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[jooleea]

Well , heres hoping you might read this Tempest !!
I had my oopherectomy in July 2015 and am still trying to find the right form of HRT. We have spoken before , but to re cap . I am 52 and had everything removed when I had my hysterectomy . I have most recently been prescribed Premarin , but after taking for a hard 5 weeks , the symptoms were just getting so much worse … extreme hot flushes , little sleep and feeling generally edgy and unstable . I was taking Cytalopram , but stopped this so as to get a clear idea what the real effect of HRT might be. I am currently taking 2 pumps of estrogel a day . could you give me some advice as to whether you think this dose might be too high ? You have mentioned that lower doses after surgical menopause could be more effective. i am seeing dr zenia Haoula , for the second time in february in Nottingam and wondered if you thought it might be worthwhile asking about Testosterone , I feel really very low , tired and with little energy and have had sex once in the last 18 months !! If so how much ( i presume this is a gel ) does one use . tO back track a bit my gps are really lacking any knowledge and I googled and asked for the referral to the circle clinic at queens medical centre in Nottingham to see dr Haoula ( I live in Leicester , so I'm about 1 hour away ), and while she does seem to have more knowledge , at my appointment showed me a list of all the HRT medications available and asked me which one id like to try … now i have some knowledge , but not that much ! hence i went for Premarin. she booked a follow up to see me in 4 months , but as it didn't suit I've brought the appt, forward . I neglected to ask what i should do if this happened, as its not that practical to just nip and see her , and the clinic is 1 afternoon a week and covers other gynae , related problems , so I'm not sure that she is a particular specialist in the HRT field .Still at my wits end , I feel I am a different person side this op . She told me i should be positive and nit negative about my hysterectomy . Its very hard not to be !! so sorry to rattle on , but really any advice re ; estrogel and dosage and possible testosterone would be much appreciated ! x

[Rhiner]

Hi Joolea, I am also a BSO lady and yes there is a meno clinic at the QMC in Nottingham. I am from this area too. I see a meno specialist privately in this area, , who is very good - I can try to message you direct with details if you like.

I am on estrodot, started on femoston but got terrible headaches after 2 months.

Rhiner

[jooleea]

Thanks so much for your reply . yes , that would be really helpful if you could send me the details of who you see.

[Tempest]

And do join in at our new thread for Surgical Menopause ladies, joolea!

[Hurdity]

Well , heres hoping you might read this Tempest !!
I had my oopherectomy in July 2015 and am still trying to find the right form of HRT. We have spoken before , but to re cap . I am 52 and had everything removed when I had my hysterectomy . I have most recently been prescribed Premarin , but after taking for a hard 5 weeks , the symptoms were just getting so much worse … extreme hot flushes , little sleep and feeling generally edgy and unstable . I was taking Cytalopram , but stopped this so as to get a clear idea what the real effect of HRT might be. I am currently taking 2 pumps of estrogel a day . could you give me some advice as to whether you think this dose might be too high ? You have mentioned that lower doses after surgical menopause could be more effective. i am seeing dr zenia Haoula , for the second time in february in Nottingam and wondered if you thought it might be worthwhile asking about Testosterone , I feel really very low , tired and with little energy and have had sex once in the last 18 months !! If so how much ( i presume this is a gel ) does one use . tO back track a bit my gps are really lacking any knowledge and I googled and asked for the referral to the circle clinic at queens medical centre in Nottingham to see dr Haoula ( I live in Leicester , so I'm about 1 hour away ), and while she does seem to have more knowledge , at my appointment showed me a list of all the HRT medications available and asked me which one id like to try … now i have some knowledge , but not that much ! hence i went for Premarin. she booked a follow up to see me in 4 months , but as it didn't suit I've brought the appt, forward . I neglected to ask what i should do if this happened, as its not that practical to just nip and see her , and the clinic is 1 afternoon a week and covers other gynae , related problems , so I'm not sure that she is a particular specialist in the HRT field .Still at my wits end , I feel I am a different person side this op . She told me i should be positive and nit negative about my hysterectomy . Its very hard not to be !! so sorry to rattle on , but really any advice re ; estrogel and dosage and possible testosterone would be much appreciated ! x

Have you only recently started to take HRT at all since your op in summer 2015? If so no wonder you are finding things difficult - since, if you were not near menopause before your op - you will have been plunged into sudden menopause. Were you having regular periods before your op?

