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[KaTo]

Hi all,

Another new member to the site here, although not new to menopause.  I had a subtotal hysterectomy bilateral salpingo oophorectomy in 2009 after years of endometriosis, ovarian cysts and fibroids.   I had a wonderful female surgeon who heroically battled with removing said organs for SIX hours one murky Friday afternoon and I miraculously walked out of the hospital some 48 hours later with a pack of Tibolone and the obligatory post op pamphlet.  I felt great, got back to the gym some six weeks later and I got my life back for all of five years.  No pain, no pmt, no depression!

I'm not sure whether to put my current state here or maybe start a new thread but needless to say I am now in a very different position and desperate for some help

KT x

[CLKD]

 

I would continue here so that your threads don't get lost! 

[Annie0710]

Welcome.  Have a look at the various threads.  There are 2 that probably  would interest you

Tibolone thread
TAH/BSO thread

I just tried looking them up but can't do all this on my phone

X

[KaTo]

I would continue here so that your threads don't get lost!

Ok will do. 

[KaTo]

I will try to keep it brief as I'm a bit of a waffler   

Straight to to the point, for the past three years I have been suffering with quite severe VA, despite the Tibolone. It came on quite suddenly but I put it to the back of my mind as I was under considerable stress having just taken over the management of an ailing pub.  I quite quickly realised that if we didn't get out quick I would probably have some sort of breakdown so we left after just 9 months. Unfortunately the VA stayed with me.  My GP finally realised something wasn't quite right after I screeched and leapt up to the ceiling during a smear test. I got pushed to and fro different HP's and GP's at my surgery until someone finally prescribed estrogen pesseries. Three months later no change at all.   .

Next step was to try Estriol cream.  I'm about six months in to this and still no improvement. Inserted at night with the applicator but by the time I get to work the following morning it plops straight back out again.  I'd be inclined to say it's getting worse now. I am constantly sore have recurrent Thrush and BV (I'm sure I have this at the same time if that is even possible).  I've read several threads on here of ladies having great success with topical eastrogen creams etc so this evening I am a little more depressed than I was before I joined here and I'm now concerned there will be no relief for me at all.

Other mild menopause symptoms are also beginning to seep through. The odd mild hot flush, and anxiety and a total loss of labido.  My family tell me I'm particularly stroppy and short tempered too.  Surely this shouldn't be happening on HRT? 

But the VA is by far the worst.  Pain during intercourse is an incorrect description. Intercourse no longer takes place due to excruciating pain akin to a flippin' machete being hacked around inside me.  I shy away from sex which is leading to tension in my marriage.  Having been a bit of sex kitten  before my hyst this is difficult for both of us to deal with. 

Clearly I need to go back to my GP but the last time I saw her she was of the opinion that I was being aggressive just by saying that I felt it needed to be sorted as it had been going on for three years. I came away in tears. 

I obviously don't come across well to GP's as I never seem to get a satisfactory conclusion when I go.  It makes me detest going.

KT

[Hurdity]

Hi KaTo

  from me too!

Sorry to hear about all your problems.

The first thing is - I presume you were given Tibolone because it also breaks down into a weakly progestogenic substance, and so will prevent the endometrial deposits from growing under the influence of oestrogen? Did you have deposits outside the womb? If so you will continue to need some form of progrestogen.

The other thing is that Tibolone is a very low dose type of HRT and not the same as the others - and the fact that you have developed VA and also your libido has declined suggests that your oestrogen dose is too low and insufficient to prevent VA (as well as the weak testosterone component of Tibolone is probably too low as well). You started this at quite a young age when your oestrogen levels should have been very high.

In your position I would want to talk to a knowledgeable GP or menopause specialist (can you ask to be referred to a meno clinic - if there is one near to you or a specialist GP in your practice?) to review your whole situation and treatment. I would want to know whether my bones were OK - is there osteoporosis in the family for example? You had an early surgical menopause and it might be an idea to ask for a check?

I would definitely get a different vaginal oestrogen if the cream doesn't stay in! Many of us use Vagifem which is a tiny vaginal tablet that sticks to the vaginal wall so doesn't fall out! Keep the cream (maybe get some more before you change the prescription) so that you can use it on external areas - labia, vaginal entrance etc - which is what several of us do.

Depending on your endometriosis - I would think about getting a higher dose oestrogen - if no deposits outside the womb then you could have a transdermal patch or gel, and for your libido, the NICE Guidelines do make provision for testosterone to be prescribed off licence but not many GPs/specialists will do so.

There is a lot of information on this website so explore the top tabs with pale green banner and have a good read about what is available - but definitely make that appointment as soon as you can and try to get a referral if possible

Let us know how you get on

Hurdity x