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[bluebird]

Hi everyone,
Have lurked for a while and done quite a bit of reading in that time but I've now got a question that I can't seem to find the answer to, so I hope someone may be able to help me.  I am 45 years old and last December had my only ovary removed due to a cyst (my other ovary was removed for the same reason in 1996).  I have been on femseven sequi since February and was ok with it for a while but over the last few months my symptoms seem to have returned i.e waking up at stupid o'clock and not getting back to sleep, short temper and the monthly bleeds have been getting lighter.  This month it happened 9 days later than it should have, so I rang the docs when I was about a week late and gave her all this information and she wants to put me onto continuous combined HRT (I still have my uterus).  Since then I have had a bleed and I'm now wondering if the time is right to change to continuous HRT and is the lining of the uterus safe?  Also for anyone who changed over, did your periods stop completely before?  I haven't had a natural period for 14 months so I'm concerned that even though the HRT is making me have the bleeds, that there is something there that needs to be shed and if I change over to continuous HRT that it will build up.  As you have probably gathered I'm getting in quite a muddle with it all.  There doesn't seem to be very much information for ladies who have had ovaries removed and have kept their uterus.
Phew! Thanks for bearing with me if you got to the end of my post!!
Bluebird

[Dancinggirl]

bluebird - welcome to MM
I do agree with you, there is simply not enough information given to us about this stage in our lives and you really should have been given proper advice after your operation.
I am certainly no expert and there are some very knowledgeable ladies on MM, with science background, who may be able to give you more precise help.
My thoughts are: now you have had both your ovaries removed, you are basically post menopause now so without HRT your wouldn't be having periods. What little oestrogen your remaining ovary produced has now stopped so your body has little or no oestrogen production so you are reliant on the HRT. Some of us do experience erratic bleeding on HRT but sometimes the patches don't stick that well and maybe you weren't absorbing the hormones that well.  The lack of a bleed might mean your womb lining hadn't built up enough at that stage and the fact that your meno symptoms had returned could indicate that absorption wasn't happening well - I suspect you may be needing a higher dose of oestrogen - you are still young and many women need more oestrogen to control symptoms.
If you do move to continuous HRT then initial bleeding and spotting for the first 3-6 months is quite normal but this should settle and result in no bleed at all after this initial stage.
I do wonder if you might be better on Oestrogel with a separate progesterone taken either monthly or continuously so you have better control over the amount of oestrogen you use. I've used OEstrogel for many years and started with just one pump per day and then increased in my mid 40s when I needed more - I had a premature menopause so have used HRT since I was 37.
I am now 59 and use  a very low dose of  Oestrogel with Utrogestan in a continuous regime and find this very good.  Your GP might like to try you on Provera which is also a good progesterone to try alongside Oestrogel. I would print out the info under TREATMENTS above to talk through with your GP.  These two progesterones may help with your low mood and PMT type symptoms as they are less harsh than the synthetic progesterone in Femsevern.  Many GPs need to be guided when prescribing HRT as they are not usually up to date on these things.
I hope that is helpful.
DG x

[CLKD]

Gynaecologists should give information before Surgival intervention regardless 

   browse round, make notes.  Join in. 

[Hurdity]

Hi bluebird

  from me too.

Dancinggirl has given you an excellent reply and I agree with everything she says. At your age I would definitely want a higher dose and also I prefer separate oestrogen and progesterone as well.

Hurdity x

[Taz2]

Hi bluebird - welcome from me. I agree with Dancinggirl and Hurdity - they know their stuff!

Taz x 

[Kathleen]

Hello bluebird and welcome to the forum.

I agree with Taz2, Dancinggirl and Hurdity are among our experts and their replies are always informative.

I hope you are able to get the help you need.

Wishing you well and keep posting.

K.

[bluebird]

Thanks for the warm welcome everyone. The advice here is fantastic and much easier to get my head around.  We have a few doctors in our  practice and some only give the information needed if you go armed with questions, otherwise it's difficult to get all the information out of them!! That being said I think I do need to go armed with questions so that I don't come out with more questions than  I had when I went in.
Hopefully I will be able to see my G.P this week to get to the bottom of what's going on.
Thanks again ladies
Bluebird