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[Ria]

Hi all
I'm New to all this forum malarkey but wanted to say hi and introduce myself.
I'm 39 (hitting the big 40 in November!) and found out in 2009 that I have the BRCA1 gene mutation.  In 2010 my mother gave up the battle against ovarian cancer (she previously had breast cancer in 1999 but also tested positive to BRCA1 the same year as myself).
In 2014 I underwent a preventative bilateral mastectomy and   in March this year I had a bilateral salpingo oophorectomy.
Since the last procedure I feel awful. I was fitted with a Mirena coil at the same time - which, thankfully I've had no trouble with - but it's the mood swings, hot flushes, loss of libido and lack of sleep that's driving me mad!  I take 2mg of Estradiol p/day and although I've been to the GP they seem reluctant to up the dosage.  I'm at my wits end. I go from normal to Hulk to blubbering mess in minutes. My poor husband and children (who are all incredibly supportive) are getting whiplash from my mood swings.  I'm not sleeping at all well, constantly waking with night sweats or restlessness and I feel exhausted most days and as for sex, well, I wouldn't care in the slightest if I never did it again, which is a shame because things were always good in that dept.  I feel so miserable.  Is this normal? My GP didn't give me much advice but signposted me to this site.  Can anyone help or suggest anything? Has anyone else gone through surgical menopause?  I'd be most grateful. Thanks for reading!

[Cazikins]

Hi Ria & 

There is a thread running on here all about surgical menopause & you can get to it if you clink onto this link:

https://www.menopausematters.co.uk/forum/index.php/topic,34701.0.html

Hopefully you will get some advice, support & help there.

Cazikins x

[CLKD]

My first route would be to the Consultant who seems to have failed to explain what will happen after surgical intervention?!? ...... there doesn't seem to be any joined up thinking 

Browse round.  Make notes!

[Hurdity]

Hi Ria

 

My first thought is that dose is too low for someone of your age and in your position - especially if it has not eliminated your night sweats and flushes. That being said ovary removal will take some time for your body to adjust to and for you to settle onto the right HRT regime. As Cazikins says there is a thread on surgical menopause but I would suggest also that you think about a different method of delivery ie transdermal oestrogen where you may well be able to achieve a higher dose than with tablets and avoids having to go through the liver/digestion. There are patches ( applied usually twice per week) or gel ( applied daily).  They are all listed here:  https://www.menopausematters.co.uk/treatafter.php

In terms of libido - women in your position should be offered testosterone because ovaries are the primary source of this hormone. https://www.menopausematters.co.uk/aftermeno.php

Role of testosterone after hysterectomy

If the ovaries are removed at the time of hysterectomy, as well as the estrogen level falling, there is also a 50% decrease in testosterone production. Some doctors recommend testosterone replacement along with estrogen replacement; testosterone helping energy levels, mood and libido. However testosterone replacement does not seem to be required by all and the ideal route and dose of testosterone for women is still being researched. It is therefore not routinely recommended following removal of the ovaries but can be considered for some women who do not fully benefit from estrogen replacement alone.

Please ask for a referral if your GP is unable/unwilling to help due to lack of knowledge. You should see a gynaecologist at a menopause clinic. The NHS (and private) ones are listed on this site (very top menu - specialists) although some of the information is out of date. Alternatively the consultant that you saw initially as CLKD said.

Good luck!

Hurdity x