Total hysterectomy and Estrogel - feeling drugged!

[Rafferty333]

I'm 43 and had a total hysterectomy 4 weeks ago due to lifeling endometriosis. I had originally wanted endometrial ablation to stop the ridiculous monthly bleeding but was advised to go for hysterectomy and HRT as it obviously offered a more permanent solution.
4 weeks in to the HRT (3 pumps estragel and 1 pea sized dose of testogel) and I feel fuzzy and knackered, I'm having difficulty concentrating and keeping my eyes open at work. I've also got the most terrible stomach cramps which I'm having to take pain-killers for.
Am I alone in these symptoms? And what can I do about them? Right now, I'm regretting my decision as 3 days of bleeding/flooding a month was preferable to this foggy pain!

You're only 4 weeks post op so that could be a big part of it and HRT is often a case of trial and error, it's frustrating but it can take time to find the right medications and doses that work for you.

I think you have to allow several weeks to see if a medication/dose will settle down, so that does add to the frustration, sorry.

I got a pre payment certificate thing as the constant changes in prescription were proving expensive but when you do get the right mix it will be so much better I promise, it's like getting your life back.

If it helps, I had an ablation a few years before my hysterectomy and all it did was make some new problems and give me a few more years of grief before the hysterectomy, with hindsight I would have preferred to go the route you have.

Take care, it is early days and it will get better

it's more likely you are suffering the effects of the operation and the anaesthetic even after 4 weeks. A GA can really knock some people out for some time.

If you want to experiment, reduce your gel to one or two pumps and see how that feels, then go back up if necessary.

Why are you back to work after 4 weeks after a major op? When did you go back?

Most women take 6 weeks off and if they had an abdominal op, 3 months is the norm.

Your body is healing inside and even if you can't see that, it's using energy.

It sounds as if you are overdoing it and ought to be at home or working very part time- too much too soon after a major op, not only the surgery but removing your ovaries as well.

Thank you. I've actually just had the results from my op back and I had severe adenomyosis so I don't think ablation would have worked anyway. I'm going to see my consultant on Friday now as I just don't feel right, so will see what he says.

Maybe you are expecting too much too soon? You have had a huge operation and it's only 4 weeks AND you have gone back to work.

There is a website called Hystersisters for women who have had hysterectomies- maybe post there and see if others have advice?

I understand that abdominal bloating and feeling unwell can be very common for a few weeks.

Good luck with your recovery. I didn't feel right until I got up to four pumps of estrogel a day. Obviously everyone is different and different combinations are needed. If I forget it I find myself wondering why I am so tired fuzzy and drained and then realise.

Thank you - will definitely look at Hystersisters and see what the consultant has to say tomorrow

I agree with everything already said- I'm 12 weeks post op and am only just now feeling like myself. I am up to 7 pumps a day plus my testosterone bug this has been done gradually and with medical support.
Trial and error is key!
Hang on in there- I promise there is light at the mend of the tunnel

@spykid - 7 pumps...wow! The most I'd heard of was 4 pumps so had assumed that was the 'maximum' - interesting to note that you've increased this much. Can I ask what you started on and why it was that you'd increased? Thank you

I had my ovaries removed, and am only 46.
Started on 4 pumps post op- swiftly found that wasn't enough!
Moved up to 6 after about 8 weeks along with addition of testosterone.
Added a 7th pump under medical advice as my sweats and insomnia had returned after 12 weeks.
My levels were also checked via blood test.

@spykid I also had ovaries removed and am 43 so do wonder if i should be on a higher dose. The consultant took blood on Friday though so should know more soon. He prescribed omeprazole and movocol for the stomach cramps which I'm dubious about as I neither have heartburn nor constipation, bout will give it a go. I've noticed my memory has become horrendous - I can barely remember my kids names let alone things at work, si something isn't quite right. My consultant said 5 pumps was the max though so I'm interested in your dosage. Will wait and see what my bloods say

It took me many weeks and much support from my menopause doctor to get my HRT levels right. I'm sure there is more tweaking ahead!
My symptoms post op were so similar to yours. Until recently word finding problems, memory issues, brain fog and poor concentration were all daily problems
It does get better! You and your body have been put through a lot.
I may now move to a patch and a gel top up with the same dose for ease- I'm running out of surface area! 🤪
I have heard of some younger women using up to 10 pumps- everyone needs different amounts.

