HRT post ovarian cancer

[ruthc]

Hi, does anyone have anything on HRT post ovarian cancer and radical hysterectomy? I’m 14 years post diagnosis and struggling with brain fog and fatigue. Is HRT an option?

[Leniko]

low dose steroids helped me.

[Doggies221]

HRT is always an option and can be irreplaceably helpful, but depends on the specific facts surrounding your type of OC. Here’s the latest on HRT after cancer published in the respected journal the Lancet: thelancet.com/journals/lanc...

[Emcee71]

Hello

Sorry to hear you're struggling with these.

I am too, and it developed fairly rapidly over the 9 weeks between surgery and chemo so I do know it's not (just) the chemo that's making me feel like this!

As Doggies221 says it depends on whether your cancer is hormone receptive (my OC is isn't but I also had very early stage endometrial cancer, which was both oestrogen and progesterone receptive).

My HRT doc said that I could be prescribed testosterone. Or rather, I did my own research and asked about it and she said yes. As far as I know, it is this hormone which will help the most with fatigue and brain function.

Good Luck!

Emily X

[Ljwatten]

Question for gp and oncologue

[SopSinger in reply to Ljwatten]

GP is very unlikely to know.

[Nara42]

Hi

I had Stage 1c2 grade 1 Endometriod adenocarcinoma 3 years ago (ER and PR fed)

A year after surgery I was told I could go on HRT

I was 41 then. They said the benefits of HRT outweigh the risks in my case.

I have no family history of female cancers and my genetic testing was all negative.

My cancer was basically caused by my endometriosis

Been on HRT 2 years now. No problems other than the fact it doesn't work well lol 😅 So my estrogen levels have remained low.

To be honest I'm fine with that and I have no menopause symptoms although to be honest by the time a year had passed after surgery I barely had any anyway !

[Doggies221 in reply to Nara42]

Such a great story, Nara. Maybe you need to adjust HRT types and doses for it to work better for you. It takes adjustments to get it right. But at least, according to science, it’s preventing bone loss /ostheroporosis for you. A study said that 3-4 years after ovary removal, most women (regardless of age) develop ostheroporosis, which I’m guessing is not good or desirable.

[Nara42 in reply to Doggies221]

I have tried different types and dosages. All the way to 150mg which is above the NHS recommendations. But nothing works very well!Its been on going for 2 years. Also seen private dr - no help there either.

Apparently it's hard for some young women in surgical menopause to ever be able to raise their estrogen levels and looks like that's me.

I'm 3 years post surgery now and I recently had a full body private DEXA scan.

My bone density is above average for a normal female of my age.

I put that down to all the running and weight lifting I do. Not the HRT 😁

So I'm not even near being at risk of Osteoporosis and hopefully it will stay that way !

[Doggies221 in reply to Nara42]

I love it. Your HRT, is only an estrogen patch? A doc told me the oral estradiol is absorbed better and as Emcee says, testosterone makes a huge difference in energy, motivation, libido, brain fog.

[Nara42 in reply to Doggies221]

Yes they offered me oral estrogen as last option. But dr mentioned slightly higher risks of blood clots and breast cancer. To be honest I'm also rubbish at remembering to take pills lol 😆 so I declined. I have no menopause symptoms so I'm not really bothered to much!As for testosterone gel I tried it a few years ago but because my estrogen is low I didn't notice any difference on it and again kept forgetting to do it lol

My last testosterone reading a year ago was fine. And infact the dr told me I was testosterone dominant. It's probably even higher now as I have been weight training for a year constantly 🫠

I can actually feel the difference and after reading weight training increases your natural testosterone I decided to sacrifice some running to do more weights.

I don't have brain fog, or a low libido anymore and I run approx 30km a week and strength train about 2 hours a week. I also work 2 part time jobs. So I would say my energy and motivation levels are generally good.

Not to say I don't have bad days but I had those before menopause also lol 😆

I also have some very helpful supplements

I did alot of research as the drs never told me I could have HRT to begin with so assumed because they said no to it to begin with that they meant forever so I basically felt I had to help myself because noone else was going to lol.

Hence looking closely into the benefits of cardio and weights in menopause and I trialled different supplements to see what helped.

It's been a slow process but now 3 years on I'm doing great! And hopefully the cancer stays away as well as I know I'm very lucky it was found early albeit by mistake !

[Doggies221 in reply to Nara42]

So glad to hear you’re doing so well. I wouldn’t dismiss the benefits of estrogen on your bones, muscles, brain. Based on all the consults I’ve had w menopause specialists, the risk of oral estradiol are miniscule. It’s awesome you’re feeling great!

