Should I ask about DHEA pessaries after hysterectomy for menopause symptoms?

[Melassa]

I’ve recently had a total hysterectomy including ovaries and now several weeks post op I’m noticing changes down below - less lubrication and my vulva seems to have withered away a bit. I’m on systemic HRT (transdermic estradiol) and have needed to up my dose, to offset increased symptoms, but it doesn’t seem to have much effect down there.

I have my 12 week check up soon and was wondering if it would be worth requesting DHEA pessaries. I heard they are more effective than estriol creams/pessaries and help with loss of sensitivity as well as with vaginal mucous etc. and the fact that it is topical limits any contraindications.

Has anyone had any bad experiences with DHEA? I’m 60 but late to menopause, I had limited symptoms and the lowest dose of HRT prior to the operation, so the op has pretty much sent my body into shock. I still had a fairly high libido and was actually enjoying better sex than my younger days, but it now seems that is beginning to wither away too. I’d like to keep enjoying an active sex life for a few more years to come and I’d heard that topical DHEA can help.

nothing to lose by mentioning it and see what they say

I think clinically it makes sense and my gynae will prescribe it, I just wanted to know from experience if it really does help and/or if anyone has had issues.

I don't have any experience but my menopause specialist recommended it over estrogen cream for sensitivity and sex drive, also over systemic testosterone

@Melassa My understanding is DHEA is not prescribed by the NHS - it's off-licence in many areas. Check with your dr.

Thanks @JinglingSpringbells I’m not in the UK and it’s a paid for medicine here too, but it is prescribed. HRT is not hugely prevalent here but there does seem to be a wide range of options available for those that do take it.

@Dingaling47 have you found it to be effective? Any drawbacks? Apart from the hassle of needing to use it every day.

I'm sorry I haven't actually tried it. It was the recommendation from my private menopause specialist but it's not available on the NHS in my area and it's quite expensive privately as an ongoing cost.

I'm assuming you mean intrarosa? It is available in some areas on the NHS for GP prescription, but not mine.

My understanding of the downsides are that you can get a temporary irritation from starting it (burning sensation and redness), increased discharge, and it can change the environment to favour thrush - so possibly more likely to get repeated thrush outbreaks. I am not sure if any of that is common or not.

If you do try it please do let me know what any downsides are !

I will! I’ve never been prone to thrush so hopefully I can avoid that side effect, but yes, I was worried about the discharge element. I had vaginal progesterone before my op and that was terrible for discharge and staining underwear. Also apparently tasted horrible. Although according to AI the DHEA pessaries are flavour free…

I think it’s intrarosa here too. I will report back.