Hysterectomy and HRT

[Letsbepractical]

I had hysterectomy 1 year ago but my cervix and ovaries were left intact. In the last few months my ovaries have truly gone to sleep and I think I’ve entered menopause with insomnia, night sweats and awful anxiety.

Im taking vagifem 10 mg 2x per week but I’m now considering topical hrt.
I keep getting conflicting advice: estrogen only (as no uterus) but some health providers say take progesterone, too, for other health benefits (bone health, sleep).
Whats your experience?
What about testosterone?
Once I start HRT should I continue with Vagifem?

I believe that you only need oestrogen because no womb but some women find the Utrogestan helps with sleep.

Transdermal Oestrogen only hrt post hysterectomy has no extra breast cancer risk either.

I thought topical oestrogen was recommended who ever you are.

You'd only be allowed testosterone if libido is really affected after tweaking oestrogen.

@Letsbepractical There is some 'discussion' over whether to use progesterone as well. For womb protection you don't need it. For sleep - it's a bit sledge hammer to crack a nut, as progesterone comes with risks (linked to breast cancer when used with estrogen.) Bone health- hmmm- jury's out on that one. Estrogen improves bone health and the 'extra' from progesterone is not established.

Many of the articles online about progesterone are either from the US or from more alternative practitioners, selling bio-identical hormones (as well as all the unnecessary tests . If one of the mainstream UK menopause gynaecologists recommends progesterone, then consider it, but as far as I know, they aren't.

You can use Vagifem with HRT for as long as you want.

I think sometimes women who've had endometriosis take progesterone after a hysterectomy, if there's a chance there's still tissue outside the uterus that might grow. I had my hysterectomy (total) in July for pre-cancer and don't take progesterone, just oestrogel. My sleep remains as good as it was when I had a Mirena and before that Utrogestan.

I'm in your situation I had a hysterectomy about 7 years ago and my menopause symptoms started a couple of years after that.

I have Estradot 75 patches, and have recently added in Ovestin vaginal cream. I had the same questions as you about progesterone but my sleep isn't THAT bad and the increased cancer risk does worry me. I have no concerns at all about the estrogen patches. Have considered asking for testosterone but to be honest it is such a battle to get the GP to even prescribe estrogen patches that I know I'd have to go private for the testosterone and I just can't face the hassle.

Thank you all for your replies, super helpful. I’ve got my appointment next week and I’ll ask for topical oestrogen and start from there. I’ll keep taking Vagifem twice a week.

I’ve started using cbd oil to help my sleep. Early days but it seems to be helping a bit!