Hormone Therapy After a Hysterectomy

Whether it is because of irregular bleeding, abnormal cysts or cancer, many women must undergo a hysterectomy within their lifetime. This surgery involves removing some or all of the reproductive organs, such as the cervix, uterus, ovaries and fallopian tubes. Depending on which organs have been removed, female hormone levels will drop in the woman, causing either menopause and/or sexual dysfunction and possibly putting her at risk for other complications.

What is HRT?

• Hormone replacement therapy (HRT) is the administration of estrogen and progesterone, or its synthetic version progestin. Therapy can be administered orally via pills, transdermally and transvaginally via creams, or intramuscularly via injection.

  Depending on the severity of symptoms, HRT may be given in higher or lower doses.

  The main purpose of this therapy is to replace the hormones that are no longer being produced by your body after a partial or full hysterectomy or surgically induced menopause.

  Side effects of HRT include bleeding, bloating, breast tenderness and swelling, headaches, mood change and nausea.

Why Choose HRT?

• When a full hysterectomy is done, the woman will fall into a surgically induced menopausal state that often times carries symptoms more severe than natural menopause. These symptoms include hot flashes, night sweats, anxiety and depression.

  Partial hysterectomies may not lead to menopause, but usually do greatly effect sexual desire and vaginal dryness.

  Women having undergone any form of hysterectomy are at a greater risk of osteoporosis and heart disease because of the depletion of hormones, that prevent these conditions, after the hysterectomy.

  These same hormones are responsible for the reduction of bad cholesterol, and without them women stand at a greater risk for cholesterol-related illness. Due to the direct nature of hormone therapy, these symptoms are best relieved through HRT.

Controversy Surrounding HRT

• In the past HRT was automatically given to women after hysterectomies; however, in recent years studies have shown that there may be far more risks involved with HRT than previously thought.

  According to the National Institutes of Health, healthy post-menopausal women undergoing HRT seem to be at a higher risk for cancer, especially breast cancer. Even though HRT does reduce unwanted or "bad" cholesterol levels, it has the added side effect of decreasing the "good" cholesterol you want, cholesterol which may help prevent heart attack and stroke. These side effects do not necessarily apply to women who are premenopausal or who are replacing the hormones their bodies should be making with HRT.

  There is also some thought that HRT may be unnecessary in many cases, as milder symptoms can be relieved through other, safer means.

  Current studies are still underway to determine the severity of risks associated with HRT. It is important for women considering HRT to fully research all possibilities they have at their disposal, discuss them with their doctor and understand all of the risks and benefits associated with HRT or alternative treatments.