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Hysterectomy and menopause

(31 Posts)
jen127 Wed 23-Jan-13 14:35:42

I've just been told my Gynae that i should have a hysterectomy. I am 43 and someone said this will definitely bring on the menopause.
I would say that I am peri menopausal at the moment. I have night sweats, insomnia, horrendous Pmt and terruble cramps and back ache and flooding.
What does the menopuase bring ?

Chihuahuas Thu 14-Feb-13 17:34:40

hello, i had a total hyst an both ovaries removed for pmdd. I dont consider it to be barbaric, extreme yes but thats what pmdd is a very extreme and severe form of pms. I had only a week per month of where i wasnt battling suicide, self harming or headbutting a wall to rid myself of the overwhelming feelings.

Have you been offered ovarian suppression at all, this is to give you a dummy run of how you would handle menopause. you could choise to have add back hrt (usually both oestrogen and progesterone and if you react to progesterone you could try oestrogen only for a short while).

The reason that ovaries and womb are removed for pmdd is that progesterne is normally the cause and your ovaries produce progesterone. If you had only your womb removed and took hrt then you would still need to take progesterone to protect it from developing cancer.

Oestrogen post surgical menopause ia rather crucial as it protects against oesteo, alziemers, cardiac issues, early death, congnetive decline to name a few. If you have a history of ca in your family you would stil be able to take oestrogen only hrt, but in patches or gel..oestrogen replacement has not been associated with breast cancer if it taken up to the usual age of menopause which is around 52.

I know of ladies who have also taken oestrogen after recovering from breast cancer as well as endo.

Who is your consultant? is he one that specialises in menopause and pms?

x

carolinefromhackney Thu 31-Jan-13 13:25:09

I have just started voluntary work at the Hysterectomy Association which is a non profit making organisation for women facing a hysterectomy, supporting choice through information. The website has lots of useful advice and up to date inforamtion and a free downloadable fact sheet. Do take a look
www.hysterectomy-association.org.uk

Good luck Caroline

digerd Thu 24-Jan-13 15:04:43

Jen
I smiled at your last sentence. As I have become older and with many experiences - I have learned that " The devil you know is better than the one you don't", in circumstances where the outcome is uncertain. And is often better, if possible to try a sample before going the whole hog that can't be reversed. .

I think the Hysterectomy first and then see how it goes sounds practical.
You can always have the ovaries out later - but does mean 2 ops instead of 1.
I had 2 cancer InSitu ops while on the Pill, but it was never attributed to the Pill. And I've been on HRT for 18 years and last breast cancer screening last year was fine, and the others haven't returned.
Good luck with your decision.

jen127 Thu 24-Jan-13 13:55:12

I am in Ireland and private - so I can go back again. the Doctor I am with is highly recommended in his field.
I agree am I swapping one issue for another. At least I know what I have at the moment.

Missbopeep Thu 24-Jan-13 12:03:45

I am sure that 2 operations are quite possible- but if this is NHS they will be trying to save the money.

I can see that logically it is the solution- whip everything out and viola! problem solved. But is it- or are you swopping one problem for another?

Are you NHS or private? If you are private and want a 2nd opinion I can recommend a lovely eminent gynae who I see in London/SW.

jen127 Thu 24-Jan-13 12:03:44

I guess I would like to make an informed decision and I don't feel fully informed. Like I said I was caught on the hop yesterday as it was unexpected.
I think I have to call him and discuss this further.
I have done nothing with regards to exploring the menopause and its symptoms as I thought I had years yet ! :-)

jen127 Thu 24-Jan-13 11:47:59

Hi Missbopeep Thank you for your contribution's.
The PMT is mixed in with the cramps and the pain. So I am unsure CBT would help to separate that out.
I don't know what the consequences will be to me personally if he leaves the ovaries. His opinion was that the PMT will continue. Unsure if the pain will. Does anyone know if you can a hysterectomy and leave the ovaries and worst case go back in and take them if need be ?

Missbopeep Thu 24-Jan-13 10:59:55

Looking at this from another angle- if your main concern is emotions and anger with PMT have you considered something like CBT which might help you control the behaviour more than you have been able to so far?

Persoanlly- and i am not you!- i think removing ovaries is barbaric and unnecassry unless there is cancer. You need your ovaries into your 70s as they produce a small amount of hormones inc testosterone. Yes this can be replaced with drugs, but it's a lifelong commitment.

Given that your periods may stop anyway from 45 onwards, is it not worth hanging on and trying other things?

jen127 Thu 24-Jan-13 10:05:22

I just had a look and I would say my PMT is not short of this level.
I have exploded twice in work and as the manager is not the way to perform.
I have absolutely no control during this time, it is like a train running through my head and everything grates on my nerves.

bumhead Wed 23-Jan-13 21:46:26

It's the severe form of PMT. PMT times 20!

http://en.wikipedia.org/wiki/Premenstrual_dysphoric_disorder

jen127 Wed 23-Jan-13 21:31:07

Excuse my ignorance but what is pmdd?

bumhead Wed 23-Jan-13 21:24:38

Jen is it PMDD you have or PMT? I am having Prostap injections for PMDD and then due for a hysterectomy with ovary removal as well for my PMDD

jen127 Wed 23-Jan-13 21:08:19

Thank you very much for your help. I will call the gynae in the morning to revisit and ask my questions.

