Zoladex and Tiblone. Is this counterproductive?

[RedDoughnut]

I'm not sure I understand what the process is.

I've been prescribed Zoladex for abnormal bleeding ( bleeding constantly after a fibroid removal) but then I get Tiblone too.

If Zoladex is supposed to switch off my hormones why are they putting them back? I was previously on HRT ( patches and Utrogestan) and loved it but the bleeding got out of control. My uterus is "bulky" and I'm currently too fat for a hysterectomy.

My bladder is very, very grumpy so I'm scared that the Zoladex will take away the oestrogen and make things worse. Vagifem etc stopped working and I needed full HRT to keep it happy.

Has anyone had this combination? Thank you
Why am I having something taken away just to add Tiblone, which presumably puts it back again?

Probably should add I'm 53.

Can you get another appt with the specialist and ask them?
They're the ones who made this decision for you so they should be happy to explain. Id ask why they haven't suggested a Mirena coil for the bleeding.

Tibolone is not standard HRT. There's quite a bit online about it, and what it does and doesn't do. From memory (and best to check it out yourself) I think it's known for not building the womb lining.

I've had 2 Mirena coils. Both came out with clots,
Could also be my bulky womb?
I have another appointment with the gynaecologist who suggested this treatment in September to see how I'm getting on ( will have had 2 x Zoladex by then.

@JinglingSpringbells Thank you ( sorry, should have said that in the last post)
If Tiblone doesn't build up womb lining then that's probably a good thing?

I think my issues are

1. stop bleeding every day
2. calm my angry bladder

Please don't take this as a criticism, as it's not meant that way- but has your dr said that being overweight increases estrogen and one effect is that it builds up the womb lining? (Risk factor for hyperplasia.)

I have a thick skin @JinglingSpringbells
I had a post 'too fat for a hysterectomy' a few weeks ago and got some much harsher comments.

I only found this the fat/bleeding link recently.
Although I have always been fat the bleeding only got bad in the last 2/3 years and very bad this year ( anemia, blood transfusion etc)

I'm just hoping there is some way to manage my issues while I lose weight as it seems a hysterectomy is almost inevitable and that needs a 5 stones loss to be possible.

As I understand it, the Tibolone is an "add back" to counteract some of the unpleasant side-effects of the Zoladex, it's not the full-strength of HRT oestrogen doses. I didn't want Zoladex as am needle-phobic so was prescribed Ryeqo tablets (privately, I don't think they can usually be prescribed on the NHS) to shrink the fibroids and stop the bleeding before my hysterectomy surgery. The combination of hormones in that seems to be similar in that it's norethisterone (i.e. progresterone) with a small amount of oestrogen. However, I'm three weeks in and still bleeding . . .

Oh, and the depressive effect of these GNRH drugs can be horrendous, so be aware of that if it's an issue. It's one of the side effects the add-back oestrogen is supposed to counteract. I had severe depression anyway and now am constantly crying, having suicidal thoughts, etc. I'm only persevering as there's an end-date for the course of medication.

@GCAcademic that's interesting. I was taking high dose norethisterone before I had my fibroid removed and it stopped the bleeding but after the op it stopped working.

I wonder if I got the Tiblone if I could top up with extra oestrogen for my bladder?

I'm sorry you are still bleeding. Have you been told how long you have to allow it to settle?

Oh @GCAcademic just read your second post, I'm so sorry to read this,

I hope perseverance pays off. What is the long term plan?

When I was waiting for an ablation I had Zoladex injections and was given Tibolone to take to help with any menopausal symptoms.

@RedDoughnut I've bee told to give it at least a month, though they did say I could stop taking the tablets if necessary. But it the bleeding starts again, I'm worried that my haemoglobin levels may to too low for them to do the surgery safely (which is what I was told by the gynaecologist recently). The long term plan is that I have a hysterectomy booked in a couple of months time and I'll stop the Ryeqo then, and then take oestrogen-only HRT as I'm having my ovaries removed.

@longtompot how did you find it? What were your symptoms and did Zoladex improve things?

No one has suggested an ablation to me. I have wondered if it would help me

I didn't have the ablation. It took over a year for it to happen and by then I'd read a whole load of stuff about how it might not be right for me. I had a polyp removed and a d&c.
I don't remember having any side affects from either drug, just hated having the Zoladex after a while as it's a tiny capsule and not a liquid which is injected under the skin on your stomach. I was also on Depo Provera and I still had super heavy periods.