HRT for someone who has never got on with hormones...

[wonderwoo]

I am considering having my ovaries removed for a chronic health problem. The gynaecologist says that I will go on HRT afterwards because I am mid-thirties and need it to prevent other health problems (osteoporosis etc). And to be honest, I am scared of having an immediate surgical-induced menopause, so I agree that this is a good plan.

However, I am concerned that I will not find a type of HRT to suit me and will have loads of side-effects (worried about it affecting me emotionally more than anything). I have always struggled with my own hormone fluctuations, both physically and emotionally, and to be honest, hormones have made my life very difficult for much of my life. I have never coped with a mini-pill (progesterone only) because it makes me an emotional wreck, and life is just awful when I am on it. The normal contraceptive was less of a nightmare, but still not great. I am worried that this all means that I will have similar problems when I take HRT. I have been reassured by a GP that they usually find a form of HRT that suits, but that sometimes it can take a few tries.

I wondered if anybody has any experience of not finding any HRT that works for them, particularly with a history of not coping with hormones in general and also if you found progesterone only pill to cause problems for you? Or the opposite – have you not got on with hormone contraceptives in the past, but found HRT to be fine?

Thanks.

I couldn't hack the pill, it really messed my hormones up.
I had a total hysterectomy a few years ago and went straight onto hrt.
The first one was a pill and all I did was vomit and faint on it.
I moved onto Evorel patches, 25 mg for the first month to see if I could cope on them, then up to 50mg.
I've had no problems since then.

First of all, the hormones used in HRT are not the same as the Pill. 99% of HRT in the UK is 'body identical' meaning the oestrogen is the same as our own and there is also a progesterone that is the same. (There are also 3 synthetic progestogens that aren't and this is where some trial and error takes place!)

It's a no-brainer for you not to use HRT in your mid 30s - lots of serious diseases can occur without oestrogen for decades- heart disease, osteoporosis, Parkinsons and dementia- not scaremongering- it's facts shown by research.

I've never got on with the pill, I tried 5 different ones 30 years ago before my GP said he wouldn't try any more, my blood pressure was rocketing. Got the Mirena coil 4 years ago and it was awful, made me totally batshit.

But I've been on Tibolone since November and it's been fine - no moodiness or depression, blood pressure is ok, it's great!

I had my ovaries and tubes out 10 days ago and am continuing the HRT for a while and it's still fine so far.

Good luck OP, I've not looked back, hope it's the same for you.

Thank you all for your replies. It is reassuring that HRT has been tolerated better than the pill.

Having my ovaries out could change my life and could free me from all the issues I have had since puberty... but could also make things worse, and I am finding it a really difficult decision to make.

Unless there are truly compelling reasons for having them removed ( cancer, suicidal type of PMS etc) then I'd think long and hard. Although your ovaries will eventually shut down at 50-ish they do still produce small amount of oestrogen for life as well as testosterone. Some women with no ovaries have to supplement with testosterone too, to keep their energy and libido levels up.

I think that sometimes, some surgeons are a bit too eager to remove whatever is causing the problem and underplay the other problems you might experience.

Without your ovaries you will be looking at using HRT for many years - and that's fine- but you will also need a type of progestogen if you are hanging onto your womb. This will give you a monthly artificial period, at least for some years until you can go onto a no-bleed type of HRT. So if your problem is related to your cycle, you will possibly still have the same problem but it will be created by using HRT.

Has this been discussed?

Thanks Polly. Yes I understand what you are saying.

I actually had a hysterectomy (uterus, tubes and cervix removed) a couple of years ago, but retained both ovaries. So, I wouldn't need to worry about having progesterone, or having a monthly hormonal cycle. I agree that having my ovaries removed is a big decision, and one I have been battling with for a couple of years now. If only I could see into future to see the impact of my decision! I agree that surgeons can understate the effects and issues around having ovaries removed. I just don't know what to do. I don't want to go into detail about the reasons for having them removed, but it could make a big difference to me. But is not a given either.

Best thing I ever did tbh.

If you don't have a uterus then you can use oestrogen alone. This makes a big difference. I've used HRT for 8 years almost and it's the progesterone side of it that is a PITA. It also means that you could use HRT indefinitely as breast cancer is less in women using oestrogen only (compared even with women not using any HRT at all.)
Hard to advise any more without knowing the details of why there might be benefits for you but hope you arrive at a decision.

One difference between HRT and the Pill for contraception or hideous periods is that HRT replaces what your body no longer produces, whereas the Pill adds more hormones to what you've already got. So HRTshould bring you up to a good level, IYSWIM, rather than overload you.

Hope it goes well for you.