Should You Take Estrogen After Your Hysterectomy?

Until the early part of 2000, Hormone Replacement Therapy or HRT used to be the routine post surgery treatment recommended by doctors for women who have also had their ovaries removed together with a hysterectomy procedure.

Things changed drastically in recent years after the risks of estrogen therapy were exposed and the supposed benefits seemed to have disappeared when further studies were conducted.

Although for most women experiencing “surgical” menopause, doctors still recommend hormone therapy, the public’s acceptance of the treatment has declined.

If you are faced with a tough decision on whether to get HRT or not, this list of pros and cons would be helpful to you.

HRT and Surgical Menopause

Surgical menopause is a condition wherein a patient who has undergone a hysterectomy which included the removal of the ovaries, experiences menopausal symptoms soon after. This is caused by a sudden drop in estrogen levels that results after the ovaries, the main producers of the hormone estrogen, are removed.

This removal of the ovaries is called an oophorectomy, a procedure often combined with a hysterectomy, though not all the time. In fact, women who only get a hysterectomy will not go into surgical menopause as their ovaries are still making estrogen. These women are expected to go into menopause naturally when they get older, although sometimes a bit earlier than usual.

Hormone replacement therapy, whether with estrogen and progestin or with estrogen alone, is a way to counteract the loss of estrogen after oophorectomy that results in surgical menopause.

HRT after Surgical Menopause: Pros and Cons

The Pros in Getting HRT

  • Women who go into surgical menopause are not that old — The risks of getting hormone therapy that grabbed the headlines are those found in older menopausal women, there may be minimal risks or none at all for younger women who get HRT. Experts believe that estrogen plays a vital role in allowing younger women to live their lives normally even after surgery. There is also a growing body of evidence that hormone therapy helps prevent the occurrence of heart disease and Parkinson’s disease in young women.
  • Other treatment for menopausal symptoms did not work – Some women find that their hot flashes, vaginal dryness, sleep problems are excruciating and nothing seems to work. HRT can be quite effective in reversing many symptoms, even preventing them in the first place. Some studies show that HRT can cut the number of hot flashes by up to 75%.
  • HRT provides other health benefitsHRT has been identified as a contributing factor in slowing down osteoporosis and increasing bone density. It seems treatment with both estrogen and progestin also reduces the risk of developing colorectal cancer even slightly.

The Cons to not get HRT:

  • Your menopausal symptoms are not that unbearable – The pain threshold of individuals vary, the same goes for women who have had surgery. Some patients do not have severely uncomfortable symptoms after surgical menopause and do not need HRT while others just don’t want to take HRT. Besides even if you do have acute symptoms, HRT is not the only way to control them. Other forms of medication or perhaps a lifestyle changes can help.
  • You got the surgery at 50 or older – Women who go into surgical menopause at 50 or older when it is approximately the natural time of menopause often decide not to get HRT. Their reasoning is that their supply of estrogen would naturally drop during menopause anyway.
  • You suffer from liver disease taking estrogen pills orally can put more stress on the liver. There are other ways of getting estrogen that bypass the liver, like by using estrogen patches.
  • You are worried of the side effects –  HRT can actually cause symptoms that it is meant to prevent. Some women on HRT experienced symptoms that resemble those of premenstrual syndrome like headaches, swollen and painful breasts and nausea.
  • HRT increases the likelihood of health problems like strokes, blood clots, heart attacks, breast and ovarian cancer. – although there is still no conclusive evidence to identify HRT as the cause of these diseases, it has been found out that the risks of getting these diseases were higher in patients taking HRT.

Putting the Pros and Cons in Perspective

Simply by just going through the list of pros and cons presented above, one might immediately come to the conclusion that the risks far outweigh the benefits of going on hormone replacement therapy. After all who would want a reduction in vaginal dryness at the risk of developing cancer? Surely not a lot of women would be willing to take that chance.

The thing is, after surgical menopause deciding on what post-surgery treatment to take is not easy. All the more with issues surrounding HRT. The attention-grabbing headlines in the media in recent years brandishing the supposed ill-effects of taking HRT only added to women’s confusion about this supposed miracle cure.

To help you make that all important decision, the most vital thing to do is to consult your doctor. Better yet, consult several doctors. Also, when you are on the process of deciding, you should take into consideration different factors like your age, your family’s medical history, and your lifestyle. Don’t rush yourself into a decision nor should you allow yourself to be rushed when you are not ready yet to commit to the treatment.

Bear in mind that you are making a decision that could potentially have an effect for the rest of your life. If you need to, do your own research into Hormone Replacement Therapy. Expert’s opinions have been known to constantly change over time. Who knows there might be another miracle cure to surgical menopause in a year’s time.

Lastly, go with your feelings and listen to your body. Getting hormone replacement therapy is a personal choice. What worked for other women, even those you personally know, might not work for you. It might be best to live a healthy lifestyle in the meantime.

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2 Responses

  1. Bernie says:

    The uterus is a hormone-responsive reproductive sex organ. Women who experience uterine orgasm will not experience it after the surgery, and the vagina is shortened, made into a closed pocket that is sutured shut at the top. Support to the bladder and bowel is compromised. If only the uterus is removed a woman has a 3X greater risk of heart disease. If the ovaries are removed the risk is 7.2 greater. These are but a few of the major aftereffects of hysterectomy documented in medical literature.

    There are some excellent resources you can use to get the information you need before making this important, irreversible decision, that may not be given to you by doctors. Watch the video “Female Anatomy: the Functions of the Female Organs” at htttp://www.hersfoundation.org/anatomy. There’s an excellent new book, THE H WORD, everything you ever wanted to know about hysterectomy.

  2. Maria says:

    I have a surgical menopouse. My doctors have not yet given me any medical adviced on what to do at this stage. I am mentally affected with the decision they took to place me on this condition. I am just 36years old. I fear my life has been taken away from me and I fine no pleasure in life any more. I have been reaserch for information on surgical menopouse and hormone replacement therapy but I fine it difficult to make a decision. Perhase you can help me as I am help and so deperate to put my life back on track as normal.

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