HRT after total hysterectomy due to uterine cancer

Posted by sbryant @sbryant, Jul 23 10:11am

I was diagnosed with uterine cancer in March. I had a total hysterectomy on May 19. They took the uterus cervix ovaries and lymph nodes. I am now having major menopause symptoms once again. My doctor said she thinks it’s safe to use HRT again for 6 to 24 months has anyone done this?

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Profile picture for Helen, Volunteer Mentor @naturegirl5

@sbryant This is a tough question. Did you share your misgivings about taking HRT? Is this your oncologist who told you she believes it is safe for you to take HRT?

Everyone is different and we have to enter into this conversations with our own oncologists. With this collaboration with our doctors we can figure out what feels like the right choice for ourselves.

I was using vaginal estradiol prior to my hysterectomy for endometrial cancer (endometroid adenocarcinoma, Stage 1 at diagnosis). There continues to be controversy about vaginal estradiol however at the time my doctors told me and the research literature was clear that the estrogen in this formulation used vaginal is safe. It’s a small amount of cream and very, very little enters the bloodstream since it’s basically being used “topically” as in on-the-skin and externally. The estradiol worked for vaginal atrophy for me.

After my hysterectomy my gyn-oncologist told me that I should not use vaginal estradiol anymore. I shouldn’t use any estrogen products. My cancer was ER+ (estrogen receptor positive). While the estradiol did not “cause” my endometrial cancer she did not think it safe to continue to use. The radiation oncologist told me the same thing.

I was post-menopausal when I had the hysterectomy. I’d had insomnia ever since peri-menopause. It hasn’t been any better and in fact my insomnia has been worse over time. What to do? I use OTC products like melatonin, I try to practice good sleep hygiene, and when I have difficulty falling asleep or staying asleep I get up and read. Yes, this insomnia is distressing but I have learned to accept it over time. And it isn’t every night.

I’ve shared a rather long explanation on my own experiences. I will say if I were in your place I’d ask my oncologist more questions and I might get another opinion from my gynecologist.

What do you think you might do?

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@naturegirl5 hi. I fear I’m going right into the same boat as you. I was also using estrodial and testosterone compounded topical cream, I stopped the progesterone formulated capsules bc they were too strong. I was worried about radiation. Did you do chemo? How was the radiation? Silly question I know. Did the dilators work? Sex life?

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Profile picture for janeeniebeanie @janeeniebeanie

@naturegirl5 hi. I fear I’m going right into the same boat as you. I was also using estrodial and testosterone compounded topical cream, I stopped the progesterone formulated capsules bc they were too strong. I was worried about radiation. Did you do chemo? How was the radiation? Silly question I know. Did the dilators work? Sex life?

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@janeeniebeanie It's been a mixed "bag". I stopped the estradiol as recommended by my radiation oncologist and gyn-oncologist. I use a formulation that contains hyaluronic acid. You can get this over-the-counter. It doesn't work nearly as well as the estradiol which is disappointing. But it does help with vaginal atrophy and helps moisture in the vagina.

I did not do chemotherapy. The radiation treatments were actually pretty easy for me to do including brachytherapy. However, these treatments left scarring and narrowing in the vagina and so I use dilators. Quite honestly, I detest using the dilators but I use them. It's been a process. My husband has been incredibly supportive as we rarely have intercourse anymore and when we do it's not like it was before my hysterectomy and radiation therapy. We use Ohnut Rings sold online by the Pelvic People.

Ohnut Rings:

-- https://thepelvicpeople.com/products/ohnut-depth-limiting-rings

There are many ways to have sex without intercourse and we've made that work. The Ohnut Rings are fun to use together and the rings make intercourse more comfortable for me.

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Can you turn back the clock on the aesthetic and bone ravages with HRT for those of use who did not take it immediately after hysterectomy for Type 2 endometrial cancer?

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