Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[TeaLoverDenise]

I'm 59 years old, dad a hysterectomy about 20 years ago; my ovaries were not removed.

I'm also an 8-year breast cancer survivor, and was supposed to have been on Tamoxifen for 5 years (I was living in America at the time) but due to the terrible symptoms, I quit after 3 years. So it's been 5 years since I've been on Tamoxifen.

The only medication I take is Omeprazole for reflux, and a daily Centrum 50+ vitamin.

I've not had any health issues at all since the breast cancer, until about 4 months ago when I suddenly started experiencing horrific hot flashes/flushes; night sweats; and sudden onset weight gain in my midriff. My libido is low, I feel a bit apathetic about life in general but would not diagnose myself at being depressed.

Finally saw my local GP a couple of weeks ago to see if she could figure out what's going on with my body.

I told her about my symptoms and past history and when I suggested to her that I thought I was going through menopause, she was adamant that I was *not* in menopause, and that I had already been through it. Until now, I've never had any menopausal-related symptoms whatsoever.

She examined my abdomen and asked if I had any aches or joint pain (which I don't, other than the usual a 59-year old person might have). She said she would do blood tests to check my thyroid and would also order an FSH test to "prove" to me that I wasn't in menopause.

I had the blood taken 2 weeks ago and today I asked for a copy of the results. The report says NORMAL for my blood count, renal profile, serum lipids, plasma fasting glucose level, liver function test, haemoglobin alc level, and bone profile. But I don't know how to interpret the FSH results and that's why I'm posting this.

Here's how it reads:

Serum TSH level
(BMJ) - NORMAL 1.7 mu/L (0.35-5.0)

Serum FSH level
(BMJ) - LH menopausal
Serum FSH level 27.5 iu/L
Serum LH level 23.8 iu/L

R HORMONE REFERENCE RANGES
NOTE: Menopausal ranges are for guidance only.
Please note the overlap with Mid-Cycle levels.
Follicular Phase:
R FSH RANGE
2.5-10.2
R LH RANGE
1.9-12.5

Mid Cycle:
R FSH RANGE
3.4-33.4
R LH RANGE
8.8-76.3

Luteal Phase:
R FSH RANGE
1.5-9.1
R LH RANGE
0.5-16.9

Post Menopausal:
R FSH RANGE
>30
R LH RANGE
>16


Erythrocyte sedimentation rate
(BMJ) - NORMAL
Erthrocyte sedimentation rate 15 mm/h (0-30)


Am I peri-menopausal, menopausal, or post-menopausal?

I won't see the doctor for another 2 weeks, but don't want to wait that long before finding out.


Thanks!

P.S. The doctor also said she was going to check my thyroid but I'm not sure where those results are to be found in the other portions of my results?

[carrs]

Hi Denise

The thyroid test is the first one. TSH is thyroid stimulating hormone and tends to be raised if you need treatment. So yours is normal.

[carrs]

There is such an overlap in ranges with the other results that i don't know what conclusions could be reached - sorry, i don't know enough about it.  The phases in the cycle are so complicated, and a person's results will change each time they are checked.

The ESR - the last one - is normal, and not really relevant.

Good luck with your enquiry! Probably some-one else will come along with more answers

[TeaLoverDenise]

Hi Denise
The thyroid test is the first one. TSH is thyroid stimulating hormone and tends to be raised if you need treatment. So yours is normal.

Thanks so much Carrie. Very helpful, and I'm relieved....

[TeaLoverDenise]

There is such an overlap in ranges with the other results that i don't know what conclusions could be reached - sorry, i don't know enough about it.  The phases in the cycle are so complicated, and a person's results will change each time they are checked. The ESR - the last one - is normal, and not really relevant.
Good luck with your enquiry! Probably some-one else will come along with more answers

Thanks again, Carrie. It is indeed complicated!

It states that Post Menopausal R FSH RANGE is >30. The results show that my Serum FSH level is 27.5 iu/L; therefore, I interpreted this to mean that I am still in Menopause.

On the other hand, it states that Post Menopausal R LH RANGE is >16. The results show that my Serum LH level is 23.8 iu/L; therefore, I interpreted this to mean that I am Post Menopausal.

See what I mean?

 

Hope someone does come along who can decipher this!

[Smokey]

Hi have you thought about asking at our local pharmacy , I had similar problem once and mine were great!

Just a thought

[sweatybet]

Hi tealoverdenise

Technically once you have had a hysterectomy you are considered post menopausal. The definition of post meno is your last period.  Blood tests are very unreliable for hormones as we go through meno. Our ovaries continue to produce hormones just not enough, often oestrogen is also produced by fat cells. Some women who lose weight find meno symptoms suddenly start. 

It may be that your ovaries have finally given up and that is why you are suddenly having symptoms.  If you want hrt you will need to push your gp or perhaps see about a meno clinic.

Sweatybet

[Rowan]

If you have had a partial hysterectomy and kept ovaries you are most likely to  experience menopause at the time you would have  had you not had op. Some women may experience it a few years earlier it all depends on the skill of the surgeon.

By the time you are 59 you are probably postmenopause either way, your ovaries don't completely give up the ghost though and can still trickle out hormones, its more then likely that your hormones are lowering and that is why you are experiencing the symptoms you described, some women can go through periodic cycles,  ( no periods though) until their seventies probably why some women have an easier menopause then other women.

