HRT - When Should I Start after My Hysterectomy? - Hystersisters Hysterectomy Article

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HRT - When Should I Start after My Hysterectomy?

HRT - When Should I Start after My Hysterectomy?

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I am less than a week post-op from dvH, both ovaries removed. So when should HRT begin? I have read some posts that say patients wake up with a hormone replacement patch on, and I have also heard that the body has some stored estrogen so one doesn't need the HRT right away. Now I am confused.

Hormone Replacement Therapy (HRT) after surgical menopause is not always necessary, and some women opt against it even when menopausal symptoms are present. Some doctors assume HRT will be required, though, and prescribe it to be used immediately after surgery. Others prefer the wait-and-see approach, gauging a woman's need for HRT as hormone levels drop off following surgery and menopausal symptoms begin to appear. You should discuss your doctor's approach with him or her before surgery if at all possible. Conduct research on your own and ask the HysterSisters about their experiences with and without HRT to help you understand the pros and cons of hormone replacement therapy in surgical menopause. Here are some example responses to this question from the HysterSisters forums:

"I did not wake up with a patch on. My doctor waited until I started experiencing signs of menopause. He said that not everyone needs HRT, and therefore he waits to see if his patients will. A word of advice: If you start experiencing menopause symptoms, don't wait too long to call your doctor. I thought I could work through them on my own...boy was I wrong! I waited longer than I should have, and now I am waiting for them to kick in. Miserable!!!! Take care."

"I am 46 and had a TAH BSO. My menopause symptoms started about 14 days post op, and steadily increased in frequency and intensity. I had hot flushes, night sweats, and a lot of trouble sleeping at night. It also felt like I had a wool blanket over my head. I started having hot flashes about 20 to 25 times per day. I finally called the doc and said HELP! She put me on ERT--Estoidal 0.5 mg dose, (lowest dose) (a pill)--and it got me back on track within 24 hours. I now sleep at night which is a major plus! My hot flashes are down to about 5 to 8 a day. While that may seem like a lot, it is way better than 25! And they are not as intense. From everything I read, you do not have to rush this decision. I wanted to wait and see what happened. When I first started out, I thought, 'Hey, this isn't too bad. I can handle it.' But it got really bad, until it interfered with my quality of life and my job. I could not think straight, and that is not good with a technical job. My doctor said that I was too early for menopause and felt it was better for my health to be on HRT. Make the decision that is right for you."

"I started off with the hot flashes, which at first were mild but increased in intensity every day. I figured I could deal with them. Then I started having night sweats and insomnia (about 4 days after the hot flashes started). Then the body aches kicked in, and I was miserable. My family couldn't stand me. My boyfriend took up residence in the spare bed room because I kept our room like a meat locker and tossed and turned all night. I finally figured out I was not going to be able to handle all this on my own. I placed a call to my doctor, and she gave me Premarin. Hope it all works out for you."

"My doc put me on Estradiol (1 mg) about a week later. I don't know what I would do with out them! My first hot falsh was awful. It hit me all at once, so bad that it steamed up my sunglasses!"

"I went to my first post-op appointment five days after my surgery. By that time, the hot flashes and crying had started. My doctor put me on 1 mg of Estrodiol once a day to start. I think it just depends on your doctor, when your menopause kicks in, and how bad it is."

"I didn't wake up with a patch on, but my doctor did start me on an oral estrogen the same day of surgery. My doctor told me that it was absolutely necessary for me to start it early because of my age. The younger you are, the higher risk you have of having other health problems if you do not have estrogen. Even with the low dose of Premarin that I started in the hospital, I had night sweats like no other. I had a horrible time sleeping, and I was so emotional; I didn't even know myself. After a couple of dosage adjustments, I have no symptoms at all! I know this isn't a decision to enter into lightly, and everyone is different. I hope you can make an educated decision on whether or not to start it. Just keep in mind that if you do decide to have HRT, it is kind of a trial and error type of thing. Different things work for different people, and sometimes it can take some time to find what is just right for you."

This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.

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