Just had surgery. HRT. Supplements. What do I need to consider?

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I've just had surgery and for various reasons both my ovaries and tubes have been removed as part of the procedure. Currently resting with my feet up on the sofa trying to ignore the pain! Not sure how soon I can expect any menopause symtoms to kick in.

I have an appointment in a couple of weeks with my GP to discuss going on HRT. I'm early to mid 40s and can't have anything that increases my blood clot risk for other reasons. Also I have endometriosis (previously treated a number of years ago and still evident at my surgery this week) so possibly this limits my options too? Also previously diagnosed with adenomyosis although symptoms more manageable in recent months. Obviously I know the GP is best to advise but I would like to be informed when I go and it feels like a minefield.

Should I also consider any kind of supplements? Various celebrities seem to be endorsing these. Is this something the GP would advise on?

Feeling a bit lost. The Internet has so much information it's difficult to know where to begin and whose claims to believe on the supplements. Any help or advice appreciated.

I'm sure you're worried about this but your consultant should have discussed HRT with you pre-op and you should be using it now depending on the reason for removing your ovaries.

So what I'm posting only applies if you are able to have HRT and it's not a complete no-no (ie some form of cancer .)

At 44 it's classed as early menopause and the standard medical advice (you can find it all online - (search early menopause) is to use HRT to protect your bones and heart.

If you have endo, you can have HRT- you just need to take progesterone of some sort daily which will (hopefully) stop the estrogen stimulating your endo.

There is an online endo support group and you may find info there too.

Supplements aren't necessary if you eat healthily and can get your HRT to work for meno symptoms.

Do not rely on your GP being an expert. Many know nothing about HRT as they've had no training in it.

If your GP isn't helpful you may have to think about seeing a consultant privately if you can.

All the best with it!

Hello- I had a full hysterectomy a couple of years ago when I was 41. I was given HRT on leaving the hospital. Whilst it’s worked for the main menopause physical symptoms, it’s not been effective for brain fog, nor achey legs. For these magnesium has been really useful. I’ve found nutrition geeks menopause pack has been good, the magnesium from there especially. I’ve experimented with a few!! There is a lot of pills in there in the pack so I now feel like I take loads but it’s worked for me. Good luck!!

That's interesting to know I should potentially have been on the hrt on leaving hospital. Pre-op the surgeon did mention a few potential options in terms of what I may be able to take and after the op I asked about how soon I should be starting it and he said 'to let things settle down for a couple of weeks' and then see the GP. I'm not aware of any reasons I won't be able to take it. No suspected cancer but histology to confirm for sure. It's just the blood clot risk that may restrict what I can have. Thank you for your replies though. I've booked a GP appointment for the week after next so will see what they say.

Many GPs are adequately trained in this, there's been a massive increase in demand and training, CPD also during med school etc. Obviously it's good to be informed but definitely have a discussion with them about pros and cons.

Do you have a follow-up booked with your consultant? Most of them do let the GP sort if as they are your primary care doctor, and you'll see them more often. It's better to start as soon as you can, and by the time you likely see your consultant you can troubleshoot them for anything that needs more specialist tweaking but you likely won't. As post-op follow-ups can be a while away and you don't want to wait all that long.

Patches are a really good idea, also look I to low dose topical vaginal oestrogen as it will help prevent vaginal dryness, low libido, prolapses if you had cervix removed etc. So definitely recommend that as well.

Are you on any other medication. Look at the British Menopause society website. Also I recommend Dr Arif on LinkedIn, the campaigns she's done with the NHS, insta etc.

Supplements endorsed by celebrities are selling tacits, many don't even take them. If it's something like magnesium you don't need their 'special one', just get some from Tesco etc, the own brands ones work well, and they are quite cheap and are the same as any others (bar dosage etc).

Sorry just to check you didn't have a hysterectomy? Are you anything like the mirena etc? As that can massively help for adenomyosis? Do you take any other medication etc?
I hope recovery is going as smooth as it can, make sure to rest a lot.

@TheLivelyViper Thanks for your reply. No follow up planned as far as I know. It wasn't a hysterectomy, still have my womb and cervix. Meds I take are Clopidogrel and Atorvastatin as a preventative measure to reduce risk of blood clots. I don't have the coil at the moment. The main reason for the op was to remove a very large cyst. It's the third one I have had removed which is the reason they took ovaries and tubes this time to prevent reoccurring. Originally they were going to do a full hysterectomy but the adenomyosis seemed to have calmed down the last 6 months so it wasn't deemed necessary. I think my hormones were all over the place due to the cyst so I wasn't keen on introducing a coil too. I will see how things go now that it's gone and I'm on the hrt I think.

I think sometimes, some drs are very quick to whip out ovaries and not give enough consideration to what happens next. It's a big step to have ovaries removed as it's an immediate surgical menopause.

There are many forms of HRT that don't cause blood clots.
The older types may have but not modern HRT.
You can use transdermal estrogen- gel, spray or a patch.
You could have a Mirena coil, or a patch with progesterone added, or maybe micronised progesterone which doesn't appear to raise clot risks.
Estrogen actually has a benefit on blood lipids and can reduce heart disease which is why it's important to use it if you have an early menopause.

The main advice I would give is

1. do your own research BUT carefully- be wary of what you read/who you follow online as every other thing is being marked up and sold as a menopause treatment these days
2. persevere because there's so much out there, it may take a while to find what's right for you.

For me, ovaries out age 43 - I can't have HRT but I can have vaginal estrogen which is marvellous, and I lift weights to keep my bones strong. Have massively cut down on alcohol to help with sleep and hot flushes.