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[osieb]

Hi, sorry this is a bit long winded but does anyone know what happens when a woman with a womb but no ovaries is taken off of HRT. Do women experience the menopause the same as other women with ovaries cos this is the second time I have been taken off of HRT. The first was when I was 48 and now when I'm 51. Each time the flushes, night sweats, dryness and mood swings have been really bad getting worse as time goes on. I am at 3 months off HRT at the moment and my gp says I have to give it 6 months at least. Last time I was like it for 9 months and I didn't have a full nights sleep for 8 of those months. The same has started to happen again so I think what I'm trying to ask is do women with no ovaries get these symptoms for the rest of their life or do they eventually go away like normal intact menopausal women.

[Hurdity]

Hi osieb

I can't really answer your question but I imagine that there will be the same range of response as there is with women with ovaries ie some women will experience a resumption of symptoms which last for a long time - maybe always, and some will experience a resumption for a short while after which they will decline and disappear, and maybe some women will never get a resumption of symptoms.

May I ask why you have been taken off HRT? Is it just for a trial period to see how you feel and because you have reached the natural average age of menopause? Have you had health problems due to HRT?

Unless there is a good medical reason to come off in your particular case there is no reason why you cannot continue with HRT. If you look at the menu on the left under Hormone Replacement Therapy - you will see that the benefits generally exceed the risks between aged 50 and 60.
http://www.menopausematters.co.uk/balance.php

If you want to come off HRT then I gather that 6 months is the understood trial period to see what happens to symptoms. If you would rather continue then go back to the doctor and request that you go back on it. 3 months was the longest I came off it ( at age 57) - and that was my choice. For me I couldn;t cope with work and the symptoms so went straight back onto it.

A friend of mine is 63 and still gets tablet HRT from doc because she works full time and also couldn't cope.

The great thing in your case is that you don't need a progestogen because you don't have a uterus - so I imagine HRT is quite straightforward for you?

Hurdity x

[osieb]

Dear hurdity, I was taken off HRT because I started to get heavy bleeding and really bad back and tummy pain. After having a scan it transpired that I had fibroids and the consultant was reluctant to remove them cos he said that by stopping the HRT it was hoped that they would shrink and disappear on their own. Since stopping the HRT the only thing that has changed is the bleeding has stopped. I still have all the pain in tummy and back but of course all the menopausal symptoms as well. I did have to have progesterone because I have everything except ovaries which were removed in my thirties because of recurring benign cysts. I have frequently asked for a total hysterectomy but have been refused each time with no satisfactory explanation why. My gp is excellent and is getting more involved in trying to help with why they won't do the hysterectomy. She is also in contact with a consultant out of our area for advice and depending on what the outcome of my next scan is I will probably go and see this consultant instead of usual one because I think a second opinion is called for now cos I really am struggling to cope. Thank you for your advice it was good to hear that HRT can still be given in your sixties.

[Hurdity]

Sorry osieb - I wasn't thinking straight last night and when I said you didn't have a womb and you didn't say that at all!

I understand that the medical professions doesn't recommend hysterectomies as often as in the past. However if you are suffering badly from menopausal symptoms and are unable to take HRT because of the fibroids, then you have a right to any treatment that enable relief from these symptoms - so I would say if a hysterectomy is the only way this can be achieved, then the consultant should allow it, and especially if they are causing you pain.

On this site (blue menu - health conditions) there is this information about fibroids and menopause:

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.

Maybe you could ask to have a Mirena fitted and see if this works to keep the fibroids shrunk, and enable you to take oestrogen? However if it is the fibroids causing pain too then this may not be the solution.

Best of luck in trying to sort it out - with the help of what sounds like an excellent GP!

Hurdity x

[Taz2]

Hi osieb. Have you considered an ablation to get rid of your fibroids. This is not so drastic as a hysterectomy which is a major op. Details here http://www.nhs.uk/Conditions/Fibroids/Pages/Treatment.aspx  along with other treatments for fibroids.

Taz x

[osieb]

Hi taz it hasn't been suggested to me about an ablation for the fibroids so I will enquire about that. Many thanks x

[osieb]

Dear hurdity thank you so much for the information you posted to me x