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Do I Have To Take Hormones After Hysterectomy

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How To Take Hrt

Do I Need Progesterone After My Hysterectomy?

There are several ways a woman can take HRT after hysterectomy, like: Tablets Skin patches Pellets placed under the skin

Your health care provider is able to tell you what works best for your symptoms. Usually, creams and gels applied inside the vagina are enough to treat vaginal dryness, where patches and implants are a better choice for treating hot flashes and preventing osteoporosis.

Getting Estrogen Therapy After Hysterectomy

If youve had both your uterus and ovaries removed, estrogen replacement therapy with estrogen alone is the most common medical intervention. However, according to WebMD, if youve had your ovaries but not your uterus removed, you may need both estrogen and progestin. This is because just getting estrogen hormone replacement alone can increase the risk of cancer in the uterus. Progestin balances out the estrogen to remove the cancer risk.

The Benefits Of Progesterone Treatment After Hysterectomy

A hysterectomy is both sudden and prolonged. Thesurgery itself can leave a woman in the hospital for 2-3 days. The recoveryperiod can be up to eight weeks, and rarely fewer than six. But unlike withsome surgeries, the effects often dont fade into memory. Particularly when youhave a hysterectomy that includes removal of the ovaries before you enternatural menopause, you can experience sudden and lasting hormonalupheaval.

This can be a significant challenge, both mentally and physically. The impact of surgical menopause can not only complicate recovery, but fundamentally change the way you live your life. For some women, it is devastating. When a hysterectomy is coupled with a removal of ovaries, the aftermath can be uncomfortable, painful, emotionally distressing, and even dangerous. For this reason, many women seek hormone replacement therapy.

Hormone replacement therapy for women without a uterus has traditionally been estrogen-only. However, there may be meaningful benefits of progesterone treatment after hysterectomy. Both approaches have pros and cons, risks and rewards, and taking a closer look at your options is essential to developing a treatment plan that works for you.

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Symptoms Of Hysterectomy And Menopause

Symptoms of the climax after removal of the uterus can be noticed already after three weeks from the day of surgery. These can be:

  • increased night sweating
  • brown discharge after menopause and hysterectomy
  • depressive states.

When the uterus is removed, hormone replacement therapy is necessary, especially for women under 50 years of age. For this purpose, estrogens and gestagens are used. Hormone therapy is important to prescribe as soon as possible, no later than a couple of months after the procedure. It helps reduce the risk of heart disease and hysterectomy and weight gain menopause problems. But, it is important to remember that HRT may not always be prescribed. There are contraindications. Here, they are:

  • surgery was related to uterine cancer
  • mammary cancer
  • diseases of the liver and kidneys
  • meningioma.

The duration of treatment is from two to five years. No need to wait for the complete disappearance of menopause after the therapy. Depending on the duration of hormone therapy, clinical manifestations are only reduced.

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Causes Of Partial Hysterectomy And Hormonal Imbalance

How to Balance Hormones After Hysterectomy

A partial hysterectomy is commonly performed to treat a medical problem. Surgery is completed to remove the uterus and sometimes the ovaries, cervix, and fallopian tubes.

Women often choose this option when theyre experiencing:

Heavy menstrual bleeding

Generally, a menstrual period lasts up to seven days as your body sheds the uterus lining. If the bleeding lasts for more than seven days or if you have these signs of heavy bleeding, it could be a sign you need medical attention:

  • Changing pads/tampons every one to two hours
  • Getting up in the middle of the night to change pads/tampons
  • Blood clots the size of a quarter or larger
  • Feeling tired or shortness of breath

Uterine fibroids

Uterine fibroids are muscular tumors that grow in the wall of the uterus. Most are not cancerous, but they can be hard to live with. Uterine fibroids can cause pain and heavy menstrual bleeding.


Endometriosis occurs when the tissue that makes up the uterus lining begins to grow outside the uterus. The endometriosis growths swell and bleed each month, just like the lining of the uterus. This common condition can cause pain, bleeding or spotting, infertility, and digestive issues.


Hormonal imbalance may cause an increased risk of cancer of the endometrium . Women may experience heavy menstrual periods, pelvic pain, and pain during sex. Different treatment options are available, and a hysterectomy may be recommended.

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Benefits Of Hrt After Hysterectomy

When you take HRT after your hysterectomy you may find relief for a number of side effects of a hysterectomy.

Reasons For Having A Hysterectomy

There are many different reasons why hysterectomy may be necessary. These include:

  • Painful, heavy or frequent periods which are not improved with medical treatments
  • Fibroids Swellings of abnormal muscle that grow in the uterus, which can cause painful, heavy periods or pressure on other pelvic organs
  • A prolapsed womb, which is caused by the dropping of the uterus.
  • Endometriosis, a condition where tissue segments from the womb attach and grow in the wrong place, causing pain
  • Adenomyosis the same problem as endometriosis, but affecting the muscle of the womb
  • Severe, recurrent or untreatable pelvic infection
  • Cancer or precancerous changes in the vagina, cervix, uterus, fallopian tubes or ovaries

Very rarely, hysterectomy is performed as an emergency procedure, such as if bleeding becomes uncontrollable during childbirth. Usually though, the operation is planned.

