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HRT | When Do I Start?

From the Menopause and Hormones Articles List



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 it doesn't need the HRT right away.


Hormone Replacement Therapy (HRT) after a hysterectomy 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 and menopausal symptoms begin to appear. You should discuss your doctor's approach 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 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 flashes, 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 20–25 times per day. I finally called the doctor and said HELP! She put me on estrogen replacement therapy (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 5–8 a day. While that may seem like a lot, it is way better than 25!"

"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 four 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 bedroom 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."

"My doctor put me on Estradiol (1 mg) about a week after my hysterectomy. I don't know what I would do with out it!"

"I went to my first post-op appointment five days after my hysterectomy. 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 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!"

As you can see, results and treatments vary per patient. Make a list of questions and concerns you have for your doctor, and make sure you get all the answers you need to make an informed decision.


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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Find a Surgeon

HysterSisters Doctor Directory
Lillian Schapiro, M.D.
275 Collier Road, Suite 250
Atlanta GA 30309
404-355-1285
Diane DiTusa, M.D.
2671 hwy 70
Manasquan NJ 08736
732-528-6999
Robert Furr, M.D.
Women's Surgery Center
1604 Gunbarrel Road
Chattanooga TN 37421
4238996511
Geoffrey Bowers, M.D.
2401 E Evesham Rd
Suite A
Voorhees NJ 08043
856-424-3323
Terry Grogg, M.D.
4461 S Broadway Suite 200
Suite 200
Grove City OH 43123
614-875-0444
Quanita Crable, M.D.
8160 Walnut Hill Lane
Ste. LL-001
Dallas TX 75231
(469)364-3764
Beverly Love, M.D.
46 Sgt. Prentiss Dr.
Natchez MS 39120
601-442-3701
Aileen Caceres, M.D.
Center for Specialized Gynecology/Florida Hospital
410 Celebration Place, Suite 302
Celebration FL 34747
(407) 303-4573
Arnold Advincula, M.D.
Florida Hospital Celebration Health
400 Celebration Place
Celebration FL 34747
(407) 303-4573

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