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So confused about HRT after TAH for endometriosis So confused about HRT after TAH for endometriosis

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  #1  
Unread 03-27-2009, 04:04 PM
So confused about HRT after TAH for endometriosis

I am almost five weeks post-op after TAH for endometriosis that was attached to and permeating my bowel.

I am starting to have menopause symptoms. The hot flashes aren't bad but I haven't slept all week and I cry at the drop of a hat. I am supposed to go back to work next week but don't see how in the state I'm in.

I go to Dr. on Monday and we've briefly discussed estrogen. He insists that endometriosis feeds on estrogen BUT it is the surge of estrogen/progesterin each month during your cycle that causes it to grow. He thinks it is completely safe for me to take a low dose of estrogen since I am only 40 and he doesn't want me suffering through all this.

Everything I read is so confusing though. The studies seem to contradict each other. Some studies say lack of estrogen increases heart disease risk, some say it doesn't, etc.
On the afternoon news they just said a woman who has her ovaries removed and does not take HRT is 40 percent more likely to die from "any cause". That was it. So, apparently now I'm 40 percent more likely to get hit by a bus!?

This is all making me incredibly anxious...or is that just another menopause symptom, lol. I officially give up.

Laura
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  #2  
Unread 03-27-2009, 04:56 PM
Re: So confused about HRT after TAH for endometriosis

I am 41 and had a total on Feb 17 for the same reason and still recovering....not sure when I can go back to work either....still very sore and have good pain tolorence but I am sore all the time....I go on Monday to my doc too....hope that I havent done something bad...I threw up about 3 weeks or so ago and I think something happened then and sneezing killed me too.....I am on estrogen since the first day after surg....and still have hot flashes and night sweats....I hope to have everything answered on Monday...will let you know
  #3  
Unread 03-27-2009, 05:12 PM
Re: So confused about HRT after TAH for endometriosis

((izallgood))

It is confusing! Endometriosis itself is confusing without the hormone issues! Let me see if I can help you a bit!

First, I want to be very clear that I have both of my ovaries so at this time I have no need for HRT. I have both a GYN and an endometriosis specialist. Both of them felt that in my situation retaining my ovaries and thus my own hormones was better for me than any of the alternatives. This means that I am likely going to have far more estrogen than you will ever have using HRT. Of course, I will also have progesterone along with my estrogen.

Here are some of the thoughts that I have ran across. If all of the endo was skillfully and expertly removed during surgery, you are at less risk of endometriosis recurrence and thus estrogen shouldn't be a problem. However, any bit of endo that was missed can grow and spread. Not all of our surgeons have the same skills and until there is recurrence it will be hard to know just how skilled your surgeon was in your case!

One thing to keep in mind, tt can be very hard to be 100% estrogen free! For one, our bodies can continue to make estrogen by converting dietary cholesterol to progesterone, then to testosterone and then on to estrogen. Fat cells can produce estrogen. There is some belief that plant estrogen such as in foods and supplements (soy, black cohosh) can be an issue with endo. To top it off, endo itself has been known to create its own supply of estrogen!

Estrogen can be very important to our overall health as you have read. While some ladies do well without any estrogen replacement, others notice problems with their hearts, bones, eyes, skin, and the list goes on! Throw in surgical menopause and not using estrogen replacement can not only cause health concerns but you can be miserable!

What we each need to do is determine what is best for us. We have to weigh our own pros and cons based on our own overall health, family health history, age, symptoms, etc. We will not all make the same choices, nor should we. We are all unique individuals with different needs and situations!

Since you are not sure what is right for you, I would suggest at least a second opinion regarding endometriosis and HRT. Possibly there is an endocrinologist in your area who treats women with endometriosis and who could offer you some help. If there is an endometriosis specialist in your area that would be a great place to start!

If you do decide to use estrogen replacement you will likely want to try to use the lowest dose possible just to help reduce your chances of endo recurrence. You may also want to ask your prescribing physician if you should also use some form of progesterone as it can help prevent the estrogen from fueling any endometriosis.

There are ladies here on the site with endo who use HRT. There are ladies here with endo who do not use HRT. And others of us have our ovaries. There is no simple "one size fits all" answer! Additionally, different doctors have varying opinions on the topic of endo and hormones!

I wish you all the very best as you work with your doctors to determine what is going to be right for you!
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