Talk hormone replacement to me?

[Brittany1116]

Short story:

Mid-30s. I had hysterectomy late April, and kept ovaries. Dr is talking about possible hormone replacement/aid/supplementation at 4 month mark. She gave me progesterone to take now, but I haven't started yet. I don't know that I want/need to? I feel mostly stable, although I did have a noticeable shift in mood, skin, and weight at precisely day 14 post-op.

Where do I start reading to educate myself before committing to anything? I am known for following rabbit trails and having analysis paralysis, but I also don't want to just take something because it's offered. 

[scholastica]

I have been on progesterone support since my mid-20s. It’s been nothing but good for me. My mom had a hysterectomy mid-30s and needed estrogen replacement through menopause. I am now in menopause and my doctor has me on an estrogen patch and progesterone too. I have zero menopause symptoms, mood is stable and I sleep. You can try the hormones and always quit if they have unpleasant side effects. You should ask your doctor about your individual risk/benefit. She is best equipped to know what you should do.

[KungFuPanda]

A friend recommended reading Estrogen Matters recently. She’s a molecular biologist, but insists it’s not too much for the average reader. It’s on my list, but I haven’t gotten to it yet. 

[busymama7]

Please stick to only bioidentical.  Synthetic hormones are the ones associated with increase risk do certain cancers.   Replace based on what your blood work shows is needed although taking progesterone is extremely safe and you really can't take too much.   It changed my life. We call it my happy pills.  

 

[MEmama]

Why is HRT being suggested?

It can take several months after a hysterectomy for the ovaries to stabilize. Personally I’d be leery of starting hormones this soon, unless they've clearly quit or you’re suffering, which it doesn’t sound like you are. Have you had your hormones tested?
 

Weight gain and mood changes are often simply the result of getting less exercise (and eating more) during recovery, which you’re still very much in. I had a short lived skin thing shortly after surgery too, but it sorted itself out after a couple of weeks. It’s quite common. 

[KidsHappen]

I use a bioidentical estrogen suppository and a bioidentical estrogen/progesterone/testosterone cream that is specially made for me by a compounding pharmacy. It was prescribed by my PCP. They tested my hormone levels to know what I needed and it works great for me. I feel better than I did before I went through menopause. Sometimes I will forget to use it for a few days and I will get hot flashes.

[Scarlett]

1 hour ago, MEmama said:

Why is HRT being suggested?

It can take several months after a hysterectomy for the ovaries to stabilize. Personally I’d be leery of starting hormones this soon, unless they've clearly quit or you’re suffering, which it doesn’t sound like you are. Have you had your hormones tested?
 

Weight gain and mood changes are often simply the result of getting less exercise (and eating more) during recovery, which you’re still very much in. I had a short lived skin thing shortly after surgery too, but it sorted itself out after a couple of weeks. It’s quite common. 

That is my question too. 

My mom had estrogen positive (is that the correct term?) breast cancer and her cancer doctor told her to avoid ANY types of estrogen even the natural ones.  But that may only be because she actually developed cancer. 

[TexasProud]

41 minutes ago, Scarlett said:

That is my question too. 

My mom had estrogen positive (is that the correct term?) breast cancer and her cancer doctor told her to avoid ANY types of estrogen even the natural ones.  But that may only be because she actually developed cancer. 

Yep, that is my mom as well and yeah, I am not on any hormones for menopause. 

Side note: Scarlett make sure your mom is getting blood work with cancer markers.  My mom battled breast cancer twice.  Both times, really small and easily treated (1998, 2008). She has gotten regular blood work checkups and mammograms faithfully.  She had stomach pain and went to the ER and she has masses in her liver and it is in every bone in her body.  Nothing in her breasts, but it is breast cancer. Her cancer marker bloodwork was REALLY high.  So... just FYI, mammograms and regular check-ups don't catch it all, which I thought it would. 

[Scarlett]

37 minutes ago, TexasProud said:

Yep, that is my mom as well and yeah, I am not on any hormones for menopause. 

Side note: Scarlett make sure your mom is getting blood work with cancer markers.  My mom battled breast cancer twice.  Both times, really small and easily treated (1998, 2008). She has gotten regular blood work checkups and mammograms faithfully.  She had stomach pain and went to the ER and she has masses in her liver and it is in every bone in her body.  Nothing in her breasts, but it is breast cancer. Her cancer marker bloodwork was REALLY high.  So... just FYI, mammograms and regular check-ups don't catch it all, which I thought it would. 

She is 18 years past her final treatment.  I don’t think she is still under the care of her oncologist.  I know she gets blood work but I don’t know if they are checking for cancer markers…..hmm I will have to bring it up.  

[TexasProud]

2 minutes ago, Scarlett said:

She is 18 years past her final treatment.  I don’t think she is still under the care of her oncologist.  I know she gets blood work but I don’t know if they are checking for cancer markers…..hmm I will have to bring it up.  

