Re: surgical menopause/migrains.
From: Joanne (anonymous@obgyn.net)
Mon, 16 Jun 1997 15:52:36 -0400
Dr. Chudacoff,
I'm sorry most of those on this forum, know my history by now. I will
answer your questions as best I can.
> Why is estrogen replacement not possible? Often headaches are caused,
> not by estrogen, but the lack of estrogen. Woman who have menstrual
> headaches have them when the estrogen is at it's lowest concentration.
> This condition is often relieved with low dose continuous oral
> contraceptive pills. So, I would imagine that your headaches are caused
> by the lack of estrogen, not because of it.
I have been advised to hold off on ERT, for awhile, due to the extensive
endometriosis that was found, and hopefully all removed, at the time of
my TAH/BSO.
>
> >Actually, I do believe the migraine, most likely, was from the Black
> >Cohosh. I had also experienced an episode of extreme depression, with
> >weepiness and feelings of wishing I was dead, though not bad enough to act on the thought, shortly after the first dose of BC.
>
> Then why are you taking this herb? What are you trying to gain by taking it?
> I had hoped that it would cut down, and maybe even eliminate the frequent night sweats I've been having.
> >The migraine happened several hours after the second capsule.
> >Now I know depression is also common with menopause, but it does seem so coincidental that these two things happened, both of which I've not been subject to in the past, after beginning Black Cohosh. I've decided not to tempt fate, so I'm staying away from it, altogether.
>
> Actually, depression with menopause can be associated with the insomnia
> the occurs with the night sweats and hot flushes. As the estrogen
> levels lower,the hypothalmus in the brain resets, causing burst of
> hormones, including LH. This causes the hot flushes. The hot flushes,
> if not actually waking you, cause a decrease in the REM stages of sleep,
> thus you become tired, irritable and depressed.
Yes, normally I would say that's true. However, I haven't shown any
signs of depression, with exception to that brief episode.
The patch is approximately the same dose as the most common oral
> estrogen replacement dose, and there are lower patches. The problem
> with patches, in my opinion, is that they bypass the liver, thus they do
> not give the same cardiac and stroke protection that the oral agents
> give. They do relieve symptoms of menopause and help prevent
> osteoporosis, but more women deprived of estrogen die from heart disease
> and stroke than do from osteoporsis. Conjugated estrogens and
> esterified estrogens have been shown to prevent all three diseases at
> the oral dose of 0.625 mg, equivalent to the patch you mentioned, and
> can often relieve menopausal symptoms. I don't know your age nor the
> situation for your ovary removal, but if you were still ovulating, which
> it sounds like, you may need the equivilent of 1.25 mg to relieve your
> early symptoms, which can then be decreased down the road.
I am 43 years old, and yes I was ovulating at the time of surgery. I had
stage IV endo, and past surgeries were ineffective in controlling spread
of disease, and the pain of it. I underwent a TAH/BSO with subsequent
bowel resection, last month. I was told that in a few months, I could
begin LOW dose ERT. But, I also have a past medical history of
phlebitis, from birth control pills, and a breast biopsy that showed
ductal hyperplasia, so I'm not even sure, I'm a candidate for estrogen
replacement.
> >
> >Thanks again.
> --
> Richard Chudacoff, MD
> Baylor College of Medicine
> BaylorMedCare
> Houston/Richmond, TX
>
> This post is intended for eduational purposes only. As with all
> medical conditions, you should seek consultation with your health
> care provider prior to instituting any therapy derived from this
> post or any posts receive on the Internet.
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