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[AuntyFester]

Hello ladies, Just wondered if anyone can give me some advice.
I had my second ovary removed on 1 April and a Mirena coil inserted at the same time - so far so good. I have been unable to take any estrogen until my histology results were through. Now I have got the all clear    I am off to see my GP today for something.
I do not want tablets so am looking for patches (Estrodot?) or gel (Estrogel?). Has anyone had experience with either of these with the Mirena fitted and what starting dose should I be expecting.
I have also had some horrible vaginal atrophy symptoms, can I/should I ask for a cream as well - or is it one or the other?
Just to give you a bit of background - I'm 50, had my first ovary removed 7 years ago due to a tortioned cyst. not been able to tolerate oral progesterone well. Been on HRT (various) since then as perimenopausal and family history of osteoporosis. Was taken off HRT last year with the emergence of issues with my remaining ovary - now sorted 
Lack of libido has been a problem since I had my first ovary out and increasing dryness. Now - well to be honest it wouldn't bother me if I never had sex again  I know this is not "normal" and not something I want to settle for. It is affecting my other half a lot and has had him in tears on more than one occasion  He has been terribly supportive and understanding but we have not really talked in detail about it before now. I would love to get this sorted and be back to having a fulfilling sex life!!  I have pointed him to this site for information too as I have found it so useful.
Thank you all in advance, sorry for the long post.

[dahliagirl]

Hi - you can use vagifem with hrt so I am sure it is not a problem with oestrogen and mirena! I do and it works for me, along with a moisturiser.  I do use more than the 2 a week though.

 There are people here who have had mirena and oestrogen, so hopefully one will be along soon 

[Dancinggirl]

I've used Oestrogel for many years and love it because you can adjust the dosage yourself according to your needs.  I use Vagifem local oestrogen alongside to help with VA and bladder problems.  Good luck  DG x

[Hurdity]

Hi AuntyFester

This is probably too late for your appointment but I've used Estradot 50 for years which controls the main menopausal symptoms of flushes and sweats and probably a whole host of other symptoms - as well as being the dose which is licensed for protection against osteoporosis. The patches are very small and I can forget about them! If you've had both ovaries removed then you may eventually want a slightly higher dose than 50 mcg.

Also like the others, I use Vagifem ( or other vaginal oestrogen) alongside full systemic HRT and most gynaes recognise that local oestrogen is often necessary to plump up that area fully.

Do hope you got on OK with your doc and keep us posted.

Hurdity x

[AuntyFester]

Hi
well I visited the Dr and have been given Estradot 25. She went through the whole 'talk' about potential side effects of HRT, even down to the fact that there is an increased potential of ovarian cancer - it was at this point I suggested to her that as I had just had my remaining ovary out this was not really an issue. She did have the grace to look embarrassed. i wouldn't have minded if she hadn't started the consultation asking about the potential incisional hernia caused by the op and telling my histology results!!
Wouldn't prescribe a higher dose - even though there is a history of osteoporosis in the family so will have to go back in three months. Will definitely be asking for another Dr this time.
I have looked at a referral to a menopause clinic but, despite details on this site I cannot find any evidence of it still being in existence and when I rang the surgery no-one had any idea what I was talking about.
I'm on patch number 2 now and think I have seen an improvement in some of my symptoms. I was certainly sleeping better - until I said it out loud!
No improvement on libido though - I guess that will take time. Whenever I try 'the deed' with hubby it is dry painful and little or no sensation (TMI). We are using a standard lubricant to help with discomfort etc but it doesn't help with the other issues of VA. I did ask for some Vagifem/Estrodil/Gynest and she refused point blank to even consider it. From everything you lovely ladies have said I am thinking of going back and seeing another Dr and pushing for this again. Any thoughts?
Thanks for the support, it's good to know there are people out there who are in the same place.
x

[dahliagirl]

If you need more oestrogen, you usually find that symptoms improve at first on the lower dose, then revert back.

Most things you find to read on the subject say that systemic oestrogen does not always have an effect on urogenital symptoms and you need the vaginal stuff too.

The doctor that prescribed my hrt tablets told me all about the cancer risks and did not update my vagifem prescription, so I ended up going back to see another one (with thrush again) to get it reinstated.  You also need them to be flexible about how much you use as 2/week of vagifem is not enough for a lot of people.  Mine allow you to double it up.

[Hurdity]

That is a very low dose - and only 50 mcg is licensed for protection against osteoporosis (less give some protection ie does prevent some bone loss - but not enough).  Glad your symptoms are beginning to improve. As dahliagirl says this is what happened to me after I stopped HRT for 3 months. My symptoms all came back so I went back on to Estradot 25 (I was 58 by then) - this worked for a while but then the symptoms crept back. As soon as I went back onto Estradot 50 they disappeared completely so I have stayed on that dose.

Hurdity x

[AuntyFester]

Thank you Hurdity and Dahliagirl.
Will be ringing the surgery this morning to make an appointment to see a different Dr. Will go armed with info form here
 

[lancashirelass]

25mg for surgical meno not enough you need more