VivaLeBeaver Wed 23-Jan-13 20:00:34

Yes I had terrible flooding. I often had to change my trousers twice a day at work.

A ablation removes the majority of your womb lining so when you get your period there isn't as much to shed. Therefore your periods are so much better. Some months I don't need to use a tampon! There's just a tiny amount of blood on wiping and that's it. It changed my life.

Missbopeep Wed 23-Jan-13 19:58:09

It islikely that you will feel terrible without HRT but more to the point you will be exchanging "nuisance" symptoms ( and I don't mean they are not horrible) for other illnesses that can be life threatening such as heart disease and osteoporosis- not to mention loss of libido and dry skin, etc etc.

jen127 Wed 23-Jan-13 19:50:08

Apologies for the spelling errors I am on the phone

jen127 Wed 23-Jan-13 19:49:34

The bleeding is flooding for 3 days with severe pmt the day before and the first two days. It feels like my head will explode. My job can be stressful and I am not coping well.
I think I might call them tomorrow and try and schedule another appointment. I was caught off guard today.
I am usually so well organised and
usually ask appropriate questions.
My concern is how bsd will things be without HRT.

VivaLeBeaver Wed 23-Jan-13 19:40:54

Jen, I had heavy and frequent periods with bad pmt. I had an endometrial ablation done. Periods are very light, regular, no painful cramps and pmt is better.

It's keyhole surgery so much lower risk. Plus the long term consequences aren't as bad. My consultant said to try it and if it didn't work then to have a hysterectomy. I think it's worth trying before a hysterectomy.

Missbopeep Wed 23-Jan-13 19:34:12

Which is worse- the bleeding or the PMT?

If you have had the Mirena coil it should have stopped all bleeding or just very slight bleeds.

Would you consider an ablation?

And live with PMT?

digerd Wed 23-Jan-13 19:27:40

Yes, but you might get the menopausal mood swings all through the month and not just a few days before period starts. Some women have the moodiness really bad. As nobody knows how you will react, it is best to be on the safe side. You already feel really tired and this symptom could intensify with no HRT.
I went through awful PMT until I went on the contraceptive pill at 26, and it changed my life.

jen127 Wed 23-Jan-13 19:14:30

The doc is of the opinion if the ovaries go so will the pmt.
I think I need to go back and ask some more questions.
I have tried everything fot the pmt . Natural and medical.
I am losing two days from work every three weeks currently.
Tried the coil and it didn't help the pain.

Missbopeep Wed 23-Jan-13 18:50:09

The point about HRT and your mum's cancer.

It's not relevant. Even if it as breast cancer it's not a factor now at your age.

At 43 you would be replacing what SHOULD be there naturally. This is totally different from taking HRT as a 50+post menopausal woman.

has your dr not talked to you about this?
If not, why not- begs the question.

You will NEED HRT.

You can also discuss- as maybe you have- other options such as an ablation or a Mirena coil.

have you tried everything for PMT? Natural products and drugs?

If you are dead set on having a hysterectomy then if I were you I'd have just that and hang onto my ovaries. And see how I felt then.

You will feel a million times worse without them and no HRT. menopause is bad enough for most woemn over a slow 5-10 year wind down, overnight is not going to be fun and in the medium-long term you may have other health problems.

digerd Wed 23-Jan-13 18:27:25

To answer your question about the menopause, but only with your ovaries in tact, the menopause is individual. Night sweats and daily hot flushes are the most common, but I got no day-time ones, only at night. With no womb you will be spared any erratic periods/flooding/pmt and associated cramps.
But some women have erratic mood swings, all the time, have difficulty concentrating, heavy legs/tiredness and aches and pains. Some are lucky and have no symptoms. But you already have some symptoms.
Know nobody who had their ovaries out as well, that didn't go immediately on HRT.
You may feel fine as a post menopausal woman with no more symptoms, and no HRT. My best friend had her last period after her 41st birthday and had no symptoms of menopause and did not go on HRT as felt fine.
But that was her.

lilachair Wed 23-Jan-13 18:26:36

Oh, I'm so sorry, I just saw they have advised against HRT? Erk. I don't know op, but I would be seeking other opinions.

lilachair Wed 23-Jan-13 18:24:33

I had a hysterectomy at 34 for endometriosis. My ovaries had to go as well. I will have to have HRT until I am in my 50's.

It's very easy, just a patch (like a nicotine patch) or you can take tablets if you prefer. It can take a little while to get the dose right. While I was getting it sorted I had the odd hot flush, and my skin went a bit weird (spots and dry patches).

If you don't have the HRT you are at a much much higher risk of osteoporosis later on, I think. Also, if your ovaries have to go, do ask your consultant about testosterone. I had a tiny implant that lasted 5 years. I can't remember why but it was highly recommended.

Five years on, no problems at all and my life is transformed smile

Hope it all goes well op.

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