Any tips for dealing with fatigue associated with surgical menopause?

I seem to be really, really tired most of the time (not even a strong cuppa wakes me up!) and I'm suspecting it's the surgical menopause. (I can't have HRT as my tumours were strongly oestrogen receptive). My gynaecologist gave me a review paper to read from the Royal College of Gynaecologists/Obstetricians which seems in effect to be saying there is little evidence to support any other treatments (herbal etc.) except perhaps doing cardio-vascular exercise, maybe yoga, and taking SSRIs (Prozac etc.) for flushes. At the moment though it's the fatigue that's really getting to me. Has anyone found any ways of handling this without (as I currently am) spending their life on the sofa ;) ?

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  • Catherine! With all that's been happening to you lately, I'm not surprised you're tired. Your tiredness may be emotional as well as menopausal. There is so much going on in our heads when we're first diagnosed, and your treatment and medications will have depleted your system. Add to that, all the stress of dealing with other aspects of life and the sofa is probably just what you need at the moment. I know you probably want to get out and about and be busy and "normal", but we have to cut ourselves a bit of slack sometimes.

    Sorry! Not much help from me. By the way, in case (like me) you're a bit sceptical of what the medical industry researchers tell you, I've heard that St John's Wort and COQ10 are good for boosting our energy levels, but I've no idea how they would react to an oestrogen receptive tumour diagnosis. You would have to check. I always left yoga class feeling rested but energised and have found that tai chi is wonderful (frustrating but wonderful ;-)) If you're interested, look on the "taoist tai chi of great britain" website. There's a "your nearest class" option on there. It's really good for many conditions. Some of the women who go to my class have found relief from Parkinson's disease and various arthritic problems. Great for balance, internal health and I find It's also good for calming the mind --it's so damned hard for me to remember all the moves that you can't think of anything else!

    Love, Wendy xx

  • Thanks so much Wendy - I used to like tai chi and have gotten out of the way of it - will look up the COQ10 too (unfortunately St John's Wort makes me photo-sensitive which is a shame because it is supposed to be great stuff!)

    Thanks again

    Love Catherine

    xx

  • Hi Catherine,

    I don't know how long it is since your operation, but don't overlook the fact that your fatigue might be because you are tired! It is important to exercise each day, but also to rest lots and recover. If you have had chemo as well, it will be perhaps 18 months before you reach your full energy levels again, and then, if my experience is anything to go by, you will not 'fire' on all cylinders all the time. Wendy is also right of course - we have lost a great deal (security, reproductivity, hopes, our feelings of immortality) and more, and these things take a huge amount of energy to adjust to. Also, the menopause adds to all the above. There is a 'grieving' process for all of the above for us all to negotiate, and that also takes energy. I find that many of my clients are diagnosed as being 'depressed' because they feel fatigued and can't get going, but when we examine it closely, we find that they are processing deep shocks and life changes.

    Never forget that you need to sleep to adjust to new understandings, as much of our re-processing happens during sleep, but also, when sleep is dealing with so much shock and change, you are likely to feel tired rather than energetic when you wake up.

    I have to add that the controversial little magnet has done more to restore my energy - two years after the end of treatment - (cut down pain and flushes and let me sleep well) than anything. It is important to challenge yourself a little, but not too much, then to relax and rest too.

    Wishing you all the best.

    Isadora.

  • I would follow your gynaecologist suggestions, especially as SSRIs are concerned. Don't fret about the sleepiness, which isn't surprising because you body has gone through so mcuh recently. I would follow her or his recommendations before you do anything else.

    My own tumour lies or is suspended in oil someplace. I do not know, because my initial treatment was negligent - and I have a lawyer on the case - whether it was or wasn't I will find out at some stage about the oestrogen status - if it hasn't been so utterly destroyed by the first guy's negligence and the oncs decision to go along with him, which my lawyer tell me, will end up before the GMC. I hope they both lose their licence to practise over this one.

  • I have not been impressed by what I have heard of Castle Hill! I live in York and go to St James' in Leeds - fantastic place. I had multiple tumours and after debulking and chemo last year developed 2 more which are being treated now. You suggested we made contact - my email is annajohn40@yahoo.co.uk

  • ps - forgive me for the literals, I am dyslexic...

  • Catherine - I had the same problem after the hysterectomy, 6 rounds of chemo, shock at being in menopause etc. I was ytterly exhausted. Once the scar was healed, I started with a personal trainer at home twice a week for half an hour each time. She is local, so it wasn't expensive and she'd had cancer too, so understood what I was going through.

    Once I felt confident [and could hold small weights away from my sides for more than 1/2 a minute!] I started going to her women's circuit training class once a week.

