hormones or no hormones???
So, I'm having to make yet another big decision...I found out in July 07 that I am BRCA1 +. I had bilat mast 9/04, chemo finished in 3/05. I'm triple negative. I've decided to go for a complete hystorectomy and have different recomendations on hormones. My Gyn says he'd put me on low dose of hormoness (doesn't think women need to suffer) my Gyn Onc. said she wouldn't put me on hormones (because I have had bc. & am BRCA1+) My general surgeon wouldn't put me on hormones either. Have any of you who have been thrown into surgical menopause decided to take hormones? I need some more thoughts on this subject as my surgery date is 11/8/07 and don't know what to do??? I've been pretty aggressive with treatments, but am affraid of side effects of menopause (that dang "unknown" ugh!). I haven't approached my oncologist yet. I see her on Tuesday. Any thoughts would be appreciated! I just need some other opionions and everytime I come to this site...I get such words of wisdom.
Thank you-
Nicki
Comments
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Nicki--your surgeon and oncologist are right--it is not advisable for women who have had bc or family history of bc to take HRT. I'm surprised that your gyn would even suggesst it knowing that you are BRCA+ and have already had bc. After all you've been thru with the bilat. mast., chemo, and now the upcoming hysterectomy, why take any chances???? I went thru immediate surgical menopause and although it's not fun, it is doable.
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Hi Nicki! There are non hormonal drugs that can help alleviate some of the symptoms. I used Effexor and clonidine for some of my symptoms for a short time. I found with my recent hyster/ooph hot flashes have returned but I expect this is temporary and seem to be getting better quickly. Having said this, I also use Estring which is a vaginal ring that helps with some of those local symptoms. I feel pretty okay using this since it has not much systemic absorption and for the most part my breast cancer was not very hormonally positive (ER19% and everything else neg). I don't think you need to make that decision immediately and could see how you feel before signing up for replacement. My first oncologist was more definite that he didn't like replacement. My current oncologist says that quality of life is important also. Another one of thiose neverending crappy decisions to make.
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My mom was dx 6 yrs ago. My sister had hysterectomy 3 yrs ago due to bleeding problems, they would not put her on HRT because of the family history. I was dx this summer with DCIS and my surgeon suggested thinking about removal of ovaries and no HRT.
Sheila
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I had my ovaries removed after my first bout with bc. Menopause was very tolerable to me. I did take Effexor, then Zoloft, for the hot flashes and moods. I had it pretty easy, compared to some of my friends who went through this naturally. (I was 45.)
The only hormonal thing I've done is use the Estring for vaginal atrophy. Even if my onc had not sanctioned this, I would have insisted, for sanity's sake and quality of life's sake.
When I was first diagnosed I heard a renowned endocrinologist speak (can't recall her name right now--menopause brain, I guess!) who said women need to choose between life and quality of life. Some simply cannot handle menopause without hormones. She was addressing a room full of breast cancer survivors, even.
It's a tough decision for some, but a no-brainer for others. You could consider a trial of Lupron injections to suppress the ovaries--that would give you a hint about how you'd do without estrogen, though it's not quite like the real deal.
I personally am in the camp of treating symptoms with other things if possible. For me, I had to have estrogen for my vagina.
Good luck wrestling with the decision. It's not easy when facing major life and body changes.
Anne
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Thank you all for your thoughts. Spoke with my onc. and she advised foregoing the hrt "for now". She also talked with me about a study done on 13000 women and their findings. (nothing really conclusive to me) but 3 out of 4 specialists advised to "wait and see" and a NP suggested the ring and Effexor...so think thats how I'm going. Nothing for now. My concern is the dryness as during chemopause I was so dry that I felt numb. (sorry...tmi?) So will definately consider that estring?. 4 days left...I'm getting nervous again. Thought my recon. surgery was it last October. dang.
Thanks again...
Nicki
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