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[Justkeepswimmin]

I'm 45, started peri 7-8 years ago. Tried synthetic HRT 2 years ago - made me depressed zombie, and I stopped within a month.  A year later, I saw a new doc.  On bioidentical hormones now: 0.625 estradiol, and 200 mg utrogestan daily.  The physical issues are much improved, but the mental side of peri is destroying my marriage, and causing me terrible anxiety/depression.i recently had an ultrasound due to 4 periods in 6 weeks, then I only went 9 days before bleeding again.  Uterus looked fine (3.5mm lining) and one ovary had a 3x3x3cm cyst.  Next step was endometrial biopsy which was normal, thank goodness. I'm thankful that nothing bad was found, but I have NO IDEA how to keep going like this.  I've tried several antidepressants without success.  I weight-lift 5 days a week, walk 2 miles a day, try to do yoga a few times a week, etc, but the mood swings, irritability, and depression are overwhelming.  My husband of 27 years tries to be understanding, but who can tolerate the swings daily for almost a decade?

So, my question: if I get a total hysterectomy and BSO, will that allow me to find a stable HRT regimen that will eliminate these crazy swings? I know the meds will need to be adjusted without my evil ovaries kicking in some hormones and that will take some time, but at least the levels will eventually be stable? Is this unrealistic optimism? I don't take the seriousness of the surgery lightly, but my marriage and life are both at critical point.

Thank you all.  This forum and the menopause subreddit have been such a blessing through this time.  I can't thank you ladies enough!

[Spangles]

I feel like I've just read about myself!
I'm thinking along the sam lines, would a hysterectomy help?
I've been on AD's for about 16 years and HRT for six, just lately I'm convinced the HRT contributes to the depression and anxiety.
I will be interested to see what other ladies think.
xXx

[CLKD]

Hysterectomy is a huge operation and you will be plunged into menopause.  So HRT really needs to be sorted prior to surgery.

Anxiety can be eased by appropriate medication.  That is, anti-anxiety medication.  On an as-necessary basis, i.e. Valium when required.  How about beta-blockas - to ease heart rate and help to stop anxiety surges?   They have helped me enormously.

As has Rescue Remedy mouth spray. 

I think there is a web-site 'hyster sisters'?  Am sure someone will be along with more advice.

[Bracken willowshimmer]

Hi jks and Spangles,

As someone who has suffered terrible anxiety since perimenopause, I would be interested to know if hysterectomy would help.   I'm 47, I take ads and am on hrt.  I will be interested in any replies on here. Xx

[racjen]

I was plunged into sudden menopause by chemotherapy 18 months ago - not quite the same as a hysterectomy but the effect is pretty much the same, sudden and complete cessation of ovarian function so pretty much no estrogen, progesterone or testosterone being produced. Up until that point I wasn't having many peri problems (I was 50) although I had had a period of depression and anxiety at age 45 which has now been put down to hormones. Since the sudden menopause I've been suffering from terrible depression and anxiety, to which I'm struggling to find a hormonal solution.

My experience would suggest that just removing the womb and ovaries isn't necessarily going to make things any better - in fact you could end up with a prolapse on top of everything else. I think the shock to the system of suddenly having all the major sex hormones removed can have catastrophic results, which can't easily be remedied by HRT alone.

[Mazza27]

Hi  jks and spangles,

I am having one for all these reasons and severe ovary pain.
5 years of hell and looking back awful moods at period time.
I have been diagnosed with PMDD which is worse due to Peri.

It is my only option now as my marriage and life is on the brink of disaster.
The only thing worrying me is will the tinnitis and migraines get worse?

My best friend had the same op due to hormone imbalance /PMDD and she is 8 months down the line and feels great best thing she ever did.

You have to do what is right for you

Mazza x

[MIS71MUM]

I had a hysterectomy two years ago but kept my ovaries. Not sure if that was a good idea!
I'm so grateful that I don't have to take any progesterone- so that's a positive.

However I still struggle to either absorb oestrogen or suffer from peri fluctuations. Or both!

As you can see from the forum we are all so different. It would make sense that a bso and hysterectomy should smooth things out but it seems it doesn't for others.

As my mood swings seem to be cyclical - I would have a BSO if offered one.

[MIS71MUM]

Btw - for JKS and Spangles, could it be the progesterone that's causing you the mood swings?