Therefore it will take some time for your body to adjust to having oestrogen again. In your position, if after 3 months (on the oestrogel) you are feeling no better I would suggest you ask fo a blood tests to see if you are absorbing the estrogel. Although blood tests are unreliable, for women in your position it might help to understand what's going on and whether in fact you need a higher dose.

It is important to get oestrogen levels at a normal level and stabilised before introducing testosterone.

Fancy telling you to be positive about your hysterectomy! That's all very well but if you are not feeling well then how can you!

Hurdity x

[jooleea]

Thanks Hurdity ! I have tried a variety of HRT medications and the estrogel is the best yet. Is there a particular blood test I need to ask for pardon my ignorance ! Just want to ask for the right test and what would deem to be normal levels ??Thanks

[jooleea]

… and yes , I was having normal regular periods before my op . Problems with HRT folioed afterward re.. severe migraine attacks when dosage of patches was changed and for that matter the type of HRT prescribed . so its been a real mine field  I also get severe hive like rash breakouts .. urticaria , which I never had before . I have told the gp and specialist about these , but am told this is a separate matter . Im very confused . I take Fexofenedine to control these breakouts , it works to some degree. But my main concern is the hot flushes and these wake me suddenly in the night , and the anxiety and general feeling of not being myself .

[Hurdity]

I think some women in your position are given blood tests for estradiol - to see if they are absorbing the gel properly - but this is a specialised area - hormone replacement following surgical meno - but the gynaes should be attentive to possible issues... she could also test for testosterone although this is often prescribed ( off licence by gynaes) without testing and on symptoms alone. It is important that T replacement is not too high though and as I said defo not before oestrogen levels are good. Annie0710 I think has experience of this and is in your position (well sort-of)?

Hurdity x

[Tempest]

I can answer re: the uticaria Joolea. I started having this during perimenopause, when my estrogen levels were fluctuating and estrogen was dominant in relation to falling progesterone. Following my surgery and being on no HRT for a year afterwards, it went away. Whilst raising my Estrogel dose above 2 pumps, it appeared again. My GP checked with my anaphlaxis consultant and she confirmed that estrogen (at least in my case) causes a rise in histamine release from mast cells. I walk a very slippery tightrope with all this (and this is another reason I may now be stopping systemic HRT altogether - I can't risk things getting worse and having episodes of idiopathic anaphylaxis again).

Everyone is individual of course, but things have become ever more complex for me - my specialists are having a hard time working out exactly what is causing what at the moment, but at least they are now liaising with each other. I've been chasing a lot of this up this week. I can say though that for me, it has caused me a great deal of stress and anxiety!

[jooleea]

Thanks Tempest. Thats really interesting and informative. ITs reassuring to know that as i had thought , the rashes were indeed linked to my hormone levels in some way . I can at least now impart this very useful information to my " specialist " and GP . IT seems are situations are very similar in many ways regarding the fact that i feel my oestrogen levels are low , but am maybe in a position where I am unable to increase my HRT dosage further due to the urticaria . ( I have a blood test next week so I hope this will reveal my oestrogen levels ) I may be in touch if I need help with deciphering the results. I hope you get yourself sorted though , It seems your condition is going through a complicated , confused time .I really sympathise as its so much more difficult to decipher the problem when there are so many factors involved , hormone levels , allergy symptoms etc. Keep in touch , and all the very best and thanks again for taking the time and trouble to help . xx

[Tempest]

You're most very welcome, Joolea! If I can be of any further help, please do give me a shout won't you? xxxx

[jooleea]

I will do . you'll get there Tempest . It just tests your patience , doesn't it ..when all you want to do is get on with life . Take strength from that positive story you suggested i read about the lady who is now fine albeit after 4 years of 'hassle' ! and all her problems re HRT etc. are now a distant memory . I guess you me , me and probably everyone else hover between giving up totally and just dealing with the day to day symptoms and  getting a fighting head on and feeling we won't be beaten by our symptoms striving to find the answers re medication. It does consume our lives and its a hard balance to deal with mentally .Thats why this forum is a godsend and we can all be strong and support, understand each other as we do . Sound a bit heavy don't I !!! But a big thanks again . You keep me sane . x