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Hormone Replacement Therapy After Hysterectomy

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What is a Hysterectomy?

A hysterectomy is an operation to remove a woman's uterus (womb). In some cases, the ovaries and fallopian tubes also are removed, and these procedures are known as oophorectomy and salpingectomy, respectively. The ovaries are organs that produce ovum (eggs) testosterone, progesterone and estrogen. Hysterectomy is one the most common surgeries for women of reproductive age, second only to cesarean section, and it is often used to treat various types of endometrial cancer.

Why consider hormone replacement therapy (HRT) after a hysterectomy?

Surgical menopause occurs a when a premenopausal woman experiences early menopause as a result of a surgery/procedure, and a hysterectomy can certainly fall under this category. During oophorectomy surgery, ovaries are removed. Due to the fact that her ovaries are no longer present to produce oestrogen (the primary female sex hormone), her estrogen levels drop immediately post hysterectomy and her system is thrown into complete disarray, with possible effects including: fatigue, joint pains, decreased short-term memory, dwindling libido, hot flashes (also known as hot flushes), night sweats, depression, vaginal dryness, decreased resistance, and weight gain. These menopausal symptoms associated with hysterectomy-induced menopause are identical to those experienced by women who undergo perimenopause and menopause, except instead of developing gradually, they can have a profound and sudden effect. Bioidentical hormone replacement therapy (BHRT) is an important adjunct when hormone function is compromised - be it natural menopause or surgical menopause.

Surgical menopause can also affect transgender patients as they transition. Hysterectomy, with or without salpingectomy/oophorectomy, is often seen as integral for transgender men who are seeking to complete the transition. While many transgender males undergo a hysterectomy to for further physical masculinization via the removal of their uterus, there are also many more who elect this procedure for preventative measures in the face of pre-existing symptoms like tumors, cysts, and fibroids, among others. Whatever their reasons are for getting a hysterectomy, transgender men who undergo that surgery can feel the same menopausal symptoms as menopausal women. In either case, hormone replacement therapy (HRT) with bioidentical hormones may play a role in alleviating the patient from hot flashes, vaginal dryness, night sweats, or any other of the many symptoms of menopause.

Benefits of Hormone Replacement Therapy after Hysterectomy

While menopause is often a natural byproduct for women going through the aging process, it occurs at different intervals and varies in severity for each individual. For many (especially younger women), this can lead to early menopause. The resulting fluctuation in the ratio of an individual's sex hormones (primarily estrogen and progesterone) often leads to that person experiencing the familiar menopause symptoms.

HRT has the potential to mitigate the negative symptoms of menopause by correcting the hormonal imbalance that develops as a result of menopause. In addition to allaying these menopausal symptoms, HRT may also reduce the risk of diabetes, tooth loss, and cataracts. By addressing these symptoms, HRT may also be vital in helping an individual reduce their stress level. Diminishing overall stress levels can be vital in avoiding a host of medical issues, especially heart disease.

Risks of Hormone Replacement Therapy after a Hysterectomy

General HRT, which utilizes synthetic hormones from horse urine and other sources, has been connected to various diseases and conditions like breast cancer, heart disease, blood clots, gall bladder disease, and stroke. While some have connected hormone replacement therapy (HRT) to the risk of breast cancer, this does not necessarily apply to bioidentical hormone replacement therapy (BHRT). Although the medical community has just begun to scratch the surface on studies that examine the differences between synthetic hormones and bioidentical hormones, many people feel that using plant-based hormones that are bioidentical to the human body can provide the same benefits as synthetic hormones without posing the same risks.

There are some side effects that have been tied to BHRT, such as acne, mood swings, and increased facial hair, but those often will result from things like improper dosing and how the hormone in question is being administered. Getting an in-depth evaluation of your existing hormone levels may decrease the odds of using the wrong dose. As for the delivery methods of HRT, they can come in the form of pills, creams, injections, gels, and more, so there's a really good chance that most people can find a method that works for them. Like most treatments, not everyone is a good candidate for BHRT. These potential risks vary for each individual based on their medical history, and this should be discussed with a doctor before undergoing treatment.

Hysterectomy As a Preventative Measure

The Center for Disease Control found that two thirds of the approximate 600,000 hysterectomies done in the United States every year are unnecessary. Many women decide to undergo a hysterectomy as a preventative measure to avoid diseases such as endometrial cancer and ovarian cancer.

When a woman is facing a decision to undergo a hysterectomy, or has had the procedure and is experiencing related after effects involving hysterectomy hormones, bioidentical hormone therapy provides relief along with a return to health and balanced hormone levels.

BodyLogicMD-affiliated practitioners have found that with proper diet, lifestyle changes (exercise and stress reduction), nutritional supplementation combined with bioidentical hormone therapy, many women can avoid undergoing a possibly unnecessary hysterectomy. If surgery is necessary, bioidentical hormone replacement therapy (BHRT) can correct surgical menopause after hysterectomy.

Updated March 5, 2019
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