Hormone replacement therapy is generally considered as a last resort because studies show it puts you at risk for strokes and blood clots. It was once thought that estrogen could protect a woman from heart disease, but studies have shown that this is not the case. However, each woman is different, so it makes sense to discuss supplementing with hormones thoroughly with your doctor before making a final decision.
Hysterectomy Explained
Hysterectomies are performed for a variety of reasons, such as endometriosis, fibroid tumors and uterine cancer. A total hysterectomy removes the uterus and the cervix, or bottom opening of the uterus. A subtotal hysterectomy leaves the cervix, but a radical hysterectomy removes the uterus, cervix and lymph nodes. Doctors can perform a hysterectomy through the vagina, through an incision in the abdomen or through a laparoscopic approach, which is a few small incisions.
Need for Hormone Replacement
If you have your ovaries removed with your uterus, it is called an oophrectomy, and it is performed at the same time as the hysterectomy. If your doctor decides on this option, you may need hormone replacement therapy. Since the ovaries are removed, they can no longer provide estrogen to your body. This will cause you to experience the symptoms of menopause prematurely. Sometimes these symptoms are uncomfortable, and estrogen has some protective benefits. Hot flashes, vaginal dryness and painful sex are some of the symptoms estrogen therapy can alleviate. Estrogen also protects your bones from osteoporosis and your heart from coronary artery disease, according to the University of Texas Medical Branch.
Risks of Hormone Replacement
There are risks to taking replacement hormones after a hysterectomy. A study that ended in 2003 showed an increase in the risk for strokes and blood clots, an uncertain risk for breast cancer and no benefit noted in the risk for heart disease, according to Southwestern Medical Center. As of 2011, the Food and Drug Administration does not recommend taking estrogen to protect a women from heart disease due to these risk factors. It recommends estrogen only for those at the highest risk for osteoporosis who cannot take other medications for it.
Alternatives
Since premature menopause symptoms are uncomfortable, there are alternatives that you can take to help relieve some of your symptoms. Some antidepressants when taken in low doses have shown promise for helping hot flashes, according to the Mayo Clinic. Exercise is one way to combat hot flashes, and keeping a journal of triggers can help you pinpoint what is causing your symptoms. Using a water-based lubricant can help with vaginal dryness. Biphosphenate medications, such as Fosamax, also can help reverse the effects of osteoporosis.