    I have never been into that kind of thing, and didn't really think it would help, but actually it made a huge difference. My stamina got better quite quickly, and the tiredness started to be 'once in a while' instead of all the time. It did take me over a year to feel 'normal' again. Your body takes such a battering, and so does your mind. Phsycologically, I just wanted to rest and stay at home. My hair was 1cm long and it didn't help me feel like Action Woman. I just felt uninspired and miserable and didn't want to do much at all.

    Then I lost my job as a freelance designer - so I took up a cleaning job, which I hated, but that was it. I was forced to do heavy physical work every day cleaning chalets [ugh!], and within 4 months I'd lost all the weight I gained on chemo, plus I felt great.

    I'd recommend excercise any time- as much as you can cope with. Even walking is good. On the upside, I am now training for a 400km fund raising cycle across Kenya in October - in aid of women's cancers - something I never ever thought I'd be capable of.

    Take it one day at a time. Good luck - hope you feel better soon

    x

    PS: I don't take HRT either, but it's a personal choice. Had quite enough of drugs thank you! ;)

  • By the way, when I first started the cleaning, making beds used to make me cry, as it was so difficult, as I was so tired...so I don't mean to come across as 'it was all easy'. It wasn't - but it worked ;)

  • I tend to agree with those above... But it may be worth while just checking with your doctor to make sure there is no other reason you are feeling like that, such as anemia etc.

    I think its easy to beat ourselves up about feeling tired when there are those that seem to coping better. Its not a time to compare or have expectations of how you 'think' you should be doing.. everyone is different. I had surgery and on my 3rd lot of chemo and struggling with the sickness but finding the tiredness so overwhelming sometimes, as I use to consider myself quite active before!

    Time will help as your body adapts to the changes..thats what I keep telling myself. Just made sure you get enough sleep, eat a healthy diet and yes exercise does help, but in moderation! Dont forget relaxing is important too though, so if you need to rest on the sofa then why not, its still early days .... Hope all goes well.

    Take care

    Julie xx

  • Yes Cat , it is soooo frustrating!!!!

    If you do get any better answers than me will you share?

    Its worth getting your bloods checked to see if there is anything physical

    As far as I have garnered, it a case of doing gentle exercise- load bearing such as walking, gentle stretches to get the blood around the body. ( even if it is just walking up the garden make sure you do a little each day)

    but it is also resting when you need to- and the bit I am not so good at, which is relaxing when you do- and not spending your energy resenting not doing!!! meditation or breathing/ relaxation have been recomended to me to help with this.

    There is a disparagy between how I am, and how I think I should be! but this in itself uses up a lot of emotional energy- so try to lose the should!

    eating well- keeping your body gently fuelled with a good diet

    keeping a regular sleep pattern at night

    I have found the most useful gaget to be a slo- cooker- it means on a bad day I can prepare a meal step by step, and rest before eating- so I can enjoy sharing it rather than be bad tempered with my o/h.

    Mentally the most useful way I have found to cope with it is to think of my energy reserves as something that needs to be banked- somthing I need to make a concious effort to put more in- and to be aware that a withdrawal will deplete my resources- so its a case of building in replenishement times to keep myself going- in these times of limited resources careful management is needed. be aware of how activies either recharge or deminish your energy levels.Nurture activities that make you laugh or smile they will help you relax and cope.

    most of all- be kind to yourself and forgive yourself- for being as you are- the body and mind have been through so much- and all at once.

    all the best

    lin

  • Dear Catherine

    I am so terribly sorry to hear that you are still struggling , but what the other ladies have said is so true ! You are so young and have had a massive trauma , so this is not unexpected , but must be so frustrating.

    I also had a borderline tumour removed, as well as a TAH in January 2010, via a massive central abdominal incision. I had a second op in June 2010 to investigate the cause of awful ongoing pain ( long story !). I have also felt totally shattered physically and emotionally until a few months ago.

    However over a year after the second operation I now feel so much better, so time is really a great healer.

    I was able to have HRT, which was and is great and cannot imagine what it is like for you without it. It has all been a nightmare and I found two computerised lifeskills courses via CBT really helpful to improve my mood, which was a problem for me. I had also found that all of my resilience had just evaporated with all of the trauma, so struggled to cope with challenging situations.

    You are probably well aware of these programmes, but one is free and is called Living Life to the Full. Another is called Beating the Blues. I have pushed myself to exercise more and get out more and that has been hugely helpful.They also emphasise the importance of regular pleasureable activities,which also help alot.

    My understanding is that there is reasonable evidence to support the use of SSRIs in the management of menopausal symptoms where HRT is contra-indicated.I have also bought one of those little magnets and will try reducing my HRT dose in the coming weeks.Perhaps you may need to consider being a little firmer with your specialist about getting you some treament for your symptoms.

    Take care of yourself Cat

    Sending you a huge cyberhug

    Charlie xxx

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