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[abbyH]

HI everyone.. It's been a while since I posted. Hope everyone is doing well.

So, following unsuccessful treatments for fibroids and the risk of ovarian cancer being high for me (mother) I opted for a vaginal hysterectomy and laproscopic ovary removal - both done last monday as a day patient...

I feel fine and am recovering well

The consultant was vague aboout HRT. and said I could take it if I 'wanted'

I have oestrogel  - left over from when I was taking it before
but obviously need no progesterone, however I know also there are benefits to taking it

Any ladies on here with a good post op regime they can recommend? and would I be able to get testosterone? I believe the NICE guidelines say we can have it 'if libido low'

Im not currently in a physical relationship but ....

Any advice welcome and thanks for reading...
Abby

[Taz2]

Hi abbyH - firstly congratulations on having a vaginal hysterectomy as a day patient! I had this done but had to spend two nights in hospital - good job really as I had bleeding problems during the first night. Have you been given advice as to your recovery from the hyster and what you can and can't do over the next six weeks or so?  It's two years this week since I had mine I've just realised.

I think the testosterone availability depends on your age to be honest. If you are in your fifties then it's not deemed necessary (according to my consultant) to prescribe it but if you are still in your early forties then you may get it prescribed. It is useful to maintain energy levels as well as libido.

Rest and enjoy being looked after for the time being!

Taz x

[abbyH]

HI Taz!
I'm actually feeling fine a week post op, been walking and am doing very gentle yoga
I am in 50s.. but hope that my GP might prescribe it
am seeing her this Friday and she's been open to giving me what I requested in past.

so should I be on HRT ? can I not take it?
I've had no guidance WHATSOEVER!

yes in and out in a day.. had a few days of being looked after, but am really fine.. and bar a bit of a bloated stomach, nothing too drastic scar wise.. the hysterectomy feels less intrusive .. everything is fine 'downstairs' as it were!

thanks a lot
xx

[Taz2]

It sounds as if you are doing fine but you do need to be careful - especially with the walking - the pelvic floor will have been compromised and you need to guard against prolapse. These are the guidelines I was given by my consultant who stressed that you do need to give the pelvic floor time to heal. It's easy to forget about how many internal stitches you have inside when there is no visible big scar on the outside. Things have been disconnected and reconnected and take a while to recover. http://gallery.mailchimp.com/a5692c6457e86f0e2182630fa/files/sbs_recovery.pdf?utm_source=Free+Hysterectomy+Booklet&utm_campaign=30c61c525a-Booklet-14&utm_medium=email 

If you needed HRT before the op then I would think you still need it after? It depends on how you are feeling. Some women don't get many  menopausal symptoms and others, as you know from on here, suffer greatly. You may need topical oestrogen for vaginal dryness and even though you are not in a relationship it is a good idea to think about how you can keep the vagina supple as depending on whether you kept your cervix or not you will lose some lubrication and the vagina is shorter than it once was. I find it strange to think of the surgeon deciding on what length they need to give us "hmm this looks like a 5cm lady"  or "this lady looks like she might need a 9cm length" 

Taz x

[abbyH]

Thanks Taz
that's very interesting, didn't get any info whatsoever
just discharged in a day and sent home with painkillers.. not very good
I have a good PF but will be super vigilent and yes walking gently only to the shops - the consultant said to resume walking as soon as possible and normal exercise as soon as I felt up to it.
I did have my cervix removed.. but was also told by another consultant this would not alter the length/shape of my vagina at all!

were they telling porkies?
I'm keen to hang on to vaginal lubrication.. so will discuss all with doc next week and have topical oestrogel.. only thing is it makes my boobs swell up rather a lot.. hopefully that might settle down after a few months?

thanks a lot
Abby

[Taz2]

Removal of the cervix does alter the shape due to the fact (as I understand it) that they have to make a "cuff" to suture the top of the vagina shut which can reduce the length. The removal of the cervix is subject to much debate. I had no choice as my operation was due to prolapsed womb but I did read up about it before hand just to see what to expect. In my opinion women are not given enough information before the op on the impact the removal of this important part of their anatomy can have. https://www.hysterectomy-association.org.uk/information/the-emotional-impact-of-hysterectomy/the-unkindest-cut-of-all-removal-of-the-cervix/   

Taz x

[Mary G]

abbyH, I would definitely continue with the gel, no two ways about it.  Also, at some stage, you might want to look into testosterone, you may well need it.

I think it is terrible that you were not given any advice about HRT following a full hysterectomy.  I will say what I always say and that is, if you don't get anywhere with the NHS or feel you are being fobbed off, have a consultation with hormone and menopause expert professor John Studd or another private gynaecologist if you can afford it. 

