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[groundhog]

Hi ladies
Most of you know my story of perforated bowel during hysterectomy.  The reason I had the hysterectomy was a suspect mass that turned out to be benign thankfully. I had the hysterectomy plus ovary removal in 2015 but I hadn't had a period since 2010 so my gynaecologist said I should not miss my  very diseased ovaries.  Two years on and the bowel problems continue along with the ripple effect of surgery going wrong.  I contacted my gynaecologist two weeks ago and told him since the op I hadn't had intercourse and had lost the desire for any intimacy.  I also said I was depressed, anxious and very low.  I asked him how could I tell if it was hormonal our depression.  He has agreed to refer me to a lady gynae for a chat.  Are there any blood tests I could have to see if I'm in need of hrt it is it a case of try it.  I don't have hot flushes,  km already on vagifem for irritation down below but in view of the bowel problems which are very much ongoing,  I think it's all linked to that.  Is there any point in seeing this lady doctor I wonder or is it going to be another waste of time.
I'm 57 this year and before the hysterectomy I can't say I had meno symptoms but realise the loss of the ovaries could have tipped the balance.
Just wondering if anyone has any thoughts xx

[Menomale]

Hi groundhog,

I'm glad you have started this thread... I was lost reading that one on your op because it's quite long and I'm too tired to read these days. I don't think any gynae would be able to tell if this is hormonal or depression for sure, but she/he would probably say both are possible and one does not exclude the other, in fact they may have common neuromodutators, neurotransmitters. If you don't have many symptoms and local oestrogen is ok for vaginal atrophy I think you could have that chat and maybe ask for a bit of testosterone to improve libido? If that doesn't help then go for the systemic oestrogen and AD's as a last resource? I hope your bowels can give you some peace soon. xxx

[Tempest]

Hi, Groundhog!

I most definitely think it is worth going to see her! I remember you mentioning this on our surgical menopause thread. Having as much input as possible to bring you back to wellness is very important, I feel. And yes - your hormone levels most certainly can be tested, and she can advise accordingly and counsel you on your best options if you chose to try HRT or discuss any other alternatives that may help you.

Anything that helps you to feel supported and reassured is well worth it. xxxxxx

[walking the dog]

I have no advice really but you having nothing to loose by going to see her and you dont know what you may gain.
Xx

[CLKD]

I would suggest taking 6-8 months ADs regardless of what is causing your low moods etc.; although you may have to stop the medication prior to surgery.  You have been through a lot! enough to cause depression in the most stable of people without surgical problems thrown in!

[Tempest]

There is usually no need to stop AD's prior to surgery, CLKD. xxxxx

[zelda]

I would certainly ask to try the AD's I can vouch they really work in relation to low mood and depression. Please don't suffer in silence life is too short.

[Tempest]

I personally think EVERYTHING should be on the table for us if we're not feeling good. We have but one life......(as far as we know, anyway)!

[coldethyl]

I would certainly have the chat with the female gynae and see what thoughts they might have. It may be that they suggest a course of AD rather than HRT if they feel your issues are more down to straight forward depression rather than menopausal hormonal problems - you have had major surgery which went wrong and are now facing having to trust to surgery again to make life more bearable - it seems inevitable to me that you would be experiencing a difficult time emotionally with effects on your desire for intimacy. I had a radical hysterectomy last September which ended up with an ileostomy and whilst I have no problems on a day to day basis with it, I've not yet got my head round the idea of having intercourse again - partially because my body is still very sore from the operation but also because if I am honest, I feel violated by the surgery - my body no longer looks like my own , which was never perfect, but at least had all its bits in right places. I think when things go wrong in an operation , we are left trying to deal with things that were and are out of our control at the same time as being expected to be grateful for what had been done. My mass turned out not to be benign so yes, everything was necessary but it is hard to be put in a position where everything and anything can be done to you because they are " saving your life."
In your circumstances, I'd be asking for a referral to some decent PTSD counselling as this would help you move on from your botched operation and feel more in control going forwards as you elect to have further surgery. Just feeling emotionally less vulnerable will put some of the balance of power back into your hands and I think it is so important that when things seem out of our control, that we are able to take some of it back. X

[groundhog]

Hi ladies and thank you for your replies,  I am actually already on AD - good old prozac 20mg - I'm not sure they do anything though - told to increase the dose but what if it's hormonal - you see the problem.................
Tempest - typical of me at the moment - I clean forgot I had posed this question on another thread - yet another meno/ depression symptom - sorry for confusion.  Can I ask Tempest are you on hrt following your oopherectomy?  We're you menopausal prior to the surgery?  Looking at your age I suspect not.  I had last period in 2010 then hysterectomy / oopherectomy 2015.

Coldethyl - thank you,  you obviously completely understand where I'm coming from having had major surgery yourself.  I do feel mutilated by the botched op but had had my stoma 30 years prior to this latest op going wrong.  I suppose if im absolutely honest I don't really miss the intimacy as I feel completely dead since this happened,  my oh however does sort of remind me daily how we dint have a normal life and I do sometimes feel so resentful towards me and has lost respect for me.  It seems he can only love the well me not the broken me,  he denies this of course.  I've noticed if I'm having a good day he thinks I'm better and so when I go down hill again,  he gets disappointed,  I don't understand him anymore. 
Sorry I digress.  I have tried counselling - where I live I'm sorry to say the mental health support in dreadful.  I am seeing a new counsellor in Friday privately who does specialise in ptsd.   Presumably coldethyl the ileostomy wasn't expected?  Having the  cancer diagnosis must have been a dreadful shock xx

[coldethyl]

No the ileostomy was unexpected as the tumour had fused to sigmoid colon so they had to remove it as one piece. I drew the double lucky straw of also having a primary uterine tumour ( very early) so my whole life was turned upside down in days.
My other half has been wonderful but life isn't the same . Whether it's cancer or any other long term illness or problem, both of you are experiencing very different things and also bring very different personalities into the ways of dealing with it. My husband is very pragmatic and upbeat so struggles with my pessimism and anxiety - this makes it hard for me to be open sometimes about how I am really feeling. Tbh I have found that there is a reluctance for how the sick person really feels to be acknowledged by all involved , from HCPs to family - it's as though we are expected to cope, be strong etc in order for others to be able to live their lives as normally as possible. My mum chats to me often, but I'm not allowed to talk about dying before her and it often feels as though I'm only allowed to skate over the surface of my real feelings. I see a psychologist through my link nurse who allegedly specialises in long term and acute health issues but even there I was told " and we won't be talking about cancer all the time." I just think it is so hard when you are in a difficult and very different emotional place from others as you become something to be handled in ways that might not help you at all but make life easier for them. I hope that your operation goes well and that you can rebuild your life - put your own needs first - you get one life and if others aren't allowing you to make it a good one, then you need to take back control yourself xxxx

[CLKD]

groundhog - it is known that some ADs poop out eventually, i.e. the brain doesn't have the relief - I have had 4 different ADs since 1988 so it may be that you either require a hike in doseage or wean off and begin on something different.

Tempest - some ADs have to be stopped prior to surgery but I can't remember which, certainly when I had breast surgery in 1996 I had to stop 24 hours B4.  I had to wait 24 hours after GA to start.