Please do. My mom isn't under the care of her oncologist either and I am guessing, when she got released in 2013 or so that maybe these type of blood tests didn't exist.  We just don't understand how we did everything we thought she should do and still she ended up with stage IV cancer everywhere in her body. ( Her regular blood work she got every year looked fine.) 

[livetoread]

https://www.mayoclinic.org/diseases-conditions/menopause/expert-answers/bioidentical-hormones/faq-20058460

I don't think the current research consensus supports the idea that bioidentical are safer or better, but like always, individual people do better on certain things than others. 

[KSera]

2 hours ago, Scarlett said:

That is my question too. 

My mom had estrogen positive (is that the correct term?) breast cancer and her cancer doctor told her to avoid ANY types of estrogen even the natural ones.  But that may only be because she actually developed cancer. 

Apparently if you still have ovaries, taking progesterone can help keep estrogen in better balance and reduces cancer risk from estrogen related cancers. And many people say they have a mood benefit as well. 

[Brittany1116]

I got zero notifications on this and had to search for it when I remembered I asked here. Thanks for your replies.

I honestly have no clue why she gave me progesterone. I was told a blood check at 6 weeks. That didn't happen. They scheduled one for early August. Meanwhile, my endocrinologist is waiting for results to possibly tweak my Rx. I had my PCP do a panel when I saw her for a check-up. I don't have numbers because I am waiting on the email but got a phone call that "all was normal and there were no signs of menopause".

I just hit the 3 month mark this week. I gained 4 pounds in the last 2 weeks. I am in PT for some related pain and bladder issues. I am wondering if I need to see someone more specialized about the hormones before I decide to use any at all. My GYN retires next month and the one who did the surgery seems pretty hands-off. 

Basically I am glad I am not bleeding profusely but I have a new host of issues to sort now. 

[Selkie]

Do you still have your ovaries? I had a hysterectomy last year at age 52 (kept ovaries) and my doctor didn’t even mention hormone replacement. I’ve been feeling great, though - no problems at all, no menopause symptoms, and I’ve lost several pounds since the surgery. Maybe hormone replacement is more necessary or beneficial for younger women who’ve had hysterectomies? Hope you can get it all figured out, and that you feel better soon.

[Brittany1116]

3 minutes ago, Selkie said:

Do you still have your ovaries? I had a hysterectomy last year at age 52 (kept ovaries) and my doctor didn’t even mention hormone replacement. I’ve been feeling great, though - no problems at all, no menopause symptoms, and I’ve lost several pounds since the surgery. Maybe hormone replacement is more necessary or beneficial for younger women who’ve had hysterectomies? Hope you can get it all figured out, and that you feel better soon.

Yes, I kept both ovaries. I am 36. My weight was originally down 8#, then leveled out to down 3-4# from preop. I am now over preop weight despite working out again. Thank you for well wishes.

[MEmama]

I’m still not clear why hormones are being considered?

I would definitely get a second opinion before going down that road. Gaining a few pounds doesn’t in of itself suggest an imbalance. 

[Brittany1116]

2 hours ago, MEmama said:

I’m still not clear why hormones are being considered?

I would definitely get a second opinion before going down that road. Gaining a few pounds doesn’t in of itself suggest an imbalance. 

The Dr who did it said patients usually take several months to level out and she replaces/supplements for them. I was under the impression this was around the 6 week check, and that the beginning would be the most wonky. A friend who had one 5 years ago said her Dr supplements everyone, so it that kind of supported in my mind what my Dr said. 

The weight thing is usually my first sign things are off. I just about never fluctuate. Every time I have had noticeable weight gain, my thyroid or hormones have been off. Unfortunately, they didn't check thyroid at the same time with last draw.

[MEmama]

21 minutes ago, Brittany1116 said:

The Dr who did it said patients usually take several months to level out and she replaces/supplements for them. I was under the impression this was around the 6 week check, and that the beginning would be the most wonky. A friend who had one 5 years ago said her Dr supplements everyone, so it that kind of supported in my mind what my Dr said. 

The weight thing is usually my first sign things are off. I just about never fluctuate. Every time I have had noticeable weight gain, my thyroid or hormones have been off. Unfortunately, they didn't check thyroid at the same time with last draw.

Interesting. I’ve never even heard of a doctor proactively suggesting hormones; I’m not against them in any way if they are warranted, but I’d be extremely leery of taking them if they aren’t absolutely necessary. YMMV of course.

Since you’ve had thyroid issues in the past, I’d start with thyroid testing as well as hormones and take it from there. 

[Soror]

I don't have personal experience but have done some reading and following along with menopause/perimenopause information.

Here is a nifty infographic from British Menopause Society that lays out breast cancer risk irt to hrt, bcp, obesity, exercise etc.

