Will you need HRT after hysterectomy surgery?
This is a decision some women have to make soon after the operation.
When they remove the ovaries during the hysterectomy (salpingo-oophorectomy) you can expect a sudden onset of menopausal symptoms.
These symptoms may suddenly hit you from 48 hours to a few weeks after the operation.
When the levels of these hormones in your body drop, your body reacts with a number of unpleasant symptoms.
Normally when a woman goes through menopause the ovaries gradually stop making the female sex hormones estrogen and progesterone. But with surgical menopause, these symptoms can come all at once and are usually very intense.
With hormone replacement therapy (HRT) they restore your hormone levels and most of these menopausal symptoms are kept at bay.
However, HRT after hysterectomy is not suitable for every woman. If you want to have HRT, it is advisable to discuss this with your doctor. Let him explain to you about the pros and cons of HRT.
Based on how severe your menopausal symptoms are, your age and your medical history he will tell you about possible risks.
For example, HRT is not suitable for you if you have a history of
• heart disease
• breast cancer, ovarian cancer or endometrial cancer
• high blood pressure
A study of the Women’s Health Initiative published in 2002 warned women that HRT was not the miracle drug people thought it was, but on the contrary could pose an increased risk of breast cancer, stroke, and heart disease. Naturally, this scared women and as a result, the use of HRT dramatically declined in the following years.
For the past decade, they carried out many studies about the health benefits and risks of hormone replacement therapy.
New updated recommendations help women by giving them more balanced and precise advice on HRT after hysterectomy and during menopause. The updated guidelines provide the latest available evidence about the risks and the health benefits of HRT. Read SAGE Publications
More recent clinical trials also found that the risks are considerably lower when a woman uses a transdermal estrogen patch with a low dose of estrogen, instead of a high or low dose of oral HRT.
Other studies searching for an HRT cancer link found that the risk of breast cancer is lower when women use estrogen only, instead of the combined HRT (estrogen and progesterone).
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.
- Relief vasomotor symptoms (hot flashes and night sweats)
- Reducing your risk of colon cancer
- It improves sexual desire and vaginal lubrication
- Reduces mood swings and depressive symptoms
- May relieve symptoms of bladder problems and prevent recurrent urinary tract infections
- Protects women from osteoporosis
How long is it safe to use HRT after hysterectomy?
The truth is, the longer you take HRT, the more you put yourself at risk of health problems. Most health professionals tell women now to use HRT in the lowest possible dose and not for longer five years.
The HRT treatment and duration differs from person to person, but they advise women to check with their doctor once a year if they need to continue the treatment.
How to take HRT?
There are several ways a woman can take HRT after hysterectomy, like:
• Creams and gels
• Skin patches
• Pellets placed under the skin (subcutaneous implants)
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.