Had a very heavy period a few weeks back, so it spurred me into action to make sure I get contraception sorted.

Condoms are not really a long term solution, I’m too old, they are too restrictive and I want that part of my life to be normal! Merina coil - was fantastic, but not an option now hormone +ve

Just returned from the gp wanting to get the copper coil, because I have very heavy periods she strongly recommended against it and instead suggested sterilisation.

I’m ok with the idea, don’t really want another general anaesthetic, but wondered if I had my ovaries out or even a full hysterectomy does that mean I still have to take tamoxifen? Has anyone been through this, I’m only 37, so still quite young.

At 37 i would think having ovaries out would be a good option if er+ (although im sure others may disagree due to long term risks). But yes you would still need to take some form of drug, either tamoxifen or you can change to an AI if ovaries are removed.

I had my ovaries removed 18 months ago, it was a very simple op, only day surgery. I was 35. I am happy that being 100% er+ that the main source of oestrogen has been removed, along with my risk of ovarian cancer. Extra calcium/vit d along with bone desity scans every 18 months now.

Hi there,
Removing ovaries is not such a big deal if you have it done laporoscopically (i.e. keyhole). Not all surgeons offer this but you could insist on them finding you one that does. It takes about 20 minutes and you should be out the same day or next day. I had it done as a day patient. I’d say I was a bit sore but no more than that. Paracetemol for couple of days sorted that out.
There should be no need for a hysterectomy unless you have other unrelated problems.
You should still take Tamoxifen as women also produce oestrogen in fatty tissues and the adrenal gland. Tamoxifen helps deal with that!
Good luck.

Thanks ladies, sounds good!

What are the long tern side effects and risks?

Early surgical menopause without HRT (cant have if er+) can lead to osteoporosis and heart disease. However, if it keeps the cancer away for a few years or longer, then its worth that risk.

So if it so good, and it is a relatively easier op, why are women not offered it more regularly? Is it because the risks of osteoporosis and heart disease are quite high?

Was early surgical menopause difficult physically? Worse than the menopause symptoms on tamox?

I was offered ooph as soon as i was dx but took the zoladex option for 15 months first instead. Mild flushes the same as when on zoladex and tamoxifen.

Hope you don’t mind me jumping in on this thread.
I’m just very interested because an oopherectomy was something I considered, and was keen to find aout more about. (36 at dx, 100% ER+) It wasn’t something the onc was keen on, but is one of those things I keep returning to and thinking about.
The risks mentioned here (heart, bone desnity) are those that were given to me-and also the fact that tamoxifen allows oestrogen to do other jobs in the body, which obviously would stop with that surgery. However, I must admit I’m still considering and trying to weigh up pros/cons, so I’ll be reading this keenly.

Just seen another very good thread on here about ooph surgery.

I have done a bit of googling and have worries about the long term effects and fact the ovaries make other hormones that help us through out lives - I guess I am worried that if I don’t have a positive experience, they can’t be put back in! I need to talk to onc about other benefits, but as my main concern is contraception then it seems a bit extreme.

I was sterilised in June. I am 33 and felt long term non hormonal contraception was not the best bet.

Quick op. Did feel quite unwell for a few days and it was quite painful but i am relieved i wont accidently get pregnant on Tamoxifen ( which i was told is possible but needs to be avoided at all costs ).

Good luck with your decision

gretchen i got my mirena inserted 9 months after having strongly ER +ve breast cancer due to excessive bleeding on tamoxifen.

there is a body of research that shows mirena is protective to the endometrium whilst on tamoxifen and there is no actual evidence to show it increases the risk of BC… they just advice against because its hormonal not because its evidence based.

both my gynaecologist and breast surgeon were happy for me to have the mirena as the amount of hormones released is tiny and its directly affecting the uterus and not going through your whole body in the same way it would if you took a pill or had an injection.

it is particularly useful in women on tamoxifen and is often inserted in ER+ve patients on tamoxifen to help reduce the risk of endometrial changes and possibly reduce the the risk of endo ca.

there are just not enough studies really at the moment but there is no evidence to say it increases the risk of recurrence.

Thanks ladies, still not decided. Thanks also Lulu, great post.

That is really interesting, my gp suggested the merina coil, but I was really against it. When first diagnosed, I did find a small study (Danish, I think), suggesting that having the coil once you have had bc does increase the chances of reoccurrence. From memory only about 150 women were involved, so a fairly small sample. Based on that I wrote off the chance of ever using the merina, but will look into it again.

Hi I’m going through similar to u I’m 34 started using tamoxifen in march17 but needed a better form of contraception so had the copper coil in may but this has made my periods ( which was barely nothing ) so heavy and now lasting 2 weeks plus (give or take ) but Iv never been used to periods like this and was thinking if I got steralised as I won’t be having anymore children that this would be the perfect solution but would I still need to take the tamoxifen ?

Hi Kat ,you could ask this question in the ask the nurses section for advice .