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[Donna-paul]

Hi has anyone who had atypical endometrial hyperplasia and had a hysterectomy and gone back on hrt? I’ve had hysterectomy 12 weeks ago for the above and had to stop hrt straight away when biopsy came back abnormal. Was on a low dose for 5 years continuous. My cancer surgeon wasn’t keen I go back on it he said only if symptoms are severe a low dose. Ok to use local oestrogen. I also had lumps in my breasts discovered at same time which turned out ok I have lumpy breasts. One breast Dr was anti hrt the other said quality of life more important 🤔 as well as chronic fatigue after major surgery my night sweats are bad and hot flushes . Tough decision if I know the symptoms will eventually stop it would be easier.

[Summer-sky]

Hi Donna-paul,

Glad you are on the mend after the hysterectomy and know it’s not an easy ride with it all, let alone the shock of hearing it needs to happen.  I can understand your confusion about how to go forward especially with debilitating night sweats and after your diagnosis and whether to take HRT.  Have you thought about trying a low dose AD which is geared more towards helping hot flushes?

[Donna-paul]

Thank you I thought most antidepressants cause sweating? I will consider all options.

[Hurdity]

Hi Donna-paul - sorry to hear about your atypical endometrial hyperplasia and that you had to have a hysterectomy but hopefully all will be well - and at least it sounds like it had not yet developed into cancer.

As far as I understand, although suspected endometrial cancer ( and presumably also atypical endometrial hyperplasia) IS  contraindication for hRT - for obvious reasons since oestrogen directly stimulates the womb lining, once you've had a hysterectomy, this contra-indication no longer applies UNLESS there is some sort of link between the atypical hyperplasia and other gynaecological cancer risk?

Certainly on this website this is not mentioned https://www.menopausematters.co.uk/contraindications.php. You do not have "Suspected or active [breast or] endometrial (womb) cancer"

Lumpy breasts as such are not a  contra-indication for HRT unless you are suspected to have breast cancer, or have had cancerous breast lumps removed or at great ris from it eg due to family history or the BRCA gene (as I understand). if you have actual lumps that need investigation and potentially removal - then this is a different matter. I always had/have lumpy breasts and have had breast lumps (not removed) but mammograms have always been clear.

I can understand your concern following your hysterectomy but I suggest you get further advice on this if you are keen to continue with hRT - can you ask for referral to a menopause clinic to look at your specific circumstances?

Failing that perhaas an e-mail to Dr Currie might help ( cost of £30) and ask her opinion?

Yes quality of life is important, and of course you can't know how long the flushes etc may continue.

All the best with your decision and future treatment.

Hurdity x

[Rosie Roo]

Hello ladies … I have just had a total hysterectomy due to womb cancer stage one .They have told me that pathology will check to see if it was oestrogen driven and to see if its all been contained in the womb . …..I’m guessing I will not be allowed hrt going forward, but as they have removed everything I’m not sure where I stand either   💁💁.  . Of course i will have to be guided by the doctors but like you have found Donna Paul. Some of them contradict each other .(I do know that they are also looking for markers for a link to colon cancer , as  if you have had womb cancer they are finding  there is a higher chance of colon cancer . )  I’m really hoping that at the very least  I will be able to resume vagifem . 
 It’s good advice from Hurdity  and I would do that Donna paul … send an email to dr currie . The night sweats hot flushes and fatigue are horrible to bear . Good luck xxx

[Summer-sky]

Hi Donna-Paul,

I understand Venlafaxine is an AD that is suggested for helping to reduce hot flushes.   Consultants do vary with whether they think HRT is allowed post hysterectomy after pre-cancerous cells being found or endometrial cancer as Rosie Roos says. In the case of endometrial cancer, often young women can be prescribed HRT for all the other benefits it can give but it is all dependent on the stage/grade of the cancer I think.  Also if certain types of endometrial cancer have been diagnosed then HRT would definitely not be allowed.  In my case, I was diagnosed with stage one / early grade endometrial cancer and had a totally hysterectomy.  My oncologist was open to a very low dose of HRT if needed and symptoms severe but only if risks were fully discussed and understood.  My understanding, of some of the limited studies out there, say that early stage/grade and severe meno symptoms might warrant having some low does HRT for symptoms but not enough studies to say categorically that it doesn’t cause reoccurrence.  It’s a difficult decision and obviously need to weigh up how severe your symptoms feel vs your own approach to risk perhaps. 12 weeks is still early stages in a way for the body to settle post op so it might be it will all even out but there are avenues to explore if not.  Summer x

[Donna-paul]

Thank you Hurdity for your reply much appreciated. Rosie Roo hope you are ok and taking it easy. Thanks Summer-sky I’m going give it a bit longer it do not help with the warm weather we have had the sweats have been worse😔 sorry to hear about your disgnois hope you ok do you take hrt ?
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