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41yrs old Surgical Menopause, need advice on HRT (endo involved) 41yrs old Surgical Menopause, need advice on HRT (endo involved)

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Unread 04-13-2011, 12:28 PM
Question - 41yrs old Surgical Menopause, need advice on HRT (endo involved) 41yrs old Surgical Menopause, need advice on HRT (endo involved)

First of all, thank you so much for this website and for all the members. Your post and advice has been so valuable to me as I go thru this recovery.

sI am 3 weeks post op. Recovery is slow, but overall doing well. This happened all of a sudden and I am just starting my research.

I had an abdominal RSO with appendicitis on March 22. My left ovaries were removed in 2005 when I had my first surgery for removal of endometrioma cysts.

My doctor suggests that I take birth control pill for the next 5-7 years until I reach the normal menopause age. Or take Estrogen patch with Pogesterone pills.

Does anyone have any advice?? Thanks so much for your valuable insight.

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Unread 04-13-2011, 06:33 PM
Re: 41yrs old in Surgical Menopause, need advice on HRT

I am assuming that you kept your uterus as you do not mention it's removal. If so, it is important to also take some sort of progesterone when taking estrogen.

P.S. If you did not have your uterus removed, please remove your surgery date as the surgery date is for a hysterectomy date.
Unread 04-13-2011, 10:11 PM
Re: 41yrs old in Surgical Menopause, need advice on HRT

I had everything removed.....uterus, cervix, right ovary & tube, inaddition the appendix as it was covered with endometrial tissue. My dr. Is wanting me to take both pogesterone & estrogen just in case there is some endometrial issue left behind it could cause an issue if I only take estrogen.
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Unread 04-14-2011, 04:17 PM
Re: 41yrs old in Surgical Menopause, need advice on HRT

Thank you for clarifying and filling in your survey. It helps us to help you better.

Estrogen can feed endo, so many doctors will prescribe progesterone or a progestin to help offset that effect.

I did not have Endo so can't speak from first hand experience. If it were me though, I would try the estrogen and progesterone first. While some women have been successful using the birth control pill after surgery, it is not the typical mode of hrt after surgical menopause.

What form/type of estrogen is your doctor suggesting?
Unread 04-14-2011, 04:53 PM
Re: 41yrs old Surgical Menopause, need advice on HRT (endo involved)

I am 42, almost 43, I had everything removed 8 weeks ago and 7 weeks ago I started Evamist...it is an estrogen topical spray that you spray onto your forearm. I love it! I haven't had menopausal symptoms or side effects yet. I also had endometriosis. My doctor said I have to stay on the estrogen until I am 50. She did not suggest progesterone. I had been on the pill since I was 17 (except to have my kids) and was trying that as therapy for fibroids and heavy bleeding and it wasn't working. I haven't ever heard of taking BC pills for post menopausal symptoms. I would get a second opinion. Sorry I couldn't help more!
Good luck...and believe me you will start feeling better in a few weeks!
Unread 04-16-2011, 12:23 AM
Re: 41yrs old Surgical Menopause, need advice on HRT (endo involved)

Thank you so much for responding Kim & Gini. Kim I was thinking the same thing, that bc pills are not the normal for menopause, but since my dr. suggested it, I thought I would explore it. My dr also wants me to take them till I reach 50, but said that even if I take it for 5-6 years it would be sufficient. I like the sound of the topical spray and will definitely speak to her about it. She suggested bc pills or an estrogen patch with progesterone pill as estrogen will feed any endo tissues left behind.

Really appreciate your input & insight. Hope you have a good weekend!!
Unread 04-16-2011, 11:40 AM
Re: 41yrs old Surgical Menopause, need advice on HRT (endo involved)

Originally Posted by A_Negi View Post
I was thinking the same thing, that bc pills are not the normal for menopause, but since my dr. suggested it, I thought I would explore it.
Actually, it isn't as unusual as you might think, especially with an endometriosis diagnosis! I am not saying it is definitely the right method for adding hormones to your system, but it is an option!