I would go by what you feel and not worry about interoperating your results, and hopefully your GP will prescribe you a low dose estrogen patch, you don't need to take progesterone as you have no uterus.

[TeaLoverDenise]

Hi have you thought about asking at our local pharmacy , I had similar problem once and mine were great!
Just a thought

That's a great suggestions, Smokey! 

[TeaLoverDenise]

Hi tealoverdenise

Technically once you have had a hysterectomy you are considered post menopausal. The definition of post meno is your last period.  Blood tests are very unreliable for hormones as we go through meno. Our ovaries continue to produce hormones just not enough, often oestrogen is also produced by fat cells. Some women who lose weight find meno symptoms suddenly start. 

It may be that your ovaries have finally given up and that is why you are suddenly having symptoms.  If you want hrt you will need to push your gp or perhaps see about a meno clinic.

Sweatybet

Thank you Sweatybet. I'm kind of a research nut when it comes to my health (wanted to be as informed as possible during my breast cancer) but have never looked into HRT. Time for a bit of reading, methinks!

My GP doesn't really know me at all. I've only been to her once before. She's not exactly the warm and fuzzy type. Not that that makes a difference but she was so adament to prove me wrong about being in menopause, I'm not sure what she'll have to say about HRT. Suppose I'll find out when I see her on Monday. 

What is a meno clinic? I'm American (married to a Brit) so still navigating the NHS waters -

[TeaLoverDenise]

If you have had a partial hysterectomy and kept ovaries you are most likely to  experience menopause at the time you would have  had you not had op. Some women may experience it a few years earlier it all depends on the skill of the surgeon. By the time you are 59 you are probably postmenopause either way, your ovaries don't completely give up the ghost though and can still trickle out hormones, its more then likely that your hormones are lowering and that is why you are experiencing the symptoms you described, some women can go through periodic cycles,  ( no periods though) until their seventies probably why some women have an easier menopause then other women. I would go by what you feel and not worry about interoperating your results, and hopefully your GP will prescribe you a low dose estrogen patch, you don't need to take progesterone as you have no uterus.

Hi silverlady, and thanks for the progesterone information; I didn't know that.

I agree that the best thing is to go with what I feel. Will definitely start reading about low dose estrogen.

It's just been so shocking to all of a sudden start with such pronounced symptoms. There was certainly no 'easing into it' - bam! The hot flashes/flushes, night sweats, and weight gain seemed to just show up on my doorstep one morning. 

[Hurdity]

Hi TeaLoverDenise

Just to clarify the point re progesterone and sub-total hysterectomy - ie retaining ovaries - apparently it also depends on whether the cervix was retained.

Here is what it says on this site:

Sub-total hysterectomy

If the main part of the uterus has been removed but the cervix retained, it is currently uncertain whether HRT can be given in the form of estrogen only or estrogen combined with progestogen. The slight concern of using estrogen only, is that there may be some of the cells of the lining of the uterus in the cervical canal which could become thickened from the estrogen. This thickening can be prevented by adding in progestogen. To find out if progestogen is required, it may be suggested to use estrogen combined with cyclical progestogen for 3 months after your operation. If there is monthly bleeding in this time, it means that cells are present which are responding to the hormones so estrogen and progestogen should be used thereafter. (These hormones can however be given together continuously to avoid monthly bleeding). If there is no bleeding in the first 3 months, then estrogen can be given on its own thereafter.

http://www.menopausematters.co.uk/aftermeno.php

Once you have read up on it maybe try it this way first?

Hurdity x

[TeaLoverDenise]

Hi TeaLoverDenise
Just to clarify the point re progesterone and sub-total hysterectomy - ie retaining ovaries - apparently it also depends on whether the cervix was retained.
Here is what it says on this site:
Sub-total hysterectomy
If the main part of the uterus has been removed but the cervix retained, it is currently uncertain whether HRT can be given in the form of estrogen only or estrogen combined with progestogen. The slight concern of using estrogen only, is that there may be some of the cells of the lining of the uterus in the cervical canal which could become thickened from the estrogen. This thickening can be prevented by adding in progestogen. To find out if progestogen is required, it may be suggested to use estrogen combined with cyclical progestogen for 3 months after your operation. If there is monthly bleeding in this time, it means that cells are present which are responding to the hormones so estrogen and progestogen should be used thereafter. (These hormones can however be given together continuously to avoid monthly bleeding). If there is no bleeding in the first 3 months, then estrogen can be given on its own thereafter.
http://www.menopausematters.co.uk/aftermeno.php
Once you have read up on it maybe try it this way first?
Hurdity x

Thank you Hurdity. My cervix was removed during hysterectomy. I remember my gyn saying at the time that removing the cervix would mean one less organ to worry about getting cancer in. So sounds like estrogen only would be fine, if my gp recommends it?

[TeaLoverDenise]

Just to update ... my GP confirmed that I 'probably' am indeed in menopause.

Because I am a breast cancer survivor (8 years), she did not want to put me on any kind of estrogen for the hot flashes, so instead has suggested that I try Venlafaxine. She said that when used as an anti-depressant, the dosage is 2 tabs/day, but when used to control hot flashes, it's just 1 tab/day.

I'll pick up my prescription tomorrow and see my GP again in 2 months.

Thanks everyone for your assistance.