Menopause Community

I also had a hard time finding the "right" HRT but I don't have ovaries or a uterus. My surgery was also for an ovarian cyst; my uterus was healthy. I miss it more than my ovaries because I miss the intense uterine orgasms and I've lost most sensation. I don't have any desire either even though my HRT seems fairly settled. I had great libido before.

Estrogen without an adequate dose of a progestin or progesterone increases risk of endometrial hyperplasia and cancer. However, hyperplasia oftentimes never develops into cancer and if it does, it generally takes many years. Here's what appears to be a comprehensive link on Endometrial Cancer (from the American Academy of Family Physicians) - http://www.aafp.org/afp/1999/0601/p3069.html. There's a section on Hormone Replacement Therapy about 1/3 of the way down the page.

I personally know several women who went into early menopause and still have all their parts. They've been on hormones for decades and haven't developed cancer. They have periodic ultrasounds to check the thickness of their uterine lining.

There are a number of ways to protect your lining that come to mind:
- A combined HRT. Some that come to mind are (oral) Prempro, Enjuvia, Activella, and (transdermal) CombiPatch.
- A progestin or progesterone taken separately from your estrogen. It can be taken continuously or cycled (to force a bleed and thin the lining). There are oral and vaginal options.
- An IUD (Mirena) - provides a slow continuous release of progestin.
- A low dose birth control pill or vaginal ring (Nuvaring)

Sometimes it takes trying various HRT's to find the one that's best for you. I don't know how many you've tried.

Has your doctor done any diagnostics to show that your uterus has a proliferative lining? A transvaginal ultrasound will show the thickness of the lining. If it's thick, maybe forcing a bleed with a progestin would be all that's needed. An endometrial biopsy or D&C would show any abnormal cells if the lining is thick.

The uterus is a sort of "place holder" for the bladder and bowels. Do a web search for "pubmed organ vaginal prolapse post hysterectomy" and read through the various studies. I've been dealing with bowel problems since surgery.

If you feel like your doctor isn't willing to support your wishes, seek out another doctor(s). I hope you've found my information helpful.

Thank you soo much for taking the time to answer!
Yes I have tryed over 10 different hormones and I get HUGE head aches. And the only hormones that does not give me the head aches are those which do not protect my uterus.
I have also had transvafinal ultrasounds every 3 months to make sure it is not thickening, but my Dr. says with this hormones it will.

My doctor told me that in the new surgery they won?t take out the cervix wich will prevent my bladder from dropping and he said my sexual life would not be affected at all. Not sure if I can trust him though
I will go deep into the "pubmed organ vaginal prolapse post hysterectomy" and the endometrial cancer link.
It feels good to talk to someone who can understand, none of my friends are there yet.
Thks again!!!

I don't have my cervix so can't tell you about the sexual effects when its preserved. However, based on my connections with other women, retaining the cervix won't necessarily preserve your sexual function. I'm not sure about the prolapse and pelvic support issues. Unfortunately, it's difficult to get accurate information. IMO the best information comes from women who've had a hysterectomy who're willing to be open and honest. It's also helpful to understand the anatomy of the pelvis and maybe peruse some hysterectomy forums.

Have you tried using Prometrium (progesterone) vaginally or one of the (synthetic) vaginal progestins? It seems they'd have less chance of causing headaches. I assume you've tried cycling the meds too (regardless of delivery route) - e.g., taking only 10-14 days per month? Hope things get better for you soon!

Forgot to mention - for vaginal delivery (off label), the Prometrium dosages of 100mg and 200mg would probably be too much especially if you're taking it continuously. A lower dose compounded progesterone (for vaginal delivery) may be an option. I'm only throwing this info out there based on networking with other women on HRT, many of them with all their parts and some with just their uterus (and others with no parts).