Chemical Menopause... any advice ?

[Kinkybutkind]

My consultant is chemically inducing menopause due to significant endometriosis (it’s in many places it really shouldn’t be)

I recently had a very unsatisfactory telephone consult with my GP who told me to pick between monthly and three monthly injections and told me they were also going to prescribe add back HRT. I asked whether this would defeat the object of inducing the menopause and was told “No! It’s for your bones”.

I have no idea what injection or HRT is being prescribed and I’m not entirely comfortable starting this without being able to do my own research or at least knowing the pros and cons of each.

Has anyone had any experience of a chemically induced menopause? If you have can I ask what meds did they use please and if you have any suggestions what questions I should ask when i make another appointment to discuss this?

Thanks in advance

I don't understand why your GP is asking this and you aren't having this conversation with the consultant who's treating you.

Why?

Have they not considered a hysterectomy instead of thrusting you into menopause?

@JinglingHellsBells

I don't understand why your GP is asking this and you aren't having this conversation with the consultant who's treating you.

Why?

Apparently the GP is the one who is prescribing and has been given instructions by the consultant.... I got a call from the doctor to say, “I need to arrange your injection, you can have monthly or three monthly”. Which was after the consultant reviewed all my results (but didn’t speak to me directly) I can’t get to physically see anyone to have a decent conversation about all this

@Aquamarine1029

Have they not considered a hysterectomy instead of thrusting you into menopause?

That’s what I am waiting for but it will be at least 12 months due to Coronavirus I’ve been told, hence the medication

I had this pre my hysterectomy but wasn’t given the option to have HRT. I had monthly injections and only had one in the end as it didn’t agree with me and I was relieved I hadn’t had a 3 month one so that maybe something to consider.

Yes, I had monthly Zoladex injections for 6 months. It made my endorsement flare up massively for a short time but then improved. the injections were very painful momentarily.

Classic menopause symptoms, not able to take HRT because of other medical conditions. But the endo symptoms stopped.

To the PP who said why not hysterectomy, I'd take 6 injections over a serious operation any day. And hysterectomy without oophorectomy may still leave you with endo symptoms

Thanks @FoolsAssassin appreciate the thought there. Good Point!

Do you mind me asking, did your symptoms return when you stopped the injections @Defiantly41 ? I was told I would have to have them until the surgery was carried out.

Never as bad. My periods did return eventually but then I went into normal menopause, slightly early (mid forties).

Before the zoladex I was hospitalised twice and needed morphine/ketaprofen for the pain

Hi there, this sounds like what I have for endometriosis following an operation which removed some but found lots where it was risky to operate.

For about 18 months, I’ve had monthly injections of zoladex (goserilin) & I take add back hrt. To be honest, I have really struggled to find the right type of hrt and I’ve experienced migraines and weight gain. I also find that the injection can make me extremely ill with nausea and vertigo a couple of days afterwards. I’m considering taking a break from the injections to see if natural menopause has kicked in although I’m some way off the average age.

I find it very difficult to talk to both my consultant/GP as they don’t always have time/answers & I do feel like a guinea pig as I try out different types of hrt. I would ask

• how long they expect you will have to take the injections,
• whether the 3 monthly injections are likely to cause more side effects than the monthly ( v interested in this as I wasn’t offered 3 monthly),
• what type of hrt you are being given & what the likely side effects are,
• who will look after you between consultant appointments (gp or consultant) in case you need to change your hrt (I had problems with this). If it is the consultant then make sure you have contact number/email so you can reach them directly.

Please don’t be put off by this though as I would say that, overall, this is better than trying to cope with the endometriosis which was ruining my life on a daily basis.

Good luck with your treatment.

... and @FoolsAssassin you may have also suffered the flare effect in the first month, it really settled for me after that

If they haven't provided the information relevant to your decision (including things like the risk of osteoporosis and how that would be managed) then you can't consent to treatment and they are being - at best - negligent.

You need to make the point to the doctor that you need more information because you haven't been given sufficient information to understand the proposed treatment or provide informed consent.

Merely agreeing to treatment you don't understand is not actually legally valid consent, so they would be assaulting you if they proceeded without bothering to inform you and obtain legally valid consent.

"We're busy" is not an excuse to assault patients.

Mine wasn’t for endometriosis Defiantly41, it was to shrink my uterus to increase chance laparoscopic hysterectomy rather than open procedure.

