE find the strength if you need to cancel. You can always re-schedule (after all, if you had a cold, the flu, or an allergic reaction -- like I did -- it would be postponed anyway). But you can't "take it back" post-op.

I'm sorry if I've opened a can of worms for you. But I had my surgery at a much older age, and developed osteoporosis in the first year post-op due to lack of estrogen. They don't call it the "change of life" for nothing! It's just as profound a change as the puberty you so recently went through, and if laparoscopic surgery, Lupron, or other means can buy you some time -- to develop bone, to wait for some improved endo treatment, whatever -- then I would urge you to consider waiting and continuing to research.

If there truly is no choice, then I wish you the best of luck for a safe surgery, and easy recovery. You MUST take care of yourself post-op -- don't let the people around you pressure you into activity before you're ready. EARLY recovery takes at least 6 to 8 weeks -- and FULL recovery can take as much as a year (it did for me).

My thoughts and prayers are with you,

Unread 01-26-2004, 01:19 PM
A question for younger sisters

I had my surgery 10-15-03 right before my 32 b-day, complete hysterectomy. My hormone levels were terribly imbalanced cause my ovaries were a mess as well as my uterus, and I had adeno, Cin III stage dysplaysia, and nothing made sense to me. My Dr. really didn't know what was wrong with me until he did the surgery and seen it. But I had bad hot flashes and sweating within a day of my surgery. Some women have enough estrogen in their system to carry them over but I didn't. After I got home I called my Dr. and he called me in some Premarin .625 mg, I have been doing very well with it too. In my opinion I would have your Dr. order some estrogen for you so that you have it IF you need it, you will know if you need it believe me so talk to your Dr. about it. Some women can handle the effects of surgical menopause (and even natural menopause) and just deal with it but I couldn't, I couldn't sleep and it felt like my skin was burning. Premarin is a common form of estrogen replacement therapy and .625 mg is basically a standard dosage but every woman is different and you might need more or less or a different kind but it works for me so far. Some women need Progesterone or testosterone as well, without my uterus I don't see the point of taking Progesterone but there is another side to that too so if you get into the "hormone jungle" you can read about it. Testosterone can help your sex drive - mine is null but I'm still sore in the lower abdomin so I'm just giving myself time. Just remember every woman is different and you have to listen to your body. Did you get the "Land of Hyster" book? It helped me alot. Don't expect alot right away from yourself, it takes time to heal and you have to allow yourself that time, and alot of rest and fluids. And this may get off your subject but look into your pain medication control after surgery. Sometimes the anesthesiologist will inject medicine into your spine to carry over for your pain right after surgery for when you wake up. It didn't work with me, I got very very nauseated and the pain was there when I came to, so was the nausea. Then they'll give you ivy medication - some of it can make you sick to your stomach. Vomiting with staples does not feel good. So be aware of that, as soon as you can eat ice chips and try to get some saltine crackers in your stomach, when my stomach felt better I switched to oral meds. Don't drink 7up or any pop! You will be filled with gas and it is important that you don't drink anything that can give you gas bubbles. When you feel comfortable to drink something other than water try juice, your goal is to have a bowel movement so remember the fiberous foods so that those bm's will be soft, you don't want to try to push. And though your not going to want to, let them get you up and walk you around, it'll help the gas move out and I promise it will make it easier for you. A nice hot shower feels good too. Think about who you want to be there in your hospital room when you wake up, your going to be hurting and not in the mood to socialize and though family and friends are there for you out of love and concern you may not want them to see you right then and there. I woke up to a room full of people - not a good idea at all. Sorry to carry on but those are the things that I was not prepared for. I can tell you now that I don't regret the hyst, it was the best thing I could have done for my health and it saved my life.
Hang in there, it'll be okay.
Unread 01-26-2004, 02:39 PM
A question for younger sisters

I had a LAVH/BSO for adneo and endo on 12/5. Due to the fact that endo thrives on estrogen my doctor has recommened that I go without hormones for 6 months to make sure the endo dies off/dries up.

I've seen several posts on the boards about women having laps for endo years after their hysts. Since I had 2 laps for endo prior to my hyst I don't want to go through that again.

Talk to your doctor about this. Some doctors agree with the no HRT and some think that it doesn't do any good. Me? I'm not taking any chances of th endo coming back.

I do have the menopause symptoms that I'm learning to live with - hot flashes, night sweats, insominia - but it's nothing compared to what I went through with the endo.

BTW - I'm 33.

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