Hope you continue with you good recovery!

[CLKD]

Maybe write a letter to Professor Studd and point out the lack of consideration that the Consultant offered - how they can sleep at night beggars belief !!!!

Little steps. 

[Hurdity]

Hi abbyH

If your consultant said you could take HRT if you wanted to then isn't that sufficient? However I agree that explanation should be given.

I presume you were post-menopausal before your op or did you not know because you were taking HRT?

The main thing is - if you go into surgical menopause through having this operation then HRT is essential (ie if not menopausal beforehand). If you are post-menopausal and have a hysterectomy and retain ovaries then I can imagine some gynaes may not necessarily suggest adding oestrogen - because you may well not notice any difference. If you are post-menopausal and have both womb and ovaries removed, depending on how far post-menopause you are you may well experience symptoms of oestrogen deficiency because there is some activity (even if not ovulation) for a few years following last period and this is most pronounced for the first two years. Also as has been said ovary removal will also reduce testosterone production especially in women for whom this is "ovary led" as my GP put it.

So - most importantly then it depends where you were in menopause when you had the operation. There is no should about it - for example if you are post-menopausal and in your 50's you could perhaps wait and see how your body reacts and take it if you feel you need to. However there is nothing to stop you taking it now - because if you have been taking it anyway then your body may well react to stopping - irrespective of how it reacts to the operation - as Taz has already said.

Re the testosterone - low libido is the most obvious symptom and you should be able to gauge this whether or not you are in a relationship ( ), but in addition fatigue and muscle pains especially after exercise may also be apparent (as they were with me). The NICE Guidelines do make provision for women to be prescribed testosterone off licence for lack of libido, but a GP inexperienced in this would need to consult a gynae I would think.

As for Prof Studd - what has he got to do with it? Really - don't go writing letters to one private consultant complaining about another gynae! Studd does not practice on the NHS and hasn't done so for some years. The BMS is doing all it can following the NICE Guidelines and I think we have a part to play as women too, in not accepting everything we are dished up nor accepting decisions based perhpas on outdated information and ignorance.

Hurdity x

[Maryjane]

You really have not been looked after regards information, your pelvic floor is most definitely now compromised and you are at risk of vaginal vault prolapse.

Please see someone with knowledge ASAP and no yoga really no yoga.

You need oestrogen to protect your lady bits , as you have now had your ovaries removed your pelvic floor and genitalia are at risk of VA vaginal atrophy.

I am afraid a lot of gynaes are useless re HRT.

[Taz2]

I had a lot of support from the Hysterectomy Association UK - they were good at answering questions. You can read the forum without joining. This is the section on surgical menopause http://forums.hysterectomy-association.org.uk/viewforum.php?f=23&sid=de8c41a458963ba3c895220b9d476e55

Taz x

[abbyH]

THanks everyone.. Why no yoga? I am an experienced yoga teacher/practitioner? obviously very gentle for now..

I was given NO information re cervix, prolapse etc etc

wow.. I feel really upset reading all this.. I was told by two doctors that I would not lose sexual function or have the shape of my vagina altered whatsoever... I guess they were wrong..

I'll see what my doctor/GP says this friday re everything

I was peri at the time of the op - had a period the week before although hadn't had one for 4 months previous..

I feel absolutely fine right now.. but it's only a week post op...  I will listen to body and see how I feel re exercise/yoga

restorative yoga is absolutely fine post op.. I don't intend to do anything more strenuous

but thanks

Abby

[CLKD]

Let your body heal - feet up, good book, Tour de France   

[Maryjane]

Basically our wombs are the " scaffolding " that holds everything up , it doesn't mean it's going to fall out over night regards bladder etc , but what was in the space where the womb was other organs take up the space bowel.

When we stop producing oestrogen the elasticity in out skin ( collegan) depletes , it does with age anyway out faces drop , our breasts , our knees so do our lady bits . So by not replacing what was there re hormones the elasticity in the vagina will reduce over time.

Physios advise against hysters unless absolutely necessary.

So if I was you I would definitely be wanting HRT.

Re yoga I personally would not be over doing it at all , I no you had a vaginal hyster but you still had major surgery. I you don't want to over tighten the pelvic floor at all whilst in healing mode as you could get something called PFD pelvic floor dysfunction.

I have PFD , nerve damage and vaginal atrophy and I take systemic and vaginal HRT.

I have seen a private HRT specialist who says the urogenital area needs oestrogen.

[abbyH]

I have Oestrogel.. and will start taking this week.. hopefully will add testosterone too
Just wanted to let everything 'settle' post op

the only thing I notice is bladder.. feel 'full' and slight sciatic pain also... seeing GP on Friday will flag up

thank you everyone xx