Surgical menopause

[AGreatUsername]

I recently had a full hysterectomy at 36.

8 weeks later I’m feeling pretty good apart from the hourly (or more) hot flushes where I am suddenly hotter than the sun. I also have such bad brain fog, I’m forgetting everything, fumbling for words and generally seem a bit mad. I’ve also lost all my confidence overnight. Not sure if that menopause relayed mind or just the hell I’m currently going through! I am dreading returning to work, it was a reasonably new job anyway and I’m sick with fear that I won’t be able to do it anymore due to my memory and inability to think.

As this is surgical menopause, how long will it last? Forever? 6 months? I have no idea. I am unable to take HRT as my cancer is hormone positive, I have heard there are alternatives like anti depressants but I don’t think I’m feeling bad enough to warrant yet more drugs on top of the ones I’m already being forced onto 😂

I had a full hysterectomy (including ovaries out) 4 weeks ago and still haven't had any meno symptoms. When did yours start?

I take Menopace Plus vitamins which are apparently brilliant for keeping meno symptoms at bay (so I guess they might be working for me!). I also take magnesium.

Sage and Black Cohosh are good for hot flushes. Ashwagandha (I can't spell that!) is an "adaptogen" said to help balance hormones. Like this stuff (I've not tried that one).

I tried oestrogen gel but I just felt like I had PMT - emotional, bloated and hungry. It didn't help the brain fog.

Oh - testosterone is meant to help brain fog I think. (Ironically, I can't remember). Could you have that?

I went through surgical menopause about six years ago; also can't take HRT. The worst symptoms lasted 18 months, but gradually tailing off over that period. I still have the odd hot flush but rarely - say, once or twice a month.

The fumbling for words thing and brain fog still happens, sadly. I think I am used to it, or have developed coping methods.

Re. work, is it a big company you work for? They may have a menopause network if so. In any event, you should talk to your manager about what support you may need. Also, ask if you can go back on a phased return because it will likely be tiring and overwhelming for the first few weeks, so you should build up to your normal hours gradually.

I agree with trying multi-vitamins if these are something you're able to take.

I won't lie and say it will all go away in no time, but it does get gradually better

Thank you. I’ll run those supplements past my oncologist @DoingJustFine

@Antarcticant I work for a huge company, they do have a menopause network actually. When I go back I’ll join it. I’m planning to ask my manager re a 50% return in the next few months (during chemo if I’m okay) so would only be doing half time for at least a few months.

Have you got a menopause specialist looking after you? There are ones who work with women like you who need alternatives.
They are the ones to ask (assume maybe they suggested the ADs?)

I'd be careful of some herbs etc suggested as they can be contraindicated as some have estrogenic actions.

Also, are you having your bones monitored in the long term to avoid osteoporosis?

@JinglingHellsBells no one has even talked to me about menopause or HRT. It hasn’t been mentioned at all. I asked the nurse in hospital who had no idea and I don’t know who to ask, my oncologist? A GP? I am hoping I’ll have DEXA scans but I don’t know when they would start. At the moment the focus is all on cancer treatment and everyone seems to have forgotten the other issues like this.

You should have a pre-operative consultation and the input on your post-op treatment should be multi-disciplinary; i.e. gynaecologist and oncologist. I would raise it with whichever of those you next speak to. Not your GP as they'd just refer back to the specialist in cases of underlying issues.

@AGreatUsername When your gynaecologist suggested surgery, did they not discuss post op care? It's unacceptable to leave you like this. You need your specialists to be talking to reach other about the long term health risks of early menopause and how to help prevent these.

Obviously I don't know why you had the op (guessing at ovarian or endometrial cancer) and of course please don't feel you need explain. I do know that (as an example) for Stage 1 endo cancer, HRT is allowed. I'd also (cautiously) suggest that there are differences in opinion on what is suitable post-op treatment, although with some clear guidance as well.

I don't know where you live but in London, the best menopause clinic in the UK for women like you with complicated needs is run at the Chelsea and Westminster Hospital, menopause clinic, and my understanding is that your GP (or another gynae) could refer you there.

no one has even talked to me about menopause or HRT. It hasn’t been mentioned at all

So how do you know you can't have it or some form of it? I picked something up online from a leading meno expert that there are new treatments in the pipeline for women who can't use traditional HRT.

This is a link here
www.imperial.nhs.uk/our-services/fertility-and-reproductive-medicine/menopause

There is a mention of drug trials for women with complicated menopause situations. Not sure if you'd fit that scenario but these are all starting points if they might help.

You could also look at the website of the Daisy Network which is a charity set up by drs at the C&W for women with early menopause, whether natural or surgical.

I have ovarian cancer, which is very strongly hormone positive so HRT or anything else containing hormone (like some of the recommended lubes etc) are a no no for me. That is all that’s been mentioned to me. I can see now maybe that shouldn’t ne the way. I don’t have a gynaecologist, I’ve been under the oncologist since the first ultrasound. I’ll raise it with her when I see her next, I don’t mind muddling along alone but I do feel like all the incredibly life altering menopause side effects have been lost amongst the more pressing cancer issues. Thanks so much all.

Total sympathy! Same thing happened to me with my breast cancer. Had a mastectomy (mid 40s),and went onto Tamoxifen and was thrown head first into the menopause. I had every symptom going and thoguht I was going insane. Nobody warned me, and I actually feel quite angry about that. Because I wasn't warned I didnt know what was happening or how to cope. Only now 6 years later have I been started on oestrogen pesseries (even though my cancer was oestrogen positive it is safe to do this). And thats only because I changed Breast sugeons by paying to see a different one privately.

Why arent women having medical conditions that will put them into menopause counselled about this pre treatment?

@AGreatUsername I really recommend that you check into the Daisy Network. It's run by consultants who are the team at the Chelsea & Westminster Hospital. they have a forum on the site and you can access research etc on the website. It's for all women who have early menopause, either naturally or surgically.

There are new drugs coming along for women who can't take HRT and you really do need expert advice. Your drs ought to be managing this and being proactive.