Weighing The Hormone Replacement Therapy Pros And Cons
When it comes to getting HRT after surgical menopause, deciding what to do isn’t easy. The contradictory headlines in the media in recent years haven’t helped. It’s easy for women to feel like they are making the wrong choice, no matter what they do.
When you’re deciding, you have to consider a lot of different factors, including your age, your family history, and your habits. Just take it slowly and don’t allow yourself to be rushed into a decision you’re not ready to make. Check the latest research into HRT. Remember that both the potential long-term benefits and risks of hormone therapy are really quite small for any individual person.
Finally, don’t discount your gut feelings. The decision to get hormone therapy after surgical menopause is personal. The right answer depends as much on your preferences as it does on the facts in your medical chart.
Hrt And Surgical Menopause
So what is surgical menopause? Itâs menopause that develops suddenly after the ovaries â the main producers of the hormone estrogen â are surgically removed.
The removal of the ovaries is called an oophorectomy. The procedure is often combined with a hysterectomyâ removal of the uterus â but not always. And in fact, women who only have their uterus removed will not go into surgical menopause. Their ovaries are still making estrogen. Theyâll go into menopause naturally when they get older, although sometimes a bit earlier than usual.
Estrogen plays a key role throughout the body. It affects the brain, the bones, the skin, the heart, the blood vessels, and more. While estrogen levels lower gradually during natural menopause, they plummet with surgical menopause. That sudden drop in estrogen can lead to menopausal symptoms that can be quite severe.
Hormone therapy after surgery â either with estrogen and progestin or with estrogen alone â is a way to counteract the supply of estrogen youâve lost. Women who have both the uterus and ovaries removed usually just get estrogen replacement therapy alone. But women who have only the ovaries removed need both estrogen and progestin. Thatâs because estrogen alone can increase the risk of cancer in the uterus. Adding progestin removes this risk.
Rarely, if ever, will both ovaries be removed without the uterus. Often, only one ovary may be removed, which will negate the need for HRT at the time of surgery,
How Long Do Symptoms Last
Perimenopausal symptoms can last four years on average. The symptoms associated with this phase will gradually ease during menopause and postmenopause. Women whove gone an entire year without a period are considered postmenopausal.
Hot flashes, also known as hot flushes, are a common symptom of perimenopause. One study found that moderate to severe hot flashes could continue past perimenopause and last for a
Researchers also found that Black women and women of average weight experience hot flashes for a longer period than white women and women who are considered overweight.
Its possible for a woman to experience menopause before the age of 55. Early menopause occurs in women who go through menopause before theyre 45 years old. Its considered premature menopause if youre menopausal and are 40 years old or younger.
Early or premature menopause can happen for many reasons. Some women can go through early or premature menopause because of surgical intervention, like a hysterectomy. It can also happen if the ovaries are damaged by chemotherapy or other conditions and treatments.
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What About My G
The ÃÂ¢G-spotÃÂ¢ is not a medically recognized part of the female anatomy, but you may have a spot on the anterior wall of the vagina that is highly sensitive and contributes to sexual arousal and satisfaction. Whether yours is affected can depend on the type of hysterectomy, whether your need repairs, and exactly where yours is located. If you have concerns about it being changed, talk to your doctor prior to your surgery.
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. Reprinted with permission: 10 Concerns about Intimacy after Hysterectomy
Hot Flashes After A Hysterectomy
A hysterectomy is a procedure that removes the uterus. Generally, it does not immediately cause menopause unless the ovaries are also removed. However, removal of the uterus can lead to menopause sooner than normal, causing women to experience symptoms like hot flashes.
Continue reading to learn more about hot flashes after hysterectomy as well as treatment for hot flashes after hysterectomy to take control of your reproductive well-being today.
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Can Menopause Cause Facial Hair Growth
Yes, increased facial hair growth can be a change related to menopause. The hormonal change your body goes through during menopause can result in several physical changes to your body, including more facial hair than you may have had in the past. This is caused by testosterone being relatively higher than estrogen. If facial hair becomes a problem for you, waxing or using other hair removers may be options.
Why Do They Happen
Although women who had hysterectomies were scientifically found to have a higher risk of suffering from hot flashes, the exact cause has not been identified. It is most likely due to an interrupted blood supply to the ovaries.
Hot flashes after hysterectomy can also be due to the fact that women are entering menopause around the time of the procedure. A disturbed blood supply may be the reason why they are entering menopause sooner than they naturally would as well.
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What Are The Symptoms Of Menopause After Hysterectomy
For most women, menopause occurs when they are between the ages of late 40s to early 50s. However, women who undergo hysterectomy surgery may start experiencing the symptoms of menopause much earlier than this.
The procedure involves removal of the uterus and is used to treat a variety of conditions such as chronic pain, infection and even certain kinds of cancer. Typically, the extent of surgery required will vary depending on the reason why you are having hysterectomy. Sometimes the doctor may also recommend taking out the cervix and ovaries, which can ultimately affect the symptoms you are experiencing.
