HRT and endometriosis

[Picklemeyellow]

I’ve just been diagnosed with endometriosis and adenomyosis at the grand old age of 50 (almost 51)!

My regular gynaecologist (I’ve been under gynae for years with ongoing gynae issues) will refer me over to the endometriosis team and I’ll ask more questions when I get an appointment but I am confused about hrt and these conditions and wonder if anyone has any experience with this?

I was hoping to try HRT because of increasingly horrible peri symptoms but I’ve read the hormones can exacerbate the endometriosis/adenomyosis causing more growth of endo tissue.

Does anyone know the answer to this?

I don't know the answer but I'm seeing an HRT specialist today and will find out. I have also recently been diagnosed with endometriosis, adenomyosis, cysts and fibroids (via a scan the GP ordered) and that didn't stop them recommending that I have HRT so let's see!

@Picklemeyellow I have adenomyosis, diagnosed a lot later than you. It was first thought to be fibroids, (which didn't change on HRT) but a more experienced consultant gynae said it was adeno. I have been on HRT for a long time and presumably the adeno was there too. I don't think it's made any difference and I've never been told to stop (and I have an excellent private consultant.) I do use HRT on a cycle and I do get some discomfort (period pain) and a fairly heavy bleed.

However, I think the way they prescribe HRT for endo especially, is to use a daily dose of estrogen + progesterone, (combined continuous) so both hormones work together to stop the lining growing.

Oh brilliant, I hope it goes well.

Thanks, that’s good to know.
Hopefully, it won’t be long until I get to see the endo team and I can ask about it in more depth then.
The gynae has mentioned they will probably suggest a hysterectomy so I may only need to go on oestrogen if I opt for that?

@Picklemeyellow If you only have endo in your uterus, I'm not sure you'd need a hysterectomy. The Mirena coil can be used as part of hrt, so that may be an option.

If you have endo elsewhere, then having a hysterectomy won't solve the problem because you will still have tissue that grows when stimulated with estrogen. However, if as I said above, you go onto combined, continuous HRT, the two hormones balance each other out, so the uterine lining (even if elsewhere in your body) shouldn't grow much (or at all.)

TBH this is something your gynae ought to know. (Mine deals with all kinds of gynae issues and is also a surgeon.)

I had a uterine ablation last year. The gynae has said inserting a Mirena will be tricky due to the scar tissue.

I’m not sure exactly where the endo is as it’s been picked up via mri and so I’ll need a lap, hopefully the endo team can advise from there 🤞

TBH this is something your gynae ought to know. (Mine deals with all kinds of gynae issues and is also a surgeon.) You’d think so, wouldn’t you? I’ve had gynae issues since my periods started at 12 years old and have been under the same gynae department since my mid 20’s. You would have hoped with all the issues and procedures I’ve been through that one of the many gynaecologists I’ve seen would have picked up that I have endometriosis and even after telling them that my sister was diagnosed in her mid 40’s still no alarm bells rang. I requested this mri scan myself, if I hadn’t I’d still be none the wiser!

I had an ovary removed because of a large cyst. A couple of years later I had a hysterectomy. I told the surgeon that I was not going back and to take the other ovary if there were any signs of trouble. He did take it and said that, because I had endometriosis, I had to wait a few months before I could have HRT so that any endo in my body could die off.
It was wonderful when I got my patches. I knew how a man feels - the same all the time with no ups and downs.

I have endo and am on continuous combined hrt. Even with both hormones daily my endo has become much worse.