[lillith112]

Hi there, is your weight lifting high impact to build muscle. ?, the reason I ask is because I used to do bodybuilding and it actually depletes estrogen and makes lots of testosterone  instead, essentially the estrogen you are applying will be useless. Also to point out that professional runners stop having periods too, it might be something to consider. Your mood swings could be from high testosterone and low estrogen levels as you do a lot of exercise, I would try cutting the exercise right down and see if that helps. x

[Hurdity]

I'm not sure that this is the case lillith but I don't know much about the effects of intense exercise - where did you read this? However I just looked up some info on this  and there was a study carried out that found this:

"We can conclude from this study that prolonged aerobic exercise induces short-term elevations in testosterone in trained, eumenorrheic women, which appears to be unrelated to estrogen levels and menstrual cycle phases. These increases may occur due to either increased androgen production and/or decreased degradations rates of the hormone. So basically, when you work out, your body is either making more testosterone or destroying less of it. Either way, you end up with a higher total level right after you exercise."

https://breakingmuscle.com/fitness/the-role-of-testosterone-for-the-female-athlete

Testosterone is a precursor of oestrogen in endegenous (internal) steroid synthesis and I also read that it is sometimes recommended for female athletes to take extra oestrogen because their metabolic activity and menstrual cycle can stop due to the intense exercise so oestrogen is necessary sometimes to prevent osteoporosis.

Justkeepswimmin - I'm not sure why you're taking 200 mg progesterone every day - that does seem a lot? Is it to prevent breakthrough bleeding? Doesn't seem to be working? I'm sure I would feel depressed if I had to take this much all the time - my max is 12 days (vaginally).

As you are still young you might be better off taking one of the CCP types - there are a couple with bio- (=body-) identical oestrogen in them ie estradiol. However the progestogen is synthetic but one of the newer types with fewer side effects. QLAIRA only has two tablet free days so you don't get the hormone crash in quite the same way. There is slight variation in the amount of oestrogen to mimic the natural cycle.  This would suppress your cycle and help reduce mood swings. Much less of a drastic step than hysterectomy with BSO. Which HRT did you try?

I would think very carefully about having BSO, also hysterectomy too, and try less invasive ways to help first if possible.

Hurdity x

[CLKD]

200mg seems an awful lot.

Also, because athletes 'over exercise' and often have faddy diets = loss of periods.  Pretty much like anorexics.  I wish that there were methods in place to do bone scans throughout an athletes' career. 

Everyone is different.  My friend said that her hysterectomy was the best thing she ever did: 15 years later she died from breast disease  .  Never found out why as she moved across the World and we lost contact.  So discussion. Discussion.  Discussion.  Make notes. 

[Yorkshire Girl]

I've had an abdominal hysterectomy with BSO just over 2 years ago for PMDD, when I was 44. It is major surgery and you are plunged straight into a surgical menopause with hormones plummeting. First 2 weeks was rest and wasn't allowed to lift no more than a kettle, then started going for short walks, can't drive for 6 weeks or lift anything. You also can't start HRT until after 6 weeks so it can be a difficult time as all the symptoms of menopause more or less hit you at once. I was started on Everol 25mg then increased slowly to 50 then 75. For some symptoms like libido, energy, lethargy, insomnia I hoped it would get better with increased oestrogen, but it didn't tried Tibolone that had no impact, so back on everol 100mg. Had blood test showed my testosterone was below 0.1 as my Dr put it non existent, now have appointment with gynaecologist in 2 weeks. Not much help from peri menopause side of it, hope it gives you some idea.

[Mazza27]

Hi Yorkshire girl,

Did it help with PMDD though?
I think the symptoms are far worse than most menopause symptoms
I have both peri menopause and pmdd

I was advised by a menopause specialist of 30 years implants both oestrogen and testosterone. You would have to go private i think but i think testosterone is being recognised by nhs from reading on here

Mazza x

[walkingthedog]

I had total hysterectomy two years ago age 51
No more pms, I'm like a new person it's the best decision I could have made for me
Now on 0.5 sachet daily of sandrena gel no testosterone

[Yorkshire Girl]

Mazza Yes it did, saved my life. Feel like a new woman, best decision I have ever made with the backing of my wonderful GP. Would take menopause symptoms over the PMDD. If I hadn't had the op I wouldn't be here now   Am hoping to be prescribed testosterone week Friday.