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Nodules on my thyroid — Ask Dr Jean

Ask Dr Jean 25 Jun 2019
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When it comes to women's health, there is no such thing as a silly question. Do you have a question you want answered, but have been too afraid or embarrassed to bring it up with your GP? Or you forgot to ask while you were in the doctor's surgery? Now, you can 'Ask Dr Jean'.


This question has been answered by Jean Hailes endocrinologist (hormone specialist) Dr Sonia Davison (pictured).

Question

Hello. I had a total hysterectomy 4 years ago. Only started taking Sandrina oestrogen gel two years ago, I was not offered any HRT by my Gyno and only started taking Sandrina as I fell in a heap. My GP told me I was a car without an engine, petrol etc. Two years ago I developed nodules on my thyroid and have a pineal cyst. I read that these can occur when there is a sudden drop in oestrogen. Is there anything else I should be taking or asking my GP? I will not read any more on Google as everything eventually leads to cancer and reading articles scare me. I would appreciate perhaps some advice if you have any.

Dr Sonia Davison

Answer

Sandrena is a type of body-identical oestrogen in the form of a gel that is applied to skin once daily. It is one of many oestrogen options available for women who need treatment for bothersome symptoms (such as hot flushes, sweats, sleep disturbance or mood instability) around the time of menopause. A progesterone preparation is usually not required after a hysterectomy apart from in special circumstances, hence the Sandrena is a good option in your situation. In addition, in terms of cancer risk, the largest study of hormone therapy to date reported no increase in breast cancer risk for women who had oestrogen only hormone therapy for up to 7 years, compared with a slight increase in risk for women who had combined oestrogen and progestogen treatment for 5 years.

I suspect that the thyroid nodules and pineal cyst are not related to menopause or the hormone therapy but are incidental findings. Thyroid nodules are common and tend to increase with age, hence will be more commonly seen around the time of menopause compared to in younger women.

Your comment about the issues surrounding seeking health advice online is very important! There are some excellent sources of health information online, but it is important to seek reputable, evidence-based advice from a source with appropriate health expertise. In my opinion, in your situation, nothing can replace a consultation with a dedicated health practitioner who has women's health expertise, and your GP was an excellent place to start. Your GP should also be able to guide you as to appropriate screening tests and general health measures that will maximise your health around menopause and beyond.