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Author Topic: Requirement to stop patches before minor day surgery  (Read 2120 times)

Katejo

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Requirement to stop patches before minor day surgery
« on: September 15, 2023, 01:34:11 PM »

Hi All

I have a minor op (removal of a neck cyst) coming up and I had a pre op yesterday. The nurse tried to tell me that I would have to stop HRT beforehand. I told her that I was sure that this only applied to tablet HRT not transdermal which doesn't have the same blood clotting risks because it doesn't get processed in the liver. I don't think I convinced her. Since then I have found the following   which agrees with me. https://www.balance-menopause.com/menopause-library/do-i-need-to-stop-hrt-before-surgery-factsheet/#:~:text=If%20you%20take%20estrogen%20through%20the%20skin%20%28transdermal%29,carry%20an%20increased%20risk%20of%20clot%20or%20stroke.

Has anyone had surgery while using  HRT patches and been allowed to continue with them? I am very reluctant to stop them just for a minor procedure.
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CLKD

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Re: Requirement to stop patches before minor day surgery
« Reply #1 on: September 15, 2023, 02:44:01 PM »

Add to your worried, if the procedure is cancelled  :-\

I would want to know exactly why any treatment needs to be stopped. 
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Katejo

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Re: Requirement to stop patches before minor day surgery
« Reply #2 on: September 15, 2023, 02:57:32 PM »

Add to your worried, if the procedure is cancelled  :-\

I would want to know exactly why any treatment needs to be stopped.
  Yes exactly plus I don't have a date yet. Only approx early November and the consultant said it could be delayed if there are more NHS strikes.
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CLKD

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Re: Requirement to stop patches before minor day surgery
« Reply #3 on: September 15, 2023, 03:17:09 PM »

Will the procedure be performed under GA or a local injection?  If there is a risk of strikes ........ what's your gut instinct?  Perhaps Dr Currie is available to ask the question via e-mail on here?  Or perhaps ring Dr Newson's Clinic for advice? 

My instinct if confronted with this is a firm 'nope'.  After all, I don't have to stop any medication for dental surgery etc..
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Katejo

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Re: Requirement to stop patches before minor day surgery
« Reply #4 on: September 15, 2023, 03:29:02 PM »

Will the procedure be performed under GA or a local injection?  If there is a risk of strikes ........ what's your gut instinct?  Perhaps Dr Currie is available to ask the question via e-mail on here?  Or perhaps ring Dr Newson's Clinic for advice? 

My instinct if confronted with this is a firm 'nope'.  After all, I don't have to stop any medication for dental surgery etc..

Definitely GA or the issue wouldn't arise.
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CLKD

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Re: Requirement to stop patches before minor day surgery
« Reply #5 on: September 15, 2023, 03:34:19 PM »

That's a little different but if you have to stop medication - would they if 1 was diabetic - then U need to make the Consultant aware that the date IS the date that the operation should take place.  I wonder if you offered to pay whether the situation would be different  :-\ ?  Cynic?  Moi? 

R U very worried?
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Taz2

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Re: Requirement to stop patches before minor day surgery
« Reply #6 on: September 15, 2023, 04:17:15 PM »

I had to stop my patches but that was for a hysterectomy which is considered major surgery where clotting may be more of a risk. I discovered afterwards that only one surgeon at my hospital insisted on this though. I wouldn't have thought minor surgery would need HRT to be stopped.

Taz x
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Sage 🍃

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Re: Requirement to stop patches before minor day surgery
« Reply #7 on: September 15, 2023, 04:27:20 PM »

This is from the The Handbook of Perioperative Medicines

https://www.ukcpa-periophandbook.co.uk/medicine-monographs/hormone-replacement-therapy-hrt

NICE guidelines aren't very clear on the subject though

https://bnf.nice.org.uk/treatment-summaries/sex-hormones/
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CLKD

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Re: Requirement to stop patches before minor day surgery
« Reply #8 on: September 15, 2023, 06:23:49 PM »

What's the general consensus ........ ask more questions about the risks?
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Katejo

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Re: Requirement to stop patches before minor day surgery
« Reply #9 on: September 16, 2023, 12:12:06 PM »

This is from the The Handbook of Perioperative Medicines

https://www.ukcpa-periophandbook.co.uk/medicine-monographs/hormone-replacement-therapy-hrt

NICE guidelines aren't very clear on the subject though

https://bnf.nice.org.uk/treatment-summaries/sex-hormones/
  The NICE guidelines are referring to women having major surgery and immobile for some time plus it talks about blood clotting problems which are irrelevant to transdermal. I posted the same question on another forum and got replies from women who had had a hysterectomy (not cancer related) and were allowed to continue HRT.
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CLKD

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Re: Requirement to stop patches before minor day surgery
« Reply #10 on: September 16, 2023, 12:14:51 PM »

Difficult to decide? 
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Katejo

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Re: Requirement to stop patches before minor day surgery
« Reply #11 on: September 16, 2023, 12:15:45 PM »

This is from the The Handbook of Perioperative Medicines

https://www.ukcpa-periophandbook.co.uk/medicine-monographs/hormone-replacement-therapy-hrt

NICE guidelines aren't very clear on the subject though

https://bnf.nice.org.uk/treatment-summaries/sex-hormones/
  The other link is pretty clear. I will print it out to show them if they continue to insist.
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GraceM

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Re: Requirement to stop patches before minor day surgery
« Reply #12 on: September 18, 2023, 03:10:16 PM »

I had a recent hysteroscopy, D&C and polyp removal under general anaesthetic.  I was told at some point that I would need to stop HRT a month prior to the procedure - I finally got an appointment with about 2 weeks notice.  I didn't stop HRT and arrived on the day and mentioned it.  Nobody batted an eyelid.  I was fine to have the procedure with my patch still attached.  Some doctors just aren't up to date on the types of HRT.  If on tablet form there is a higher risk, but many are on transdermal oestrogen nowadays.
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CLKD

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Re: Requirement to stop patches before minor day surgery
« Reply #13 on: September 18, 2023, 04:18:24 PM »

Tnx GraceM - how is your recovery ?
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Rumbaba

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Re: Requirement to stop patches before minor day surgery
« Reply #14 on: September 22, 2023, 04:56:13 PM »

Will the procedure be performed under GA or a local injection?  If there is a risk of strikes ........ what's your gut instinct?  Perhaps Dr Currie is available to ask the question via e-mail on here?  Or perhaps ring Dr Newson's Clinic for advice? 

My instinct if confronted with this is a firm 'nope'.  After all, I don't have to stop any medication for dental surgery etc..


That's not quite true. My partner is a dentist, and there are certain medications which have to be paused for some dental procedures.
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