In recovery from radical hysterectomy - what should I expect?

[LittleMissSunshiner]

Hi, I'd be grateful for input from anyone who's either knowledgeable on the subject or has experience.

I'm 53 but had not had any signs of menopause prior to surgery.

I had a radical hysterectomy two weeks ago (uterus, fallopian tubes, ovaries, cervix removed).

So, I'll now be in sudden onset menopause, no symptoms so far - what should I expect?

The surgery was done differently than originally planned and was seemingly quite brutal for various reasons - the surgeon had difficulties (not her fault) as my uterus was exceptionally large, over 300g, but it was done with keyhole / laparoscopy and removed vaginally, I believe in line with certain protocols.

So, I have no abdominal cut bar three small holes that are healing well. My vagina on the other hand was grazed, bruised, and cut and stitched a lot, inc perineal, which I wasn't expecting - my main / only 'issue' is discomfort trying to sit down on a chair. On day 11, I cut the one tightest of my stitches myself as they were stitched way too tight and it was either that or A&E which I couldn't face.

I'm in recovery from all that and feel much better every day - able to walk around out and about with a walking stick for support. I've come off the painkillers bar the odd ibuprofen or low dose codeine & paracetamol. I do feel quite exhausted and have been sleeping a lot but that's nice as usually I have a lot of anxiety and obsessive thoughts and struggle to relax. So, overall I'm happy the procedure is done and everything's gone for biopsy.

My issue is the menopause side - what should I expect? And how soon? I was issued an oestradiol gel pump in hospital with no instruction bar told to rub it in my arm. I've been doing one pump of gel once a day, no idea if this is correct. I see other people saying two pumps or twice a day. Regardless, I've had no symptoms of menopause whatsoever.

How long after ovaries being removed does it take for menopause symptoms to kick in? What sort of symptoms would I be looking for? I've never had a hot flush for example, would I now start to get them? Will the oestradiol be already making the difference sufficient that I won't get any symptoms? I honestly don't know what to expect. I hear people say they had to adjust their HRT and fine tune it or this and that but I've got no-one to consult with on this matter.

Any experiences or advice?

I had my first hot flush less than 24 hours after my ovaries came out. No HRT as I'm not able to have it - just had to ride out my menopause. I'd been fully having periods beforehand.

If you have a hot flush you will certainly know about it, so I'm guessing your oestradiol is keeping symptoms at bay for the moment.

I hope your recovery goes well. Mine was abdominal so I had a large wound to deal with - the keyhole surgery must be a big advantage.

Ah thanks for this info.

I'm sorry you can't have HRT but I guess there's solid reasons and tbh it's not even something I've researched the pros and cons with.

My surgery was planned to be abdominal and far more extensive than what actually happened so I guess I got lucky. The surgeons team decided certain things didn't need to happen on the day.

Same time, having a giant uterus wrangled out seems to have been quite something and my surgeon repeatedly denoted 'with difficultly' several times in the proceedings notes and also expressed her 'difficulties' to me verbally.

Overall, I can't really believe I don't feel any different - I even started to suspect they hadn't done it (they have done it). I'm still in the same chronic abdominal pain as I was before as it turns out that must have been colo-rectal / other abdominal issues and not gynae anyhow but I was having constant daily bleeding that has now stopped.

It will take a while for everything to heal internally - I was in pain for several weeks and bleeding sporadically from my vagina - nothing like menstrual blood, it was pale pink spotting. My uterus had been fused to my bowel and ovaries so there was a lot to surgically disentangle. Are there plans to further investigate your colorectal issues once you have healed from the hysterectomy?

I had similar issues - my left ovary, left bladder, colon and uterus were all bonded with scar tissue in one specific site (injury from previous surgery).

The original plan was to cut out all scar tissue and take a section of colon whilst inserting bladder stents to keep my ureters safe. So... I'm not sure what happened and whether to feel relieved that never happened or worried that they didn't do the whole job?

No idea how they untangled it all and got my uterus out without making the abdominal cut that was originally intended but surgeon must have done, 'with difficulty' as she said. My abdominal cuts are tiny little keyhole 'X's and not cuts, so that's cute. I do have the pink discharge / spotting, nothing serious and glad you mention this as was beginning to worry that it was infection discharge (no sign of infection).

I've made an appt wi GP to ensure that I am referred to colorectal investigation as was told by gynae surgeon 'now is not the time' and to heal first but far as I know she hasn't referred me.