I used to be quite paranoid about it but will be keeping it in mind depending on how menopause goes for me. I already have issues with hormonal related insomnia and easily gain weight with hormone shifts. 

 

WHC-UnderstandingRisksofBreastCancer-MARCH2017.pdf

[regentrude]

Can someone please explain why HRT would be needed if only the uterus was removed? I thought the *ovaries* produce the hormones? Thanks.

[MEmama]

1 minute ago, regentrude said:

Can someone please explain why HRT would be needed if only the uterus was removed? I thought the *ovaries* produce the hormones? Thanks.

Ovaries can go wonky and even shut down entirely after a hysterectomy; although it isn’t common, it is a minor risk. It is not uncommon to experience some hormonal fluctuations in the months following a hysterectomy as they adjust (similar to period symptoms but less predictable— moodiness, acne, and so forth). It typically settles down after a time. 
 

Why hormones would be blanket prescribed is a mystery to me though. OP did mention her gyno is retiring, so perhaps it’s old fashioned advise? 

[Brittany1116]

My GYN isn't yet 60. She was a school teacher for a while, and medicine was her second act. I am unsure why she is retiring. I have no idea why my friend's Dr prescribes it to everyone. 

I am frustrated that I am probably going to have to find a new Dr since one is gone, and one doesn't give me any info. I am still waiting on the hormone numbers to be emailed. I know enough to know "in range" does not equal optimal, but I don't know much more beyond that. 

[Brittany1116]

50 minutes ago, MEmama said:

Ovaries can go wonky and even shut down entirely after a hysterectomy; although it isn’t common, it is a minor risk. It is not uncommon to experience some hormonal fluctuations in the months following a hysterectomy as they adjust (similar to period symptoms but less predictable— moodiness, acne, and so forth). 

My aunt's ovaries failed after a few months and she had a second surgery.

[MEmama]

13 minutes ago, Brittany1116 said:

My aunt's ovaries failed after a few months and she had a second surgery.

I’m curious what the second surgery was for? AFAIK there’s no bringing ovaries back to life (hence HRT) if they do fail.

[KSera]

Any chance the hysterectomy was due to endometriosis? Progesterone might be prescribed in that case to help prevent estrogen dominance causing continued growth of endometriosis on the remaining structures. I do see that bio identical progesterone is recommended by lots of natural medicine kind of places after ovary sparing hysterectomy

16 minutes ago, Brittany1116 said:

My aunt's ovaries failed after a few months and she had a second surgery.

I did not know this was a thing. Was she older and nearing menopause anyway, or did this happen when she was young?

[Pawz4me]

FWIW--I had a partial hysterectomy (kept ovaries) when I was 41. Because I'd kept my ovaries no mention was made at that time about HRT. I felt perfectly normal after my hysterectomy, the most normal I'd felt in years. It was only in my later 40's, when I started having significant peri-menopause symptoms, that HRT was ever discussed. 

Good luck getting things figured out.

[Brittany1116]

39 minutes ago, MEmama said:

I’m curious what the second surgery was for? AFAIK there’s no bringing ovaries back to life (hence HRT) if they do fail.

They removed them. 

37 minutes ago, KSera said:

Any chance the hysterectomy was due to endometriosis? Progesterone might be prescribed in that case to help prevent estrogen dominance causing continued growth of endometriosis on the remaining structures. I do see that bio identical progesterone is recommended by lots of natural medicine kind of places after ovary sparing hysterectomy

I did not know this was a thing. Was she older and nearing menopause anyway, or did this happen when she was young?

Mine was for adenomyosis and extreme periods, but they found diffuse endometriosis during. 

Hers was younger than mine. I think she was 32. 

[MEmama]

2 hours ago, Brittany1116 said:

They removed them. 

Mine was for adenomyosis and extreme periods, but they found diffuse endometriosis during. 

Hers was younger than mine. I think she was 32. 

I’m curious why she would have non functioning ovaries removed? 
 

Endo might make sense for taking hormones, as a PP mentioned. Idk much about it, other than it can (and maybe usually does) come back after a hysto since it’s a seperate beast. I’m sorry you have to go through that. 

[DeainUSA]

I'm guessing you've already explored the hystersisters forums?

I had everything removed in my early 40's but my cervix.  Due to a blood clot history, hormones were not even an option. My doctor did make it clear not to suffer, and he could recommend some natural avenues to at least leviate symptoms.   Luckily I was fine, beyond needing a portable fan everywhere, lol.

[Brittany1116]

1 hour ago, MEmama said:

I’m curious why she would have non functioning ovaries removed? 
 

Endo might make sense for taking hormones, as a PP mentioned. Idk much about it, other than it can (and maybe usually does) come back after a hysto since it’s a seperate beast. I’m sorry you have to go through that. 

It was the early 80s so I assume things were very different then.