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.
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.
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