Hormone Replacement Therapy (HRT) after a hysterectomy

Total hysterectomy at age 34. Was on Premarin for years. I stopped all hormones in 2000. I developed a lot of health issues when I stopped. 20 years later, at the age of 75, my doctor started me on bio identical bi-est and testosterone topical cream. I have it compounded with no added ingredients or chemicals. This is only way I can tolerate hormones

I had a double mastectomy 1 yr ago. One tumor estrogen fed. My gynecologist has me on bio identical hormones that are plant derived. I have the pellets injected every 4 months. The testerone helps with the side effects tremendously & helps me feel so much better as a woman. My oncologist is on board as well. If we stop all hormones our bodies get old quickly ...what kind of life is that. Check into the bio-identicals.

As far as i know, most hormones these days are bioidentical and micronized. Any doc who prescribes them, should know about this.
I inject bioidentical estrogen, and take projesterone and testosterone as bioidentical micronized capsules.
I get a blood test done every 6 months.

Ok, that is so helpful-thank you!! I agree on the quality of life. Thank you for sharing and may you be well:)

Yes, i was taking all plant derived but only estradiol. I wonder if a combo might help me. Thank you!

Check into them, but beware! I was on the bioidentical hormones for 5 years (pellets implanted), and I was doing fine - or so I thought. Then at the age of 55, I became very ill with extreme fatigue, dizziness, and nausea. I had to quit my job because I couldn't function at work. The diagnosis was Mono, and then I found out SEVERAL other woman just in my small town who were getting the implants, were also diagnosed with Mono and couldn't get well. I finally found a gynecologist who explained that when you receive these implants, your body recognizes them as a foreign object and all your body's defenses concentrate on fighting off the foreign object, which leaves your body open to other infections and viruses. I wish I had NEVER started the implants. If they did cause this hideous illness I've been dealing with for 20 months now, they ruined my life and I've been trying to recover it ever since.

Thank you for sharing this. I really hope you are on road to recovery!

ATROPHY/DRYNESS. I have used the Pfizer Estring for several years. It is a ring (much like a small diaphragm) that you insert and replace every three months. It is slow release estrogen, and has been amazing to prevent/ dramatically reduce vaginal atrophy and vaginal dryness. Even though my breast cancer is triple negative (not fed by hormones), we have discontinued the Estring during chemo, but hope to resume after my double mastectomy this fall. As you know, not all doctors support the Estring, or any hormonal treatment, however, my gynecologist and my Mayo Clinic care team are supportive of this in my case.

The Estring is expensive and insurance coverage can be a problem. My gynecologist wrote a letter to insurance, that I had tried all other methods, and they did not work for me. Insurance now covers, but with high co-pay (~$250?). Fortunately, Pfizer has a coupon on their website, which I use to get it for $45.

Also, if the Estring is not your thing, the Mayo Clinic Women’s Clinic advised me that using a vaginal moisturizer/lubricant three or more times a week can also help with atrophy and dryness. Just be sure it has NO parabens or glycerin. I like Luvena Moisturizer & Lubricant. It can be hard to find. Sometimes CVS, Walgreens, Target has it. Otherwise, I order it online. I use before bed a few times a week and before sex.

FISSURES. @lindes For fissures, consider Mupiricin (also called Bactroban). It is a prescription antibiotic ointment. It is the only thing that works for me to heal/prevent fissures (they hurt!). My gynecologist was unaware, so I asked my dermatologist. He prescribed it, and it worked! My gynecologist now prescribes it for her patients with fissures.
ALSO, from Mayo Clinic Woman’s health clinic, “The number one cause of fissures is yeast”, they said. So they prescribed that I take one Diflucan at the beginning of each month to control yeast. We are prone to yeast infections in our family.

So... talk to you gynecologist/ oncologist and determine if any of this is right for you. But this has been my story and my journey to manage the joys of menopause and still remain comfortable, and remain a sexually active 63-year-old woman. My partner and I aren’t ready to give up on sexual intimacy, so on we go. Love and blessings to all. ♥️

Did you have a hysterectomy, including ovaries, and the surgery put you into menopause? What was your experience? What medical specialty (your gynecologist?) helped you figure out how to deal with your menopausal symptoms? Were you prescribed HRT and what worked for you?

I had a hysterectomy Jan 26, 1999. For three months prior to that, I was given a shot of Lupron, to attempt a medical menopause, and stop bleeding fibroids. Didn't work. My right ovary was retained, everything else came out, including fibroids big enough in total to weigh as an eight month old fetus. I was never offered hormone replacement, perhaps because of family history of breast cancer [mother's sister]. It was a 1.5 years before the remaining ovary ceased function. I have never been put on HRT, nor even approached by any medical professional about going on it.
Ginger