The key for you as your doctor and (((Kim))) already mentioned is not using unopposed estrogen. Estrogen is what allows endometriosis to grow and spread. Progesterone (or progestin) can help stem its growth. So using a combination of the two could allow for the benefits of the estrogen while keeping the endometriosis at bay.

You will find ladies have mixed success with using HRT with an endometriosis diagnosis. Part of it depends on how much endometriosis your surgeon was able to remove and how many estrogen receptors there are in what was missed.

My SIL had her hysterectomy and oophorectomy for endometriosis almost 20 years ago. She used ERT for most of those 20 years and is one who has done well endo wise. Other ladies find that within weeks or months the old endometriosis symptoms creep back. Others are okay for a few years. I kept my ovaries because of my age and pretty much dealt with endo issues from the time of my hysterectomy until an excision surgery seven years later. Now, even with both ovaries I am doing fine. There is simply no way to know in advance if and how much endometriosis will be a part of our future so we have to try to make decisions to keep it at bay but also take care of today.

For those of us with endometriosis, we have to weigh the risks of continued endometriosis issues with the risks of no or low estrogen. No two of us will make the same decision as we will have different overall and family medical histories.

Getting a second opinion is not a bad idea, especially if you are not comfortable with your doctor's plan. You could also make an appointment to sit down and talk to your doctor (when I want to do this I schedule a consultation appointment). Ask why she prefers one choice over the other and what the benefits/risks of each choice might be.

Keep in mind, many ladies find they have to try a variety of different hormones to find what works for them. While one lady may find sprays are successful, that delivery method may not absorb for another. Creams might work for another, pills for her neighbor. Others do very well with patches. HRT is not one size fits all and having endo in the mix so that you need to start with a combination of two hormones could make your situation even more complex. Just remember, patients and perseverance is what wins the race!

My goes out to you and I hope you can work with a doctor knowledgeable regarding both endometriosis and hormones so you can feel your best while keeping endometriosis at bay!

Unread 04-17-2011, 09:52 PM
Angry - 41yrs old Surgical Menopause, need advice on HRT (endo involved) Re: 41yrs old Surgical Menopause, need advice on HRT (endo involved)

I'm so confused and frustrated. Everything was removed due to stage IV endo, ando and fibroids and the dr recommended no estrogen - only progesterone if I really needed it - so currently, no HRT. Because of a secondary issue, my menopause issues weren't clear at 6 wk appt. But by week 8, it was very obvious that I was having hot flashes, night sweats, insomnia, mood swings, fuzzy thinking and very emotional. When I tried to make another appt, the dr was booked for 2 months!

I'm trying to handle it but its making me crazy and very frustrated. And now I read that I could probably have something to help! Ugggghhh!
Unread 04-18-2011, 10:31 AM
Re: 41yrs old Surgical Menopause, need advice on HRT (endo involved)

I would call my doctor back and explain that you really really need a sooner appointment, im 1o weeks post op, just turned 43, the estrace pills made my body hurt all over and my feet swell, tried the vivel dot patches, felt as if I had the flu, finally changed to estro-gel that you rub on your arm last week, so far so good, althought I must say I have never had one hot flash or night sweat on any of the meds, doctor says I may be a lucky one that doesnt really need HRT, but im using the lowest dose to prevent bone loss, and my breast do get a little tender if Im not taking something. Hope it helps its really hard to know what the right thing is for you, but you will know if its not right, your body will tell you loud and clear..Good luck.
Unread 04-18-2011, 01:42 PM
Re: 41yrs old Surgical Menopause, need advice on HRT (endo involved)

Thanks for listening and the advice but I've call the dr's office three times so another call isn't going to help. My appt is next week so I think I'll make it now.

Glad to hear that maybe you've found something that will work for you. Good Luck!

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