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Celeste NP
Celeste NP, Nurse Practitioner
Category: Health
Satisfied Customers: 1002
Experience:  Family Practice with emphasis in Women's Health, Forensics, Urgent Care, for 14 years.
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I had a sub total hysterectomy in Nov 2007, I am now 37.

Customer Question

I had a sub total hysterectomy in Nov 2007, I am now 37. Because of my age and the fact that i still have my ovaries, i wasn't put on HRT (which i'm glad about, as i can't afford to gain any more weight, which is likely if i take HRT)
But the hot flushes and night sweats are a nightmare, i've had blood tests which now show i'm only slightly menopausal. GP doesnt want to put me on HRT yet.
I also have a neurological disability which means i'm confined to a wheelchair, its awful because my arms feel cold to touch but inside my body i'm burning up when the hot flushes come on.
Can you suggest anything that would help (which have no weight gain side effects) I have already tried evening primrose and black cohosh tablets, which didnt really help.
Submitted: 6 years ago.
Category: Health
Expert:  Celeste NP replied 6 years ago.


You can look at two options:

1 - Adding progesterone in a cream form will help the estrogen that you have kick into gear and work better. You can get some natural progesterones at the health food store. I would not add any extra estrogen that way though, just the progesterone.

2 - Adding an SSRI which is typically used for depression can also help hot flashes. The ones most used are Prozac and Effexor. The reason that these help is that they attach to the same receptor sites as the hormones do and can improve hot flashes.

I would not try both of these at the same time. Try one for 4-6 weeks and then add the other if it is not controlled with one method. Of course your physician will need to be involved in this decision!

Customer: replied 6 years ago.

My Gp has suggested i try B6 tablets. I have heard that sage tablets can help too. Can you offer advice on either of these tablets?

When you say add progestrorne in a cream form, do you mean as in edible cream or cream as in rubbing it into your body?

Do SSRI's interfere with medication i'm on, that is: Duloxetine, Baclofen, Fosamax?

Expert:  Celeste NP replied 6 years ago.

When you take a "b" tablet you really need to take them as a complex since they really all work together well. As far as really helping with hot flashes that has not been my experience. Especially if the Black Cohash and primrose did not work too well for you.

The progesterone cream is something you apply a small amount to your body. Not edible.

The SSRI would compete with the Cymbalta or Duloxetine. SO that may not be a good option for you unless your physician would consider changing you to Effexor or Prozac. That you would have to discuss with him though.

Customer: replied 6 years ago.

I've read that the progestorone cream you'd dab a little inside your wrist at the onset of a hot flush - does this sound right? and how long will it take to work?

i think i'll have to rule out the SSRI.

Expert:  Celeste NP replied 6 years ago.

I recommend that my patients use this on a daily basis about 1 ml and not wait for hot flashes to occur. It works better as a steady state.

I can understand not wanting to do the SSRI in your case.

Customer: replied 6 years ago.
just applying a little each morning on the inside of the wrist, do you suggest?
Expert:  Celeste NP replied 6 years ago.

Yes, the wrist or the abdomen you can use either site. It depends on the cream you use but most have a recommended dose or way of measuring. But definitely apply a steady dose daily.

Hopefully this will be enough to help resolve your symptoms!

Customer: replied 6 years ago.
I have decided to try the B6 tablets first,. when would you suggest is the best time of the day to take one?
Expert:  Celeste NP replied 6 years ago.

The morning would be fine or even noon if you have morning meds that you don't want to take it with.

I wish you the best!

Customer: replied 6 years ago.
My hot flushes are worse from late afternoon right through to midnight (on and off) so if i take the B6 in the morning with breakfast, will it still be effective for later in the day?
Expert:  Celeste NP replied 6 years ago.
You could take it at noon just to be sure but B6 will build up in your body over time with taking it so you will get 24 hour coverage.
Celeste NP and 2 other Health Specialists are ready to help you
Customer: replied 6 years ago.
thank you very much for all your advice, i will now accept your answer.
Expert:  Celeste NP replied 6 years ago.
Your very welcome. Take care!
Customer: replied 5 years ago.

Hi i'm coming back to you a year on..............i'm still no better , i started takng B6 tablets in October 2010, i took it for 7 months and saw no difference, and then i took sage tablets for 2 months, still no difference. Then i noticed that hot flushes and weight gain are now listed as side effects for Duloxetine (cymbalta), so my GP suggested i try coming off it month by month lowering the dose. So over the past 3 months i have been lowering the dose. 2 weeks ago i stopped taking it altogether but the hot flushes have not subsided, how long should i give it to notice any difference (if there is going to be any difference)? Have you heard of ground flax seed (that you can sprinkle on your cereal) being used to help stop hot flushes?