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Thyroid medication/Hysterectomy
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forgetful88 posted:
I will be getting a hysterectomy in about a month.

I am 42 & currently on 200mcg of Synthroid for graves (TT in 1994).

My gyno has already told me she will put me on HRT due to having my last ovary removed.

Does anyone know of any issues having a hysterectomy & being on thyroid medication, then having to start HRT?
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Anon_6061 responded:
Thyroid problems are more prevalent after menopause especially after surgical menopause since it's a shock to the endocrine system.Taking HRT and thyroid hormone can cause a bit of tweaking because estrogen binds thyroid hormone.

You didn't mention the reason for your hysterectomy but many gynecological problems can be managed with less invasive treatments that preserve the sex organs. Hysterectomy is the most overused surgery after c-section.

I had a hysterectomy and it has been nothing short of devastating. The hormonal changes (even with HRT) have been a hellish ride. But I miss my uterus even more because its loss has destroyed my sex life and my figure. And my bladder and bowels no longer work properly either because they're sitting down low in my abdomen where my uterus used to be.

Hormone "replacement" helps but isn't what it's "cracked up" to be. Nothing can replace our bodies' own hormones. And it seems this could be especially problematic for you since you'll need to "balance" estrogen and thyroid meds.

The ovaries of a woman with all her parts produce hormones into her 80's to keep her healthy - heart, brain (cognition, mood, memory), bones, eyes, skin, hair. Studies show that normal ovarian function is essential to many aspects of lifelong health. You can find these studies in PubMed.

Have you checked out the Hystersisters website? The "No Ovaries Yes HRT" forum would be helpful in understanding what women commonly face after this surgery. As you can see from their hysterectomy dates, some had the surgery decades ago and are still (or again) trying to get "balanced."
 
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forgetful88 replied to Anon_6061's response:
Thank you for replying. I have to have my hysterectomy due to endometris. I had one ovary removed about 5 yrs ago due to a large complex cyst.

Theyd did blook work where my only ovary is not even functioning anymore & I have another cysts that has been growing since Oct.

They have had trouble regulating my thyroid medication for the last 19yrs. Either too much or not enough.

My Endo said that yes I would need an increase in thyroid medication, DUE to the hysterectomy, but she won't do blood work until about 2 months after hysterectomy. My gyno will put me on HRT, due to fear of bone loss.

I will know more about all of this on the 17 of Jan, when I go for the consultation. I was suppoed to have gotten done in Oct., but with the holidays & wanting to talk to my Endo first I held off until after the new year.

I will keep you updated..Thanks.
 
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Anon_6061 replied to forgetful88's response:
Endometriosis implants can usually be found throughout the pelvis so hysterectomy isn't considered a "cure" for endo.

Excision surgery by an endometriosis specialist generally gives the best possible outcome for symptom relief but even then some implants can be left behind regardless of whether or not organs are removed. Here are a few websites that may be helpful -
http://www.endo-resolved.com/hysterectomy.html. This link also contains some women's experiences after having a hysterectomy for endo.
http://endometriosis.org/treatments/hysterectomy/
http://www.endofound.org/endometriosis

And taking estrogen after your organs are removed can be like "miracle gro" for the remaining implants. Yet, going without estrogen increases your risk for a number of health problems - heart disease, stroke, bone loss, dementia, Parkinsonism, cognitive impairment, depression, anxiety, vision, skin, and body composition changes, severe hot flashes, urogenital atrophy, sexual dysfunction -
http://www.ncbi.nlm.nih.gov/pubmed/20226402
http://www.ncbi.nlm.nih.gov/pubmed/17476148

Also, there are some increased cancer risks of having hysterectomy (with or without ovary removal), one being thyroid cancer - http://www.ncbi.nlm.nih.gov/pubmed/12548194 and another being kidney (renal cell) cancer -
http://www.ncbi.nlm.nih.gov/pubmed/21149759
http://www.ncbi.nlm.nih.gov/pubmed/10566555
http://www.ncbi.nlm.nih.gov/pubmed/18711701.

There are some other health risks too of simple hysterectomy (without ovary removal). You can do a search in PubMed to find these.

I didn't have endo but did have a hysterectomy and my health and quality of life have suffered horribly. I fell into a suicidal depression with anxiety, insomnia, memory loss, overwhelmed by everything, inability to focus (like ADD), hair loss, dry and rapidly aging skin, blurry vision, bladder and bowel problems , loss of all sexual desire and response along with the nuisance and uncomfortable hot flashes.

Good luck in your quest to improve your health and quality of life!
 
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Mary Jane Minkin, MD replied to Anon_6061's response:
Just a quick update on estrogen replacement after surgery for endometriosis: some gynecologists will recommend treating with both estrogen and a progestin. This is one of the few times that gynecologists may recommend progestin therapy to a woman who has had a hysterectomy. So don't be astounded if your gynecologist does make that recommendation. In a sense, the progestin acts as a sort of balancer to the potential stimulation of any residual tiny implants of endometriosis; the progestin counteracts the stimulation,
Mary Jane
 
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Anon_2912 replied to Mary Jane Minkin, MD's response:
So there should be no issues with thyroid medication & HRT medication?

That is my concern. My endo tells me I will have to increase the thyroid medication, My gyno says it won't affect the thyroid medication.
 
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Mary Jane Minkin, MD replied to Anon_2912's response:
Dear Anon_2912,
What estrogen therapy does is to increase a substance called thyroid hormone binding globulin; so that more thyroid hormone may be bound up with this substance in the blood. So you may need a bit more thyroid medication, to increase your free thyroxine. Bottom line is that it is the free thyroxine that is active; it is easy to measure, and you may need a tiny bit more thyroid to help balance things out-but having to adjust the thyroid medication should be straightforward. And having thyroid problems should not preclude the use of estrogen; you just need to adjust things a bit occasionally.
Good luck,
Mary Jane
 
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momo2525 replied to Mary Jane Minkin, MD's response:
This is a very interesting conversation as I have recently ( a few months ago) decreased my HRT (Premarine) to half. I have been on it since I was 43 and I am now 62. Since I have decreased the medication my thyroid has begun to act up. My doctor tells me that it doesn't show up on the tests but I have all the symptoms. Why didnt I get any suggestions in the first place. Should I go back and talk to her again about it? I am now in the process of going off the HRT completely but I am wondering what this will bring. My doctor is in Canada ( I live there) and I am down in Florida for the winter.
 
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Anon_6061 replied to momo2525's response:
What "thyroid acting up" symptoms are you having? There are symptoms that are common to thyroid dysfunction and ovary removal (or reduced ovarian function). So it can be hard to know the source or cause of the symptoms. Then again, since your endocrine system is compromised by the loss of endocrine glands (ovaries), the cause may be a combination of ovarian hormone deficiency and thyroid dysfunction. You see without your ovaries, the other endocrine glands have to work harder. Also, the ovaries of women with all their parts produce hormones into their 80's. These hormones are essential to good health.


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