Ring or email the consultant's secretary and ask for him/her to call you as you have questions about treatment. Consultants are contactable!

I had monthly zoladex injections, They temporarily halted the Endometriosis but plunged me into depression. Maybe the HRT counterbalances that.

I am currently on 12 weekly Zoladex injections with add back HRT. I have stage 4 endometriosis and will be on the injections until I have my operation.

Before I started the treatment, I was regularly hospitalised with the pain and often out of work. It takes a while to settle after the first injection as hormones are involved but I feel like the old me again. I have experienced weight gain, some hair loss and acne on my chin but I'd rather this than return to how I was before.

Where this does involve hormonal changes, it is never the same for everyone.

I had it described to me that it doesn't get rid of endo, more that it pauses it's growth. Tbh I don't think they fully understand how it all works.

I am incredibly lucky that my hospital has an endo specialist nurse who you can email any queries to.

Your GP but especially the consultant are very wrong to ask you to make a decision when you are not fully informed.

Your consultant ought to have talked you through the options and the risks v benefits.

passing this over to your GP and him giving you choices when you aren't informed is not acceptable. It's very poor medical treatment.

Go back to the consultant and ask for more information or ask your GP to follow up.

I had Zoladex and tibolone last year for 3 months, one injection per month. it didn’t stop my bleeding tbh I had periods during it but it made my cycles longer afterward which was a blessing (used to have 2 periods a month and bleeding in between) going for a hysterectomy this year at 39 for severe endo and adenomyosis. I believe the HRT was a low ish dose so as not to aggravate the endo. I felt a bit rough and the injections were not fun but I am glad I did it as it was the last thing to try before they would refer me for the hysterectomy, they want to try everything before the big surgery which is fair enough

Hiya, just finished a three month treatment (3x1) of Zoladex with add back HRT for endometriosis and extreme PMS. It hasn’t worked for me sadly and I am going to have a hysterectomy (at some point!!) The HRT was a bit tricky to balance and I had all the menopause symptoms before getting it right, but the main reason for stopping is that the injections made me feel really poorly for at least a week afterwards. The Zoladex has now stopped working too...bleeding/cramps have started back again. If you can tolerate the Zoladex then it is a good treatment as the HRT does work well. Good luck!!

Thank you to everyone who has commented, I appreciate all of your comments, very much. I’ve had a chat with the practice nurse today who advised it is the Prostap3 injection that I have been prescribed - it’s apparently gentler according to her than Zoladex. Also, similar to many on here, Tibolone as add back HRT. They are hopeful this will see me through until my hysterectomy once the Covid crisis is over. I’ve also been prescribed cholecalciferol (vitamin D essentially). Thanks again for all your comments it really has helped hearing others experiences

I had a 6 month chemical menopause using Nafarelin at 25 for endo and then conceived a month afterwards which was a bit of a shock! I had my second child shortly after and then no endo symptoms for 12 years. My second chemical menopause was with Zoladex. I was offered HRT but it didn’t agree with me, although in hindsight it may have been the initial reaction to the Zoladex. Both times I had the hot flushes and night sweats. I have to say that the actual natural menopause was a breeze and I am so happy to be free of all the pain and heavy bleeding of endo. It’s so liberating!

Hi @Kinkybutkind

Jumping to say squeak help! I have zoladex injection tomorrow
Plus tibolone

I'm really scared!

Mine is all peri meno problems and my mirena plus gel aren't getting my symptoms under control. Not hot flushes but more bladder and bowel which have caused bad prolapses.

I'm looking down the spout of hysterectomy. I have a bulky uterus 🙄 and I had endo / ado when younger. Mirena has had them under control for ten years and then hit early ish meno

I'm just so scared with it right now. I'm on my own and just met an amazing guy (v v early days)

I'd love to have a friend through this

I just had my first zoladex injection where the specialist told me I would not get a period

But here I am 2 weeks later in pain having either a breakthrough bleed or period which ever it is its not welcome

I think everyone is different but for me when i had my first injection i was pain free for 3 days then for 7 days i had 1-2 hours pain in my pelvis but my fatigue and chronic pain drastically improved until boom my period came

I have had heavy bleeding all day and have been bed bound with all my usual endo pain, digestive pain, fatigue and insomnia

Will keep you updated but right now I have mixed feelings about the jab