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estrogen after hyst and bso for endo??? estrogen after hyst and bso for endo???

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Unread 01-28-2008, 08:12 PM
estrogen after hyst and bso for endo???

Hi Ladies-

I've read lots of posts about women with endo not taking HRT for a period of time after my BSO surgery last week.

My doc had me start on the vivelle dot 1.0 the day i had my surgery. I have a long history of endo that has grown back even after my hyst. in 2006.

Does anyone have any data on all of this? I'm concerned b/c I don't want my endo to return BUT i also suffered from severe PMDD and had horrible hormone fluctuations, insomnia, bouts of anger, acne, et cetera all month long.

I think my doc. was probably more concerned about my PMDD than my endo, though i'm just guessing. They both are problematic. I don't want my endo to regrow but i also can't handle menopause symptoms.

For those of you who have endo and have been taking hormones since your surgery, how are you?

I thought i might reduce my HRT from 1.0 to .75 to see if that helps.

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Unread 01-29-2008, 12:01 AM
estrogen after hyst and bso for endo???

For specifics, we have several Endometriosis Resources.

I am not pointing you to specific resources as there are many theories regarding endometriosis. Not all doctor agree as to where endometriosis comes from or how to treat it. Part of your treatment involves the opinions and knowledge of your doctor along with your specific circumstances. The skill of your surgeon plays a big part.

Case in point, Me! It was best for me to retain both of my ovaries even though this meant any endometriosis left behind could be fueled by my own estrogen. And endometriosis had been knowingly left behind as my GYN did not have the skill to remove some of it. But we had to weigh all the pros and cons for me and make the best decision for me. I did recently have a laparoscopy with an endometriosis specialist but I am on the right track for me.

My guess is that you are correct -- your doctor is more concerned with the PMDD issues rather than the endometriosis. I don't believe your doctor is discounting how important the endometriosis is, but s/he is trying to treat the symptom that are affecting you the most and are which occur on a more consistent basis.

Also, it may be that your doctor feels that his/her skills were sufficent to remove all the endometriosis from your body and does not feel that endometriosis will be an issue in the future. Since there is no cure for endometriosis (other than what is removed is gone but microscopic stuff can go undetected), only time will tell.

I would suggest keeping a journal regarding all of your symptoms and how you are feeling. Make notes regarding any changes you notice -- more irritabilty, more tiredness, change in appetite, libido issues, diet changes, and the dose of HRT along with any viatmins and supplements you may be taking. Sharing all of all this can be helpful for you and your doctor. I would suggest that you not adjust your hormone doses frequently, and not without talking to your doctor, as it can take time to really notice if they are workig or not. HRT involves a lot of patients and trial and error. You may also need to use progesterone along with any estrogen to help prevent endometriosis recurrence.

If at all possible, I would suggest working with a doctor who is very knowledgeable regarding both endometriosis and hormones. This may not be your surgeon or even your current GYN or GP. Many women have found that post hysterectomy and post oophorectomy they have needed to find a doctor was more knowledgeable regarding HRT. If there happens to be an endometriosis specialist in your are, that might be a good start. Other suggestions for doctors would include a reproductive endocrinologist or one connected with a compounding pharmacy.

In the end we each have to do what is best for us. The more we know about our medical conditions, in this case endometriosis and PMDD, the more we know about hormones and how they affect and benefit our overall health, the better decisions we each can make for us!

I would suggest talking to your doctor about your concerns before adjusting your HRT. Also ask if there are other options for treating the PMDD ouside of estrogen replacement (ERT). Some women have success with the use of anti-depressants.

Since I have my ovaries I have had ups and downs and I did just have a laparoscopy for endometriosis excision and lysis of adhesions. But we still feel keeping my ovaries was and is right for me. I do know that a BSO could be in my future.

Keep an open line of communication with your doctor(s) and keep your GP involved. A GP can look at things from a different perspective and offer different thoughts and insights. A GP can also help refer you to the specialists who can help you better!

I wish you all the best and hope you find answers and support here on the site for you situation. If you need it, we do have an Endometriosis Support forum where there are women dealing with endometriosis both pre and post hysterectomy.

Many best wish to you as you wede through the Hormonal Jungle. Do be aware that not all women understand endometriois so their advice might not be appropriate for your situation. And do keep searching for what is right for you! HRT involves a lot of trial and error so give it some! S
Unread 01-29-2008, 09:30 AM
estrogen after hyst and bso for endo???

Thank you!! A absolutely agree with everything you said and I appreciate you taking the time to write back. I'll keep you all posted.

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