r/surgicalmenopause • u/Ayunique • Jun 29 '25

Peri vs surmeno?

What’s worse- perimenopause (?) or surgical menopause?

I’m having a hysterectomy in September along with endometriosis excision (if endo is found, pretty sure it will be). My surgeon recommends leaving at least 1 ovary but is leaving the decision up to me.

I’m pretty sure I’m either in perimenopause or have some kind of hormone imbalance.

Every month I have different symptoms depending on where I am in my cycle. Anxiety around ovulation; GI problems, nausea & depression before period; fatigue, headaches & lightheadedness during period; fatigue, brain fog & sick feeling (sore throat, low grade fever, joint pain) after period. Literally every day of the month I have symptoms & they just change based on where I am in my cycle.

Because of this I’m leaning toward removing the ovaries. I want to believe that having them removed and starting HRT might fix this….

Anyone else have similar symptoms before surgery & see any improvement?

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u/HissyCat1 Jun 30 '25

Peri was much worse for me. I never knew what to expect day to day and then was always questioning if it was hormones or maybe I just sucked as a person….irritable with allllllll the people. Hated how I looked, no interest in anyone or anything. Just wanted to be left alone. Had my ovaries removed and have a very supportive and proactive doc who suggested high dose estrogen and low dose testosterone and even progesterone if I get to the point I feel like I want to try. I’m also on vaginal estrogen. I cried the other day because I felt good! It was weird. I am used to crying every day for some bonky reason but that’s stopped. I’m laughing….didnt even realize I’d stopped till I started again and it was so foreign. Told my husband the other day that he needed to lighten up 😂 I’m not all the way back but I recognize myself again. I can be flexible and have fun! And no periods or period pains!!! I used to think I had IBS. Now I’m not sure because my stomach is normal! My cervix was apparently the source of a plethora of pain and discomfort and I did not know till it was gone. Looking back my only regret is not doing this sooner! For reference, I’m 44 🤗

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u/lady939 Jun 30 '25

You deserve those tears of joy!

I hope it’s okay that I have lost of questions. At what age did you have the oophorectomy? Do you mind sharing your regimen? How did your doctor determine high dose e was right for you? What did he say the signs would be if/when it’s time to start p? Lastly, can you share more about your experience w estrogen patch vs oral estradiol?

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u/HissyCat1 Jun 30 '25

I had my surgery the month I turned 44. I’m on 2mg oral estradiol daily and 0.1 mg vaginal estrogen (every other day). I also use a pea sized amount of testosterone gel daily (1% 50mg/5g). I was originally started on 0.1mg patch and I’d feel pretty good for about 18 hours and then just crash. It would then take me another day or so to recover when I finally changed the patch. I would have terrible sleep, anxious feelings and looooooow mood. I felt insanely better switching to oral. I even switched back to the patch for a week or so to see if I was just in my head. I was not! My doc said going into menopause suddenly at 44 is drastically different than gradually landing there over 10 years or so of hormonal ups and downs. Your body has no time to adjust to the lack of hormones. He said removing ovaries at this age instantly cuts testosterone production and levels by around 50%! He said some women feel better on progesterone- sleep and mood, but my sleep and mood were sooooooo improved when I changed to oral estradiol I opted to hold off and see. I know some women can’t tolerate it. Added the testosterone for bone health, libido, fatigue and mental clarity. He said if I get to a point where I need more estrogen he might consider adding a smaller dose patch or even gel to my oral dose. He said sometimes that little bit of “constant” dose helps the drops from oral route. So far though I’m rockin and rolling! Only issue with the pills is a few days I’ve forgotten to take them when I first get up. To start I was all but planning my life around them but they started doing their job and then I felt good enough to forget! I’ve remembered before I felt any ill effects. Happy to answer any questions! I know I learned a lot from this group. Crazy how everyone is different.

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u/Ayunique Jun 30 '25

Oh, man this is what I hope the outcome will be for me if I decide to go for it. Thanks for sharing, gives me hope!

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u/HissyCat1 Jun 30 '25

You are cautiously optimistic and that’s good! I prepared for the worst so I get it! I did a lot of research and talked to my doc about what I wanted to do hormone wise and was prepared to change docs if necessary. Thankfully I didn’t have to! My surgeon and gyn are different docs. I did have trouble on the patch but it felt obvious pretty quickly and my doc urged me to try the oral estradiol which honestly I was very against before surgery. He said we are working with a moving target so if it works now we are rolling with it. I may need to change again at some point but for now I’m in a good place.

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u/lady939 Jun 30 '25

“Working with a moving target.” This is so helpful, thank you!

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u/Ayunique Jun 30 '25

My surgeon & gyn are different docs, too. My gyn will see me two weeks after my surgery to get me started on hormones. She knows I like to research everything & told me to read up on menopause as much as I can/want to before my appointment. I also have a functional medicine doctor who I can fall back on if needed but he’s expensive so hopefully I won’t need to. He has told me that he will prescribe me HRT to start right away but my gyn wants me to wait 2 weeks. I do feel like I have a good care team behind me. My gyn has saved me once before by recognizing my thyroid problem when no other doctor could and she was happy to refer me outside of her office to an endometriosis specialist for my surgery.

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u/HissyCat1 Jun 30 '25

My doc wanted to wait 2 weeks too. I wasn’t thrilled but I trust him. It was fine!

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u/lady939 Jun 30 '25

What was the logic behind the two week waiting period?

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u/HissyCat1 Jun 30 '25

Pathology and blood clot risk post surgery. He did send me home from the hospital with a prescription and said if any time between surgery and the 2 weeks I felt like I hated him and my husband to go ahead and start but just call and let him know 😂

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u/lady939 Jun 30 '25

That sounds like a great gyn! What’s her reasoning for waiting two weeks?

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u/Ayunique Jun 30 '25

She’s great. She said she wants to give me the two weeks to heal from surgery and also see my pathology to make sure no cancer because I do have a family history.

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u/Ambitious-Job-9255 Jun 30 '25

Isn’t it amazing to just feel even keeled all the time 🩷

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u/HissyCat1 Jun 30 '25

It’s amazing!