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[ichante]

Hi Ladies, I'm new to this forum but hope I can get some reassurance and advice.

I am due to see my gynaecologist tomorrow and terribly afraid of what might be the inevitable next step. I am 50 years old now and started seeing the specialist gynaecologist two years ago. After suffering with severe PMS symptoms, debilitating physical symptoms including, fatigue, flu like symptoms, pelvic pains, depression and felt suicidal every month on the days leading up to my period.  After some persuasion my gp eventually referred me to a specialist and the gyneacologist put me on HRT. After two years on Evorel patches and Crinone/progesterone treatment things got slightly better particularly moodwise. At the end of last year, I was put on the Decapeptyl analogue injections  to shut down my overies but they made the menopause symptoms  worse, so the everol patch was increased to 150mcg. Unfortunatley,  I have fibroids and they have now grown into 3 large Fibords which means I have constant backache and very heavy painful periods.  My moods and anxiety  are starting to get worse, because I am in so much pain all month long. 
I don't think the specialist will suggest starting the injections again, because my meno symptoms will get worse and if I am put on a higher does of HRT,  my fibroids will just grow even larger.

I feel he will suggest a hysterectomy, which I think is the right thing for me, but I am worried that once I agree to have the op, things will be out of my control and I am also terrified of the complications.

I've left alot out of this post, but as many of you know my story is not unique and it would be easy to fill in the gaps.  I have not worked in two years, I'm exhausted, in pain and emotionally drained. I am normally a strong feisty female but i'm just a jibbering wreck and and my children want their Mum back .

I would really welcome some advice - HELP!!!

[Rowan]

Its a shame that increasing your estrogenpatch to 150mcg ( a hefty dose) has caused  your fibroids to grow, it is thought too that progesterone can increase their growth and now you think a hysterectomy will be suggested.

A hysterectomy may well relieve a lot of your problems and could well make sorting your HRT out easier.

Hysterectomy is a big step, here are some links to educate yourself and make sure you choose what is right for you.

http://www.nuff.org/links_patientinformation.htm

Not all fibroids shrink post menopause, I was told by my consultant that mine probably wouldn't, I had a hysterectomy, conserving ovaries and cervix.

[ichante]

Hi Silverlady,

Thanks so much for your reply.

I was initially being treated for severe PMS/PMDD and think I am perimenopausal.  As you mentioned the fibroids have only become a problem because of the HRT treatment.  The hefty dose you mentioned, HAS helped alot with my extreme low moods. Prior to HRT the depression and anxiety were the most worrying of my symptoms. I tried  3 different types of anti-depressants but they made me worse; saying up all night; feeling like a zombie and the thought of leaving my children always stopped me from acting upon the suicidal feelings, but one antidepressant made me stop feeling anything at all. So I know they are not good for me.

Thanks for the link I will make sure I check it out and go prepared tomorrow.
Thanks again.

[Dyan]

Just sending you a  :bighug:ichanti.

[Hurdity]

Hi ichanti

Firstly I just wanted to say 

Sorry to hear your story and your ongoing problems.

I don't really understand about the Decapepytl injections? From what I read they are used to treat endometriosis and fibroids in particular and act by decreasing the oestrogen in the body - so of course this would lead to menopause symptoms. Therefore increasing the oestrogen ( as you have - to 150 mcg) will only exacerbate the problem the Decapeptyl is attempting to treat?  . I am wondering why you had to start them?

Are you still having the injections and is the effect of them reversible on the functioning of the pituitary gland when you stop the injections?

Here is what it says about fibroids and HRT on this site:

Fibroids   
    Fibroids are benign smooth muscle tumours of the uterine (womb) wall and are dependant on estrogen. They tend to shrink after the menopause but shrinkage may not occur, or they may even increase in size with HRT use. Increase is thought to occur in 25% of HRT users and mainly occurs in the first six months of therapy. There is some evidence that transdermal (patch or gel) but not tablet HRT nor tibolone may promote fibroid growth. [ref 24] Fibroid size can be monitored by regular examinations and sometimes by ultrasound scans. There is some evidence that the use of the progestogen releasing intra-uterine system, Mirena may cause fibroids to reduce in size. Mirena is often used in the perimenopause by women who have heavy periods and/or require contraception and can provide the progestogen part of their HRT.

Have you thought of using a Mirena as suggested above? Some women get on really well with this although some experience side effects since it is a synthetic progestogen, although littlre systemic absorption is intended. This might be inadvisable though if the cause of your PMDD is extreme progesterone intolerance.

Also have you read what Prof Studd says about PMS/PMDD?

http://www.studd.co.uk/pms.php

If you follow this link then the menu on the right of the page will take you to a series of articles about the treatment of PMS/PMDD such as this one:

http://www.studd.co.uk/pms_various.php

I appreciate that with fibroids this might be difficult and I am wondering whether your speciliast gynae has suggested other options such as Prof Studd suggests. Are you on NHS? if not there may be others in your area who would suggest different treatments if you are not happy with what is being suggested.

Good luck with your appointment and do let us know the outcome.

Hope this helps

Hurdity  x

[ichante]

Hi Dyan,

Thanks for the hug - I need it. Leaving soon for my appointment, will keep you up to date when I get home. x
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Hi Hurdity,

I really appreciate the warm welcome, and yes your reply has helped.
The coil was suggested to me - but I was reluctant to try it because of my sensitivity in that area.
The injections were supposed to shut down my ovaries to see if my PMDD symptoms reduce. They did for 1 cycle, but menopause symptoms kicked in after two months of being on them.  That is why the oestrogen  patches were increased, leading to a growth in my fibroids.
I had a brief look at the links to Prof Studd's articles which helped clear my foggy, anxious thoughts.
I'm leaving soon for my appointment, I do feel more prepared to ask the right questions.
Will let you know how it went.

Thanks again. x