Related Topics: Features, Hysterectomy

After A Hysterectomy – A Doctor’s View

As a private GP with many years of experience of bioidentical hormones, Dr Bond offers her thoughts on an increasingly common surgery for women and just exactly what hormones are needed afterwards.

Dame Dr Shirley Bond

This is a subject about which there is a great deal of confusion. The first cause of this confusion is due to the fact that the term hysterectomy is often used to cover two completely different procedures.

Strictly speaking the term hysterectomy should only be used to describe just the removal of the uterus but is frequently used, even by doctors, when both the uterus and the ovaries are removed.

These two procedures produce different effects on the body because the hormones are only disrupted if the ovaries are removed. Removal of the uterus on its own does not have this effect.

What is needed after a hysterectomy

* If you have only had your uterus removed you do not need hormone replacement unless you were already taking it.

* If your ovaries are removed as well you may need hormones replacement.

* If you were post menopausal and not taking hormones then you do not need them.

* If you are premenopausal or peri-menopausal you may need hormone replacement. If you were already taking it then certainly you should continue.

If you were not taking it then you may well need it as removal of the ovaries, because of the loss of hormone production, produces a crash menopause.

Why women need progesterone after a hysterectomy

We then come to the confusion regarding what hormones you should take. Most doctors will tell you that you only need to take oestrogen as you dont need progesterone because you havent got a uterus.

This error arises because most doctors when they refer to progesterone actually mean progestogen which is the chemical hormone put into HRT to protect the uterus from the effects of excess oestrogen so of course you dont need it.

However what is so frequently forgotten is the fact the if you take extra oestrogen it should be balanced by progesterone.

Progesterone is the naturally occurring hormone made in the ovaries. Its function is to protect the body against the unwanted effects of taking oestrogen such as breast cancer and other effects of oestrogen dominance.

Extra oestrogen should never be taken without the balancing effects of progesterone. Furthermore often after the ovaries are removed a woman does not need extra oestrogen but will have more a lack of progesterone.

This is because fatty tissue (as in the abdomen, hips and thighs) makes oestrogen and often takes over when the ovaries are removed but there will not be enough progesterone available to balance it.

More information:

Many women are told after a hysterectomy that they only need oestrogen, but for protection from heart disease, strokes, breast cancer and osteoporosis women also need progesterone. This is clearly seen when symptoms of oestrogen dominance, where the progesterone levels are much lower than the oestrogen levels, are present.

The Diet To Help Beat Oestrogen Dominance

What Is Oestrogen Dominance?

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AnnA Rushton | 5:40 pm, March 31st, 2022

Heather we are very sorry to hear this and no progesterone cannot make your situation worse, as it is the hormone which opposes the excess oestrogen and which is linked to endometriosis.

Heather | 5:25 pm, March 16th, 2022

I wonder if you can advise me, please, as I’m really flummoxed about what best to do. Two attempts were made to give me a full hysterectomy in 2008. The last attempt was a challenge but was successful. Stage 4 endometriosis meant every organ in my pelvis was glued together each time the surgeon when in to operative, so the hysterectomy couldn’t be completed until later that year. I had a chocolate cyst , polycystic ovaries & a massive infected pelvic abscess. I was advised never to go back on HRT, which I was told had exacerbated the endometriosis as I was most likely oestrogen dominant. I am now 64 and trying natural progesterone cream. Is this likely to cause an increase of what may be left of endometriosis inside my pelvis (if all couldn’t be removed) and could it inflame painful adhesions, which have developed since?. I hope you can help please as my GP has only said that I would have to have further surgery to remove the painful adhesions which would continue to come back. I am in a lot of pain and contacting you is a last resort because the GP has made me feel very anxious. Thank you.

AnnA Rushton | 10:18 pm, August 6th, 2019

Cheryl Please email support@wellsprings-health.com for individual help with your symptoms as they will be able to go into more detail than is possible here.

Cheryl | 10:56 am, August 5th, 2019

Had a hysterectomy in 2010, still have ovaries and been on menopause for around 2 yrs have family history of breast cancer – great nan and great great aunts both died of this and now my mum diagnosed so been told can’t have HRT and also some of the natural remedies contain soya which can pose a risk?

AnnA Rushton | 4:45 pm, August 9th, 2015

Lily you do need to discuss this further with your doctors but women do need both progesterone and oestrogen to protect their bones and certainly progesterone to protect the heart. If your doctors do take you off HRT you would be best with a bioidentical combination cream such as 20-1 to help with the withdrawal symptoms.

lily | 6:58 pm, August 8th, 2015

what About someone who has had historecomy where everything was removed at the age of 26 1965 was not put on any hormones. then in 1974 was put on premarin and has been on it ever since. but since I moved the new doctors say I don’t need it .Im afraid to stop it . I think It has kept my from heart problems and bone problems but it is very expensive.I’m 77 yrs old .

 
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