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Why Bother With Supplements After Hysterectomy

When you have a hysterectomy it will put you in the surgical meno. There are some side effects that go alongside this, some which youll probably be familiar with, such as hot flashes, difficulty sleeping and feeling more anxious.

Other problems include higher risk of osteoporosis and heart disease, mood changes, anxiety, lack of sex drive, vaginal dryness and poor sleep.

Hormone changes, namely the drop in estrogen, is responsible for these uncomfortable, annoying and sometimes embarrassing symptoms.

What Supplements Should I Take After Hysterectomy

How to Balance Your Hormones After a Hysterectomy with Dr. Jessica Drummond

1. CBD

Our Remedy CBD really helped with my sleep which was disturbed after surgery. I actually took CBD before surgery too, but obviously then I wasnt aware of its benefits for using after a hysterectomy.

My levels of anxiety were higher than ever pre and post op and this caused lots of tossing and turning at night. CBD is thought to give your serotonin levels a boost, if they are low youre more likely to feel anxious.

Serotonin is a hormone that will be likely be affected after your surgery as your hormones fluctuate. Low serotonin can make you feel anxious, depressed and stressed so you need to think of giving that a boost now.

I put the oil in a herbal tea or hot chocolate and it helps me to relax, unwind and drift off. It also contains Omega 3 and 6 which may also be good for healing wounds

Cannabidiol has been very beneficial in many menopausal symptoms as well as mental relaxation when it comes to stressful times

2. Menopause multivitamin

I really like a multi vitamin aimed at the menopause as you get lots you need in one tablet, rather than buying it all individually

Look for one that contains magnesium which you need as these levels drop quickly and it can lead to struggling with sleep. It also plays a vital role in reducing stress and depression associated with menopause as proved by individual researches. Its also needed for bone health, something really important now as our bones get weaker much more quickly.

3. Vitamin D

4. Maca Root

5. Collagen

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How To Get Started On Hrt

Speak to your local GP practice if you’re interested in starting HRT.

You can usually begin HRT as soon as you start experiencing menopausal symptoms and will not usually need to have any tests first. However, a blood test to measure your hormone levels may be carried out if you’re aged 40 to 45. Blood tests may also be carried out to help diagnose suspected premature menopause if youre under 40 and have menopausal symptoms.

Your GP can explain the different types of HRT available and help you choose one that’s suitable for you.

How Long Should I Take Hormone Therapy

In general, there is no time limit to how long you can take hormone therapy. You should take the lowest dose of hormone therapy that works for you, and continue routine monitoring with your healthcare provider to reevaluate your treatment plan each year. If you develop a new medical condition while taking HT, see your provider to discuss if its still safe to continue taking HT.

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Breast Cancer Benefit May Not Apply To All

Several other important warnings also apply.

The first is that estrogen did not appear to help some women. Those were women at higher risk for breast cancer because they had a family history or history of having benign breast disease. Estrogen may even increase the risk of breast cancer in women who already have other risk factors.

âFor women who are most in need of a breast cancer reduction strategy, this approach isnât going to work,â says researcher Garnet L. Anderson, MD, principle investigator of the Womenâs Health Initiative Clinical Coordinating Center in Seattle.

âThese agents should not be used for breast cancer prevention, even though we clearly show a lower risk of breast cancer in these women taking hormones,â says Anderson, who is also a member of the Fred Hutchinson Cancer Research Center.

The second important consideration is that the study tested a kind of estrogen called conjugated equine estrogen, which is sold under the brand name Premarin. In recent years, that formulation has become less popular. More women have moved toward using estradiol, which is chemically closer to the bodyâs own estrogen. But researchers say they arenât sure if the two kinds of estrogen work the same way.

âConjugated equine estrogens are very complex pills,â Anderson says. âThere are a lot of different estrogen compounds in them. We really donât know what the active agents are. To make a leap to another form is really hard to say.â

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Who Shouldn’t Take Hormone Therapy

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Hormone therapy is not usually recommended if you:

  • Have or had breast cancer or endometrial cancer.
  • Have abnormal vaginal bleeding.

Less common side effects of hormone therapy include:

  • Fluid retention.
  • Skin discoloration .
  • Increased breast density making mammogram interpretation more difficult.
  • Skin irritation under estrogen patch.

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Common Side Effects Of Hysterectomy

Hysterectomy may affect the physical and mental health of a woman, especially when it is performed in the menopausal or perimenopausal stage. The woman suddenly and directly enters the post menopause stage without passing through the phases of perimenopause and menopause. The body cannot accept this drastic change and therefore a woman usually faces a lot of problems.

Hormonal changes do have a major impact on the womans health. Levels of hormones after hysterectomy decrease considerably. This increases the risk of cardiovascular and skeletal diseases. A reduction in the testosterone level may cause height loss and osteoporosis . Side effects of partial hysterectomy and side effects of total or radical hysterectomy are almost the same. They may vary slightly, depending upon the reason for which the surgery is performed and the procedure followed. Surgical complications are not discussed in this article.