This is really helpful, and reassuring. I wasn't sure whether this huge drop in memory and concentration was something I just had to accept - the downside of being period-pain free, so happy to hear that this isn't necessarily the case...as it's a bit embarrassing to stand up in front of your team and forget 50% of their names!

I'm a Headteacher and it was appallingly embarrassing to begin with! when they get your levels right it will rectify itself xx

Oh good grief! My consultant called, my levels are on the low side so I'm up to 5 pumps and we'll continue to monitor. My testosterone levels are a little high - I take complete blame for this though as I think I'm useless at measuring out the right amount from that little sachet!
I think I'm getting there on the oestrogen, I just wish the tummy cramps weren't so bad, unsurprisingly the heartburn medication hasn't done a thing

Ah yes- all the other wonderful symptoms of the operation- the joys!
I think gastro and twingy cramps settled down after 6 weeks.
I suppose everything inside has to heal and adjust.
Everything has taken longer than I expected but there is definitely a light at the end of the tunnel- I promise

Update - I've seen my consultant again and turns out my oestrogen levels are low and I'm not absorbing the gel well. I'm now on patches (100mg) and still the 5 pumps of gel but if this doesn't work I'm considering the implant. I really wanted the gels and patches to work and I'm nervous that I'm never going to get my brain back ☹. I've got more energy but still have aching bones and the most terrible memory loss - praying something will improve soon as I feel like I'm losing my mind!

I'm in Australia. I don't know where you are. But I am 45 just had a full hysterectomy and rectocele repair surgery in December. I was put on patches after two weeks. I was really hot when I got home. But I am feeling ok now. I didn't know but I have been prescribed Estrogen suppositories as well? Anyone had this too? I haven't started but they said it's like the patch once a week.

Hi @sweet74, I haven't heard of suppositories, but let me know how you get on with them.
@spykid, could you tell me whether memory/brain-fog improvement was gradual? I fear I'm in the 'gets worse before it gets better' phase and following being increased to 6 pumps plus 100mg patches every other day, I had an implant put in 2 weeks ago and my brain fog has made no improvement. Trying very hard not to lose hope

Looking back the brain fog seemed to really clear after Xmas for me- I think around 10 weeks post-op. It was around this time that I started with testosterone daily too, that definitely helped with the brain fog and clarity of mind.

How many weeks post op are you? It's a much longer road back to normal than any of us ever realize!

Thank you. I'm 10 weeks now. I've been on testosterone gel from the start and also have a testosterone implant so I can ease off the gel at some point.
I can't find anyone who has implants, they don't seem to be widely used so don't really have much anecdotal feedback to go on. Think I'll just keep slathering the gel and patches on in addition to the implants and see what happens. I really don't want to have to default to pills!

They don't tell you but you do need vaginal suppositories. Lack of Estrogen will thin everything and dry things out. More UTIs etc...which can cause some mental health issues. I thought I was sore just from the operation. It definitely helps.
Still recovering. Doctor said it's not like a cut on the arm. It will take 6 months to properly heal. Good days and bad days.

I am still taking movical every night. I have stopped it for a while and the pain is horrible without it. I am going to see my GP about my levels today. Hopefully everything is ok

I've been having oestrogen implants twice a year for the last 31years. I get the 50 (micrograms or whatever the measurement is). It is likely they have started you at 25 so perhaps another one is needed sooner rather than later.

Implants are wonderful. For the rest of the year you can forget the menopause. No messy gels every day, no patches twice a week and hopefully nobody gets prescribed pills these days. (NEVER accept pills)

I hope everything settles down for you soon.