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[ShelleyB1970]

Hi,

I am hoping to get some advice from your collective wisdom.

I am 51 and a week ago had a total hysterectomy due to an ovarian growth. Everything was removed uterus, ovaries, tubes and cervix. Before the surgery I was having some menopausal symptoms but these have ramped up significantly since the operation.

I have researched HRT extensively and concluded that an oestrogen patch will be my best option.

On discharge the gynae tried to give me a prescription of Tibolone. For information I have an immediate family risk of stroke. My dad had a stroke very young as did my paternal grandmother. Based on this and the long term health benefits I asked the gynae for an oestrogen patch prescription which he refused and said if I didn't take the Tibolone then I would have to go home with nothing. So I went home with nothing.

I have since researched Tibolone and stand by my decision. I have approached my GP but again been told I have to take the Tibolone. No reasons given.

Does anyone know why this is? Why are they insisting on me taking Tibolone when the oestrogen only patch seems a much better option, especially given my family history? Has anyone got any advice I can go to my GP with? I have a face to face appointment on Monday and I want all the information I can put together to put forward my case! I'm feeling very stressed and emotional at the thought of having to fight my GP to get the medication I want.

Thank you so much.

[Shells99]

Hi there

Have you asked the consultant or GP why they are refusing oestrogen and pushing tibolone?

I am also interested in why you have discarded the tibolone as an option. I have been taking tibolone for about 8 months and have been feeling fine on it apart from a few weeks of bloody discharge around the 6 month mark. I've had this all checked out and the outcome was that it was just hormonal. So I was advised to go back on the tibolone if I wanted to.
For me the tibolone helped with mood, aches and pains, energy and slightly improved my libido.
I chose tibolone because of the testosterone included and I also read that it's not your typical HRT but actually a steroid!

Hope you get sorted with what you want and need.

[ShelleyB1970]

Hi there,

I have many reasons for not wanting to take Tibolone. Firstly I don't need the progesterone. My uterus has been removed so I only need oestrogen.
I would prefer to have the patch due to it being trans-dermal and not oral.

I have an immediate family history of stroke,both my dad and paternal grandmother had strokes fairly young. Although the increase in risk taking Tibolone is reportedly low, there is an increased risk so against an option where there is a zero increased risk option I would rather have that.

Everything I have researched regarding the oestrogen patch evidences long term health benefits to having an oestrogen patch. There are no similar reports I can find about Tibolone.

I know there are cons as well to the patch but all I can find is mostly pros. I'm interested in understanding why I might have been prescribed Tibolone rather than the patch.

[Taz2]

Hi ShelleyB1970. Sorry you are having problems getting the HRT you want. Could your doctor's decision have anything to do with the ovarian growth? I'm not sure what type of growth you had.

Taz 

[ShelleyB1970]

I guess that could be possible. I hadn't considered that.

The growth was not cancerous but it was large. I think around 21cm x 21cm by the time it was removed. I asked what it was made up of and was just told some cells and fluid.

I will see if the GP mentions the growth on Monday at my face to face appointment. Certainly up to now both Dr's I have spoken to regarding the reason for prescribing Tibolone haven't mentioned that at all. All I get is a "this is what we are prescribing you" response. No explanation why.

[Taz2]

It could also be that Tibolone mimics testosterone which will help with your energy levels and also libido. It's sometimes difficult to get testosterone prescribed on the NHS due to it not being licensed for women in the UK and this may be a way round it. You are young to have lost all of the hormones in one go so perhaps you could discuss the teststerone issue with your GP?

Taz x

[Hurdity]

Hi ShellyB1970

  from me too.

What a singularly unhelpful and if I may say - patriarchal approach. I mean how dare he threaten you with no HRT if you don't accept his decision? What happened to freedom of choice? Shared decision making in the best interest of the patient? As Taz says - re the ovarian growth, if there is a particular reason then he should tell you but I can think of nothing from my limited knowledge. To cap it all if you have family history of stroke then yes oestrogen patch is advised. Also as she says it may be they feel that the testosterone component of Tibolone would help you but this is not medically necessary as such but is an option should you wish it.

This gynaecologist is clearly not a menopause specialist I would suggest....

Please let us know how you got on with your appointment and then we can see if you are able to take this further...

Hurdity x