Common side effects of hysterectomy include

  • Hot flashes
  • Development of excess facial hair on the upper lip and chin region
  • Vaginal dryness
  • Weight gain

Before Choosing A Hysterectomy

If, after talking about all the options with your doctor, you choose to have a hysterectomy, your doctor should discuss several things with you before the operation. These include:

  • your medical history as some pre-existing conditions may influence decisions on surgery and anaesthetics
  • the pros and cons of abdominal surgery versus vaginal surgery
  • your support options after surgery
  • your feelings about the surgery.

You will have a range of tests before your hysterectomy, including a complete blood-count test to check for problems such as anaemia .

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What Other Changes May Occur

You may encounter information saying that a hysterectomy makes you gain weight or lose your sex drive. These issues may develop, but only if both ovaries are removed. A hysterectomy alone doesnt affect your weight or desire for sex.

Many women feel healthier because the symptoms they had before surgery are gone. As a result, they become more active and find sex more enjoyable.

You should plan on six to eight weeks to rest and heal, depending on the type of hysterectomy and whether Dr. Macey performs minimally invasive surgery or you need conventional open surgery.

Many women struggle with unexpected emotions following their hysterectomy, so during your recovery, you may feel a sense of loss or struggle with depression. Though theres no way to predict how youll react or feel, please know that Dr. Macey is available, and you should call if you encounter challenges during your recovery.

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What You Can Expect Emotionally

HRT after Hysterectomy

Whatever feelings or emotions arise during this time, honor them and share them with someone you trust.

If you were looking forward to the relief that a hysterectomy was going to bring to you, you might be surprised by feelings of grief. Its not uncommon to feel a sense of loss. If you feel grief over the loss of your uterus and your ability to have children, thats normal.

If your surgery was motivated by illness or cancer, you might feel depressed. This is normal too. Enlisting the support of your doctor or a mental health therapist will help you make your way through them and back to the lighter side.

Many women feel happy after their hysterectomy. Thats normal too!

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A Note From Cleveland Clinic

The decision to take hormone therapy needs to be a very personalized one. Hormone therapy is not for everyone. Discuss the risks and benefits of hormone therapy with your healthcare provider at an office visit specifically dedicated for this conversation. Youll need the time to address all the issues and answer questions in order to arrive at a decision that is best for you. Factors considered should be your age, family history, personal medical history and the severity of your menopausal symptoms.

Be sure to talk about the pros and cons of the different types and forms of HT as well as non-hormonal options such as dietary changes, exercise and weight management, meditation and alternative options.

Herbs That Contain Efas

Fennel and fenugreek contain essential fatty acids, the substances that improve brain function, skin and hair, while they help prevent bone loss and heart disease. A lack of these same health benefits is directly related to menopause symptoms such as mood swings, confusion, osteoporosis, vaginal dryness and cardiovascular disease. Balch warns that fennel suppresses the appetite. She also states that fenugreek can cause gas, bloating and diarrhea. These herbs are not intended as a substitute for traditional medical treatment.

  • Fennel and fenugreek contain essential fatty acids, the substances that improve brain function, skin and hair, while they help prevent bone loss and heart disease.
  • She also states that fenugreek can cause gas, bloating and diarrhea.

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What Is Known About Hormone Therapy And The Risk Of Breast Cancer

Taking combined hormone therapy can increase your risk of developing breast cancer. Here are some important findings:

  • Taking combination hormone therapy showed a rare increase of absolute risk of less than one additional case of breast cancer per 1000 person years of use.
  • There was a nonsignificant reduction in breast cancer seen in women with hysterectomies on estrogen only therapy.
  • If youve been diagnosed with breast cancer you should not take systemic hormone therapy.

Mayo Clinic Q And A: Estrogen Replacement Therapy After Ovary Removal

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DEAR MAYO CLINIC: I have been using an estrogen hormone patch for two years since having a hysterectomy at 38. I had my ovaries removed as part of the procedure. How often should I have my estrogen levels tested, and how long will I need to continue hormone replacement?

ANSWER: For a woman in your situation, estrogen replacement therapy typically is recommended until the average age of natural menopause usually around 51. This is done mainly to reduce the risk of long-term health problems associated with removal of the ovaries. To ensure youre receiving the right dose, its a good idea to have your estrogen level checked at least once a year, and eight to 12 weeks after any dose changes.

A hysterectomy is surgical removal of the uterus. As in your case, the procedure often is combined with removal of the ovaries a surgery known as an oophorectomy. If the surgery involves removing both ovaries, its called a bilateral oophorectomy. When only one ovary is removed, its a unilateral oophorectomy. Because the ovaries make the main hormones responsible for a womans menstrual cycle, removing your ovaries results in menopause.

When both ovaries are removed before a woman goes through menopause naturally, there is an increase in the risk of a number of serious long-term health problems. They include heart disease, cognitive dysfunction and dementia, mood disorders, bone thinning, and early death. The younger a woman is when she has bilateral oophorectomy, the higher the risk.

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