[Emcee71 in reply to Nara42]

That's interesting to know about weight training and its ability to increase testosterone. I hate to say it but I cannot imagine myself doing it! I'm more of a swimmer, walker and quite enjoy getting on my hybrid bike (leisurely and on the flat 😂). I admire you for doing it and glad to hear it is helping x

[JanCan15 in reply to Nara42]

I wish I could be like you!! I’ve tried to keep in shape but low energy and stiffness just hold me back. I’ll keep trying!!

[Fluffyjumper]

My OC wasn’t hormone receptive. I’m 2 years post radical hysterectomy. I was concerned about osteoporosis and other effects of low oestrogen. I started on a low dose of oestrogen gel last month.

[Doggies221 in reply to Fluffyjumper]

Has it made a difference, Fluffy?

[Fluffyjumper]

It’s early days and I’m on a low dose but I feel like I have more energy. I was told that oestrogen may not help with brain fog but I feel slightly more focused. To be honest, I regret leaving it so long to ask about HRT. As mentioned above, I was concerned about osteoporosis and some of the other benefits of oestrogen post menopause, such as cardiovascular effects.

[Doggies221 in reply to Fluffyjumper]

Thanks for sharing. Testosterone cream does help w/ energy, motivation and brain fog. It kinda gives a bit of vital force back to the body.

[SopSinger]

I had terrible menopause symptoms after radical hysterectomy and was almost suicidal. My GP discussed it with my oncologist, as I had early stage endometrial cancer as well as ovarian, but they both agreed that quality of life was important too, and I could risk oral HRT, very gradually reducing the dose. Within a week I was feeling human again! Reducing the dose worked well for a while, but eventually the symptoms started to return. I then asked the GP to refer me to a menopause clinic. I had to travel 80 miles round trip for the first consultation but all the follow-up has been done by phone and I'm on a low dose patch which the clinic doctor is happy for me to take for life. Bottom line: HRT was a lifesaver for me, and I've been 18 years NED, so it certainly hasn't done me any harm.

[Doggies221 in reply to SopSinger]

Hi SopSinger, did the oral or the patch make a better difference for you in terms of resolving your symptoms? When you say low dose patch, 0.25 mcg? Thank you!

[SopSinger in reply to Doggies221]

I'd say both equally effective, but the patch is safer because the dose is lower. Hang on, just have to run upstairs to check. 25 mcg (0.025 mg)

[Doggies221 in reply to SopSinger]

Thank you so much, SopSinger. I’m assuming 18 years ago you started on a higher dose estrogen and came down to low dose progressively. I thought both the oral and patch come in all kinds of doses. May you always stay well!

[Yorkiepudd]

Hi Ruth

I’ve no info on HRT I’m afraid as it’s never been discussed for me. However I do get brain fog and find keeping my B12 levels up make a world of difference. I just use the Better You daily spray x

[Doggies221 in reply to Yorkiepudd]

Yorkie, you could inquire into HRT. There is currently no scientific evidence that in OC, other than low grade serous, HRT has any impact on cancer. You can read the Lancet article I pasted above. It reflects all of the scientific knowledge to date. That’s all we have to go by, but ultimately it’s a tailored individual choice. Good luck!

[Yorkiepudd in reply to Doggies221]

Hi, I’ve never personally broached HRT as aside from the brain fog (I seem to have very low B12 anyway) I’ve been very lucky to not really have any menopausal issues.

[JanCan15]

I’m had OC in 2016, radical hyst, and chemo as well. I started HRT within 6 months after my surgery. I was 42. I feel like it’s safe but have a hard time finding doctors that will prescribe it, especially the testosterone cream. It has helped a bit but I try to keep my dose as low as possible to decrease the risk. So it helps with some symptoms but I have low energy, brain fog, and weight gain and stiffness. I never used to have all this. But without HRT I would be in worse shape. I just do an estrogen patch and the testosterone cream.

[Doggies221 in reply to JanCan15]

So happy to hear you’re well, JanCan. Do you mind sharing what type of OC you had? Did they test your ER/PR receptors on the tumor slides before prescribing HRT? (Not that the result would inform anything but sometimes I think they feel better to test those —again, aside from breast cancer, science has not established what constitutes hormone-sensitive cancers). As far as the patch, my friends have to go back to the doc to adjust the dose several times in order to resolve menopausal symptoms. Maybe, should you choose to do that, you can adjust dose to feel better. I found the testosterone cream helpful.