Zoladex

[Footy-girl81]

I have to start the zoladex 3.6mg injection in 4 weeks, got to try it for 3 months, to see if it works, but can I ever have children after this?

[Impatient]

Depends what your medical situation is and why you are being put on zoladex and how your body reacts to the drug when you stop taking it. What's your endo history and surgery history so far?

[Footy-girl81 in reply to Impatient]

They don't know what's going on, had a op 4 weeks ago to see if I had endo, but that was all clear, at the mo, I am on tablets to stop me from bleeding all the time, had hospital today, that's when they have said about the zoladex

[Impatient in reply to Footy-girl81]

If there was no endo present - then endo is not any risk to your fertility, but I suspect they are now offering you zoladex to see if by stopping your periods the pains persist or stop too.

If the pain stops, then you are more likely to have a condition called adenomyoisis which is very similar to endo - but hidden inside the uterus muscle walls and cannot usually be seen with a lap camera.

there is a website for adenomyosis.

adenomyosisadviceassociatio...

You do not need to have zoladex - taking it is voluntary, it doesn't kill or cure either endo or adeno, it is offered in the hope it can provide you with some sort of relief from symptoms for a temporary time frame.

But the drug shuts down the pituiatry gland in the brain which is where lots of different hormones are made and when those are stopped from being made your body will react with assorted side effects which can be anywhere from tolerated to extremely unpleasant.

Zoladex is a chemo drug.

Much the same side effects to be expected as you are already familiar with from hearing about cancer patients having the same chemo for breast or prostate cancers.

It's how our own bodies cope with the loss of hormones that determines how well we get on with the treatment or how badly it makes us feel.

The patient advice leaflets for zoladex are freely avilable online and I absolutely insist you read it thoroughly to know what will happen.

This is definitely one drug where homework is essential.

It is a super powerful drug -unlike any other you are ever likely to be given in your lifetime and you need to know what it can do to you and yo need to let your family know too so they can be aware of changes to your health and personality too.

If you are at work or in higher education- you are entitled to time off as and when you need it - just like cancer patients get on the same drug. Some days - even some hours may be better than others and it is a very erratic experience not knowing from one moment to the next how many side effects can be hitting you at the same time.

Some days you may be bed bound all day - some days you won't be able to drive or read if you wake up with blurred vision for example, so you do need to consider how much support you have home.

There are lots of reasons not to take it, and very few reasons in its favour.

If you have previously existing health issues like a past history of depression - then DO NOT take it, likewise diabetes and kidney problems and thyroid problems and heart problems and so on. The warnings are very real and you should heed them.

The drug is implanted in your stomach once a month, alternating sides every 28 days. So deciding to start the drug means you have that drug in your body working full time for 28 days whatever the side effects you end up with. You cannot escape that.

And the traces of the drug subside away over the next 4 months. Each implant has trace amounts in the body up to 4 months.

The unpredictability of the drug is that shutting down the pituitary gland is one thing, but there is no drug to switch that back on and your own body has to try and do that at some stage, reactivating the pituitary gland itself and **hope** that it will wake up and fully get working again,.

This is where the risk to fertility is concerned because in some small % of cases the pituitary does not fully wake up and produce all the hormones the body needs, and if by chance the sex hormones are not brought back in to full production then your ovaries might not wake up and ovulate again. It is a very low risk of that happening but it can happen and there is no way to predict it from one woman to the next.

If you are being given zoladex to help diagnose possible adenomyosis, then I would advise before you start any zoladex, ask your gynaecologist to arrange an MRI scan on your uterus when you are on a period bleed (which sounds like most of the time.) That should be a better way to determine if there is adeno present, as it bleeds into the uterus muscle and it causes the muscle to get thicker and lumpy in places.

If there is no endo and no scarring or adhesions, then at the moment there is no threat from that to your fertility at all. Did they run dye through your fallopian tubes to check they were unblocked and clear tubes too? Adeno is not threatening fertility either - but is a horrid condition to hve to put up with till you are finished having babies and can have a hysterectomy to remove all the adeno cells.

The zoladex is for a max 6 months in lifetime, it doesn't matter if you only manage 1 month, 2 or 3 and give up - makes no difference to the risk to the pituitary not waking up some time after, but it may just help give you a break from bleeding all the time, but it won't be a forever solution.

The biggest risk to your fertility is what you decide to do about the ongoing bleeding as the most effective treatments involve cooking the lining of the womb to cause a build up of scarring to stop the bleeds but that means the womb is unable to carry a pregnancy and you'd need a surrogate to carry the pregnancy for you. Or you put up with the bleeding and trying different ways to control your periods or better yet try and stop them long term - with

arm implants Nexplanon (3 years at a time) or Mirena coil (every 5 years) or 3monthly injections of Depo-Provera. All can be used whether it is endo or adeno that is causing your heavy ongoing bleeds.

Zoldex can be brutal - do check it throughly before deciding if it is something you do want to try - but if they are trying to determine if adenomyosis is the problem now then there are less risky ways to try and get that diagnosed. Don't start zoldex till you are sure you want to give it a go and if after doing your homework you decide not to then you don't have to and you should decline it. You can always go back and have it at a later point in life if you change your mind.

Zoladex should not be being used as a diagnostic medication. It isn't designed for that and the manufacturers don't approve of its being used in this way, though it seems far too many gynaecologists seem willing to risk their patients long term health by overlooking this fact.