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October 27, 2011

Hormone Replacement Therapy After Hysterectomy

HRT after Hysterectomy and Young Women
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Hormone Replacement Therapy After Hysterectomy – Standard Post-Op Treatment

Hormone replacement therapy after hysterectomy has been the customary post-operative practice prescribed by physicians for women who also had their ovaries surgically removed. However, this practice has lost some of its popularity following the reported findings of the Women’s Health Initiative (WHI). Nonetheless, the benefits of hormone replacement therapy outweight the risks for many women after hysterectomy for women who prematurely suffer the symptoms of menopause.

If you are confronted with a similar dilemma, continue reading on to learn about its risks and benefits, and help you make an informed choice.

Why Take Hormone Replacement Therapy After Hysterectomy

1. Hormone replacement therapy after hysterectomy reduces some risks for younger women. Risks associated with HRT in the WHI study primarily involved older menopausal women (over age 60 who were taking synthetic hormones and in an oral form). Women who undergo hysterectomy, including the removal of their ovaries will experience menopausal symptoms due to decrease in levels of estrogen caused by the removal of the ovaries which are the primary manufacturers of estrogen. Health experts are convinced that instead of being harmful, hormone replacement therapy after hysterectomy is beneficial in helping younger women to go on with their normal lives even after the surgical procedure. Proof that HRT helps decrease the risks for heart disease and Parkinson’s disease among young women is gradually taking shape and has long been shown to prevent/treat osteoporosis.

2. HRT after hysterectomy is shown to reduce the occurrence of hot flashes by as much as 75 percent. HRT is proven to be effective in relieving many menopausal (including surgical menopause) symptoms, such as hot flashes, sleep problems, and vaginal dryness. Other alternative treatment options are not as effective.

3. HRT after hysterectomy offers other health benefits. It has been demonstrated to have a role in decelerating osteoporosis and in intensifying bone density. Estrogen and progesterone therapy is also believed to somehow lower the risk of developing colorectal cancer.

We believe that replacement with bioidentical hormones is the best therapy for replacement after a hysterectomy.  Bioidentical hormones are structurally identical to those that the body naturally makes.

Things to Consider if You’ve Had a Hysterectomy

1.  The Women’s Health Initiative was designed to deterimine if HRT prevents cardiovascular death, cancer, Alzheimer’s disease, and other outcomes in menopausal and postmenopausal women using synthetic hormones.  The findings of this study were reported in a misleading way.  For instance, there was a 26% increase in breast cancer in one of the HRT group (which looks frightening).  But, this is represents an increase of 8 more breast cancers per 10,000 women, or 0.08% increased risk (not so frightening).

2.  Keep in mind hormones not identical to what the female body makes were used and the study made no attempt to evaluate any symptomatic improvement in the women receiving HRT.  Many women will accept a slight increase in risk if the treatment makes them feel much better.

2.  Oral estrogen preparations were used in the WHI studies.  Oral estrogens are metabolized by the liver and tend to be pro-inflammatory increasing the risk for blood clots. For this reason, considering other options that bypass the liver, such as estrogen creams or patches.

3.  Since a hysterectomy is the surgical removal of the uterus, many physicians only prescribel estrogen and not progesterone.  Unopposed estrogen does and can place women at risk for cancer and other health issues.  Progesterone counterbalances the effects of estrogen, and even though a woman may no longer have a uterus progestereone replacement should be considered too.

See related articles.

“Causes of Elevated Estrogen Levels”Causes of Elevated Estrogen Levels

“3 Questions You Would Want to Ask About Hormone Replacement Therapy (Menopause)”

“7 Things You Must Tell Your Doctor Before Taking Estrogen Hormone Replacement Therapy”

Hormone Replacement Therapy After Hysterectomy

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Dr. Joe Jacko


Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio. Read more about Dr. Joe Jacko

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