Related Topics: Hysterectomy

What Hormones Are Needed After A Hysterectomy?

Having a hysterectomy is an immediate journey into menopause but how do you best treat it? Conventional advice is oestrogen-only HRT but bioidentical doctors like Dame Dr Shirley Bond take a very different view.

AnnA Rushton

As many women have a hysterectomy for reasons such as endometriosis, fibroids and a pre-cancerous womb, all conditions related to oestrogen dominance.

So it has always seemed strange to me that so many consultants, doctors and gynaecologists say that only oestrogen is needed after such an operation.

Further that progesterone is not required for a woman who no longer has a womb, this but it is not a view shared by bioidentical doctors.

Unopposed oestrogen, which is what is usually prescribed after a hysterectomy, is linked to several serious health concerns including cancer, heart disease and strokes.

Recognising those concerns, the guidelines for how long HRT should be taken have been reconsidered and now short term use of under five years is the generally accepted time frame.

As this issue of oestrogen-only HRT has been raised more frequently, as more women do undergo hysterectomy, I asked Dame Dr Shirley Bond for her comments.

She is one of the UK’s foremost private GPs specialising in women’s hormonal health and is the medical advisor to the Natural Menopause Advisory Service.

She has been prescribing, and using bioidentical hormones herself, for many years and worked with the late Dr John Lee and myself on his lectures in London.

He visited for several years to speak to the BMA (British Medical Association) and to give talks to women on the risks of oestrogen dominance and hormone imbalance.

From the desk of Dame Dr Shirley Bond DCmdrSOStj MB BS LRCP MRCS FFARCS

Oestrogen should always be balanced in the body with progesterone to prevent the unwanted effects of oestrogen such as weight gain, fluid retention, depression and many others including breast cancer.

Doctors often tell patients they only need oestrogen after a hysterectomy. This is because they are confusing progesterone and progestogens. In traditional HRT oestrogen is given with progestogens.

The only role of the progestogens is to protect the lining of the uterus so of course you don’t need it after a hysterectomy.

Progesterone on the other hand while protecting the uterus also protects the breast and balances other unwanted effects that oestrogen on its own will produce.

Why have bioidentical hormones after a hysterectomy?

Whether or not to take HRT is of course a personal choice, but as Dr Bond has pointed out the risks of unopposed oestrogen are considerable. Many women after hysterectomy do produce oestrogen in their fat cells, this is the reason for the weight gain and bloating that so often occurs.

So going on to an oestrogen only HRT means their oestrogen load is considerably increased and very few doctors are knowledgeable about bioidentical hormones, whether progesterone or the new combined creams with bioidentical progesterone and oestrogen.

Progesterone is vital to oppose excess oestrogen because oestrogen dominance needs addressing as it increases the risks for breast cancer as well as for heart disease and strokes.

What is often forgotten is that progesterone is also vital for bone building, and this process takes place throughout our lives. Old bone is broken down by oestrogen and the space is then filled with new bone – but to do this progesterone is essential.

This is why many women with osteoporosis continue to supplement with it throughout their menopause and beyond.

More information:

After a hysterectomy whether you need progesterone or progesterone and oestrogen will be decided by your symptoms and their severity.

Some women need only progesterone, especially if they have put on weight around the middle as they will then still be producing oestrogen from the fat cells there.

Others do benefit from a combined cream which has progesterone and a small amount of oestrogen for more severe symptoms or if they are low in oestrogen and showing signs such as vaginal dryness.

Do Your Symptoms Need Oestrogen As Well As Progesterone?


  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -

New comments are now closed on this article
Comments 4
Sorted by:  Date | Recommended
AnnA Rushton | 1:22 pm, September 16th, 2020

Caroline Please email for individual help with your symptoms as they will be able to go into more detail than is possible here.

CAROLINE | 12:28 pm, September 15th, 2020

Hi i had a full hysterectomy 5 yrs ago i am now 57, i suffered terribly afterwards with hot flushes i am now 3 stone heavier i was taken off HRT 8 months ago as my mum now has breast cancer all my symptoms came back i suffer with depression and anxiety and allergies my hot flushes make my anxiety worse sometimes think I’m going crazy! I have been on antidepressants a long time! I have been applying your 20-1 cream nearly four weeks but my hot flushes and anxiety are bad will this stop and am i on the right cream? Please help. Kind regards Caroline

AnnA Rushton | 10:42 am, May 17th, 2018

By limiting your oestrogen exposure Estelle. Please email for individual help with your symptoms as they will be able to go into more detail than is possible here.

Ruth | 9:45 pm, May 16th, 2018

You mention progesterone a lot. I had a hysterectomy 8 years ago & have just started oestrogen only HRT. I cannot tolerate progesterone of any type. They all make me feel crazy so how can I combat oestrogen dominance if I cannot take progesterone?

About Us
Contact Us
The Team
Terms of Use  © 
Learn more about Serenity Natural Progesterone Cream Learn more about Serenity Natural Progesterone Cream