6 (actually 7) Week Checkup

Yesterday was my "6 week" follow-up appointment, it ended up being 7 weeks exactly because of schedule conflicts and a last minute induction/c-section that my doctor got called away to. The good news is that I have been given the all clear. It was a very quick exam with the speculum then a quick manual exam. She said that it all looked great, things stayed where they were supposed to, that I healed up very well and won't need to go back to see her for a year. Since I no longer have my uterus, I don't have to have pap smears done but I do have to have yearly pelvic exams. She then said, "As a surgeon, it's a thing of beauty. I know that may sound weird but a surgeon has the right to be proud of a job well done." I completely cracked up and told her that I NEVER would have thought that I would hear that during a gynecologist appointment!

I will say that I am a bit nervous about my trek back into the world of sex. The good news is that, unlike before my surgery, I want to have sex. But I just had a lot of work done to my lovely lady parts and 6 weeks worth of recovery, what if something happens? What if it hurts? What if that one stitched up area isn't quite healed and my doctor just overlooked it? What if? What if? What if? Yes, as embarrassing as it was, I talked to my doctor and asked her the above questions. She assured me that things would be just fine, to take my time, use lubricant if necessary, etc. and I am sure that things will be fine but still I am a little worried and nervous. Guess that's what the mango flavored vodka in the freezer is for, a few drinks and I'm sure I'll be a lot less worried. =)

Another part and the most lengthy part of my appointment yesterday was about hormone replacement therapy. Wow, that is a confusing topic. So many websites and so much information can get incredibly confusing. I also found that it was difficult to find a website or sites that a good middle ground kind of website. This website said that if I took hormones, I was killing myself by doing that, then the next would say that I was killing myself by not taking hormones. Estrogen with progesterone, progesterone alone, estrogen alone, natural hormones, synthetic hormones, sprays, gels, creams, rings, pills - it went on and on. So many passionate/extreme views made it difficult to find what I needed. The biggest issue that I found was that ALL of the websites that I found did not pertain to women in their 30's that had a hysterectomy. All that I found were geared towards post menopausal women. I am not post menopausal so how did this pertain to me? Often times I would come away from an hour or two or research exhausted and even more confused. So I will tell you what I found to be helpful and what my doctor told me and then you will have to research what will work best for you from that point on. EACH person is different, in my mind, there is no right or wrong, it is what works for you and only you.

To start: After surgery, just because I still had no idea what I wanted, I asked for a pill to take once a day. I was finding that within a couple hours of taking the pill I would get a headache. This was due to the spike in hormones. As the spike waned I would feel fine, great actually and not give it another thought until the middle of the night. As the hormone levels dipped way down my body would heat up. I wouldn't say they were horrible hot flashes but definitely hotter than I should be. I would end up sleeping with the windows open and no covers, that may not sound bad if you are in a warm sunny place but it's still getting down to the 40's at night here. I continued to take the pill and kept filing away information to bombard my doctor with.

Doctor said: She reconfirmed that all or most of the information out there is for post menopausal women and that I did not fall into that category. The health risks and potential side effects of hormone replacement therapy (HRT) that I read about were all true and real in those women. She said that they should be on little to no hormones at that point. But she then said that pre-menopausal women (like me) that do not take HRT have the same health risks and potential side effects. The way she explained it and it made sense to me, is this way, at this age your body naturally produces, needs, wants hormones and it can process them, deal with them, use them it to it's advantage. When you reach menopause your body naturally turns that switch off and you no longer need hormones so taking them at that point is what causes problems. Your body no longer needs or wants them so it doesn't process them properly and that causes problems. It makes sense to me and I hope I explained it well enough for you.

We then went on to discuss my options for taking hormones. Pills, patch, vaginal ring, cream, gels and sprays are all available. She wanted me off the pill because the pill is processed by the liver. This is very hard on livers and she just doesn't like what she sees in the research papers about that. Everything else is absorbed through the skin and right into your system pretty much leaving the liver out of it. The patch is worn and changed every 5-7 days or before that if it falls off. This can cause skin irritation in some people. I break out after wearing a Band-aid so this option did not appeal to me. The vaginal ring is inserted, obvious statement here, into the vagina and changed once a month. I liked the idea of the once a month thing but, okay I'm just going to say it but I have to say that it's a bit embarrassing, I enjoy oral sex and the idea of that ring being there made me uncomfortable. So I didn't go with that option. That leaves, creams, gels and sprays. All of which are applied daily to the forearm. I decided against the cream, which may seem a silly reason to some, because I didn't like the packaging. Lots of little foil packs, a foil pack a day just seemed wasteful. The bottle of gel seemed a little more earth friendly and one pump of the bottle is one dose. I use two pumps a day, one in the morning and one at night to alleviate or minimize the ups and downs in my hormone levels. She also gave me a sample of the spray and I REALLY like the spray. One spray in the morning, one at night and it absorbs almost instantly. The only problem with that one is that it is a brand new way to apply it so it's going to be expensive and possibly not covered by my insurance. I will have to update you on that later. So my choice after all of that, for now, is the gel but I will switch to the spray if it's affordable or covered by my insurance. Same medicine different delivery methods.

I am still researching the pros and cons of synthetic/manufactured hormones versus all natural hormones. I'm not sure where I am yet on that but am finding it hard to find any solid studies on the natural hormones. I would assume that natural would be better for you but until I know for sure I'm sticking with this.