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[Jen29]

Hi I am 37 and had my ovaries removed in September.

I was supposed to have a full hysterectomy back in 2018 but nhs waiting times and covid meant I was waiting too long. I used a company benenden which I pay around £12 a month and they covered the cost for me to go private and I had my ovaries removed.

I had suffered severe heavy painful period from young. After a laparoscopy it was found I had endometriosis and suspected adenomyosis. The surgeon said I didn’t need a full hysterectomy I just needed my ovaries removed and that would stop my periods and my uterus would shrink anyway.

This surgeon was wrong to do this and my Gp could not believe he didn’t take my uterus away. Anyway I had to the worst period ever while trying to settle on hrt. I’ve realised I can’t tolerate progesterone. I knew this as I’ve never been able to be on a contraceptive pill and also mirena coil was horrendous (all over body aches and pains). I had already been on prostap injections in 2018 and I had a chemical menopause for about a year to see if a hysterectomy would work and I couldn’t tolerate the hrt then but didn’t know about progesterone intolerance.

So I moved onto utrogestan oral 100mg. And this was worse than everol
Conti. All over body aches and itching all over no sleep up all night I felt terrible. Now I am trialing utrogestan vaginal but it’s 200mg and I’ve to start taking every other night. This is my first day trying and I am worried it will give me the same sort of side effects.

I have now been referred to go back into the NHS to get my uterus removed which will be good as I won’t need to take progesterone. But me having the severe period has confirmed for me I have adenomyosis. I’m so angry as I should have fought harder to get that surgeon to listen to me and I thought because it was private they would know best.

I know I need oestrogen and my gp says I need to be on much higher than the 50 that I’m on due to my age. But it’s dangerous high oestrogen if I can’t get the progesterone to keep the uterus from thickening.

Is anyone in a similar situation?

Has anyone tried vaginal utrogestan and had success over oral? I’m just worried this 200mg dose will be far too much. My next step is to be referred to hrt clinic if I react to the vaginal utrogestan.

Also I’d like to add I’ve had two children so my decision to have a hysterectomy was easy for me. I just thought it would change my life for the better as my quality of life with my periods was awful.

Many thanks

[sheila99]

Is there a reason you've been told to take it every other night? 100mg every day would give you a more consistent dose. You might find that this delay will trigger a bleed. Using it vaginally avoids digestive issues so you might find it's better. I still have sleep issues this way so I take it in the morning and by night I seem to be OK. According to Newson but not the NHS you need half the dose if you take it vaginally. Assuming you're on a conti regime that would be 100mg every other day.

[Elaine90]

My situation is different from yours in that I had a hysterectomy as well as BSO at the time of endo surgery, but I don't get on with Utrogestan either (causes insomnia).

What I wanted to bring up is that, in ladies with a history of endometriosis, the recommendation (from BMS, ESHRE and others) is to have combined HRT since oestrogen only can cause the endo to grow back. I don't know how common it is, but certainly on the Endometriosis UK forum, there are ladies there who've had reoccurrence on oestrogen only following hysterectomy and BSO.

"For hysterectomised women with endometriosis it is advised that continuous combined HRT is started for at least the first few years after surgery. This may be changed later to estrogen alone due to a possible better safety profile in women over the age of natural menopause but this needs to be balanced with the theoretical risk of reactivation and malignant transformation of any residual endometriosis, which can occur many years later "

https://thebms.org.uk/wp-content/uploads/2020/04/10-BMS-TfC-Induced-Menopause-in-women-with-endometriosis-APR2020.pdf