Gradual ovarian suppression?

ARmom4

Hi all! I just started Tamoxifen a week ago. While talking with my MO, I asked his thoughts on ovarian removal and he said based on the SOFT trial and considering I'm high risk, it would provide some benefit. So he referred me to an OB/GYN. I'm wondering if there's a way to gradually step down my estrogen levels before ovary removal? I know ovary removal puts you in instant menopause. I feel like it would be better to gradually step down if possible. Is it possible?

orangeflower

The only other option I know of is Lupron. It does put you into very rapid menopause, but my doctor said it’s not as rapid as ovarian removal. She said the menopausal symptoms would be worse with ovarian removal.

VioletKali

I looked at the results of the SOFT trial and decided that the small % of positive result was not good enough for *me* to put my body through menopause and drugs. After cancer, my hormone levels were already lower than they were pre cancer, so that was good enough for *me*.

Have your estrogen levels checked to see exactly where you are. My levels were much much lower than what is typical of my age. Chemo put me in menopause and my ovaries never totally went back to 100% Perhaps your estrogen levels may be naturally much lower than normal too. (I am a Nurse that tries to look at the big picture in regards the quality of life)

I did not want to take tamoxifen because I take psych meds that I am VERY happy and stable on for over a decade, why ruin my mind and mood? I am ALL about quality-quantity means nothing if I am not happy.

AI drugs made my joints hurt like crazy, so that was a no as well.

ARmom4

VioletKali: I wasn't able to complete chemo due to severe reactions. My MO decided he didn't want to try a more harsh chemo because the risks outweigh the benefits. So, I did not go into "chemopause". My cancer is 100% ER+, 98% PR+ and I have a genetic mutation. Ovaries make 80% of our estrogen. To me, blocking that estrogen is important especially since I couldn't finish chemo. I appreciate your opinion, but my question was about whether gradual suppression is possible. Thanks.

buttonsmachine

ARmom, Zoladex and Lupron are drugs that suppress the ovaries, and it's reversible. You may want to consider those options first and see how you feel before doing a more permanent surgical option.

I've been on Zoladex for about two years, and it's been okay for me. I like to *hope* that I'll be premenopausal again one day, because being postmenopausal at our age is not great from a quality of life perspective. But we do what we must to get rid of the cancer. Being postmenopausal at a young age increases the risk of heart problems, cognitive problems, joint problems, osteoporosis, and can cause vaginal dryness and atrophy... there are other not great things too. In any case, you might find that you don't want to be stuck with those side effects forever.

I'm not trying to scare you, but I'm also trying to give you a realistic picture of the less enjoyable aspects of being young and postmenopausal - whether from drugs or surgery.

That being said, I've found ovarian suppression drugs and hormone therapy to be tolerable overall, but there are definitely times where ovary removal makes sense. Best wishes whatever you decide, it's hard for sure.

ElaineTherese

I've been on Zoladex for five years (along with Aromasin). I'm on the seven year plan right now. It's been OK, though I definitely did get the hot flashes and mood swings a few months into it. (Taking Celexa for the mood swings was a big help.) I also developed full-blown osteoporosis, which is now being treated with Prolia. (Graduated to osteopenia recently.) Would I have been worse off with an oophorectomy? I have no idea. I only know that I have two more years of this drug regimen and then I can reduce the number of medications I take.