Ovarian Preservation Or Oophorectomy In Oncologic Surgeryrecommendations For Cervical Endometrial And Ovarian Cancer
Ovarian preservation in oncologic surgery depends on the stage of the disease and the patients age. The European Society for Medical Oncology, European Society of Gynaecological Oncology and European Society for Radiotherapy and Oncology cervical cancer guidelines , for the management of stage T1b1/T2a1 recommend ovarian preservation in premenopausal patients with cellular squamous cell carcinoma or adenocarcinoma and bilateral salpingectomy should be considered .
The ESMO-ESGO-ESTRO consensus on endometrial cancer recommended that standard surgery for endometrial cancer is total hysterectomy with bilateral salpingo-oophorectomy. Ovarian preservation may be considered only in patients younger than 45 years with grade 1 EEC with < 50% myometrial invasion and no apparent ovarian or extra-uterine pathology. Ovarian preservation is not recommended for patients with a family history of cancer, including the risk of ovarian cancer. Genetic tests are recommended .
Regarding ovarian cancer, the ESMO-ESGO consensus recommendations are that fertility sparing surgery can be performed at all stage IA and IC1 patients, for low risk ovarian carcinomas. Ovarian preservation for invasive epithelial ovarian cancers is not recommended at a higher stage than FIGO I .
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Effects On Womens Health
The abrupt discontinuation of ovarian function in pre-menopausal women is associated with more severe consequences than natural menopause, such as increased overall mortality rate , and increased rates of pulmonary and colorectal cancer, coronary disease, stroke, cognitive impairment, Parkinsons disease, psychiatric disorders, osteoporosis and sexual dysfunction .
Although for many years it has been thought that the ovary retains a degree of androgen production even after menopause, more recent immunocytochemical evidence shows that the postmenopausal ovary lacks steroidogenic enzymes and luteinizing hormone receptors and the major source of postmenopausal circulating androgens being in fact the adrenal gland .
When Is A Hysterectomy Needed
According to the Office of Womens Health at the U.S. Department of Health and Human Services , some of the most common reasons for a hysterectomy include:
- Uterine fibroids. These non-cancerous tumors grow on the wall of the uterus and can cause pain and heavy bleeding.
- Endometriosis. This is a condition in which endometrial cells grow outside of the uterus, attaching themselves to other pelvic organs. This can result in chronic pain and excessive bleeding.
- Endometrial hyperplasia and adenomyosis. These are two separate conditions affecting the lining of the uterus and resulting in abnormal bleeding.
- Cancer of the cervix, ovaries or endometrium .
- Uterine prolapse. This is when the uterus slips out of place, into the vagina.
- Chronic pelvic conditions, including pelvic pain or pelvic inflammatory disease.
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If My Cervix Was Removed In My Hysterectomy Do I Still Need To Have Pap Tests
If you have had a total hysterectomy in which the cervix was removed along with the uterus, you will not usually require Pap testing. An exception is if your hysterectomy was done because of cervical cancer or its precursors. Ask your health care provider if you need to have periodic Pap tests. It is important for all women who have had a hysterectomy to have regular gynecologic exams as part of their health care.
Can I Have An Orgasm After Menopause
Yes, you can still have an orgasm after menopause. An orgasm may feel hard to achieve once you have reached menopause, but there is no physical reason to prevent you from having an orgasm. Using lubricants and increasing foreplay can help with discomfort. Try to be open with your partner about your feelings and talk to them about what feels good.
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The Cons: Reasons To Lean Against Hrt After Surgical Menopause
- Your menopausal symptoms aren’t bothering you, or other treatments work fine. Some women don’t have very severe symptoms after surgical menopause and don’t want or need treatment. Even if you do have acute symptoms, HRT is not the only way to control them. Other drugs or lifestyle changes can help. Talk to your doctor.Ã
- You’re 50 or older. Many women who go into surgical menopause at 50 or older — the natural time of menopause – decide not to get HRT. That’s because their supply of estrogen would naturally drop during menopause anyway. There is some evidence that the older you are when you start HRT, the higher the cardiovascular risks – at least initially.Ã
- You have liver disease. Estrogen pills can put a lot of stress on the liver. So if you have liver disease, your doctor may not want you to take oral HRT. Other ways of getting estrogen – like patches and gels – bypass the liver and are safer options.Ã
- You’re concerned about the side effects. HRT can also cause symptoms of its own. Many resemble the symptoms of premenstrual syndrome — swollen and painful breasts, headaches, and nausea.Ã
- You’re at a higher risk of health problems like:
o Strokes. Hormone therapy can increase the risk of stroke, although your odds are still very low.
o Blood clots. Oral estrogen, at least, may also raise the risk of blood clots. Estrogen patches and creams may pose a lower risk, but that’s still unclear.
How Long Will Menopause Last After Total Hysterectomy
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How Will I Know I Am In Menopause After My Hysterectomy
No periods for 12 months is the common sign that menopause has arrived. But what about for you? Youve had a hysterectomy, so you have hadnt periods in years. How are you going to know when menopause arrives?
No worries. More than likely, menopause is going to arrive with plenty of notice. More than you want.
How Long Does Menopause Last After A Total Hysterectomy
This is known as a surgical menopause. If a hysterectomy leaves 1 or both of your ovaries intact, theres a chance that youll experience the menopause within 5 years of having the operation. Although your hormone levels decrease after the menopause, your ovaries continue producing testosterone for up to 20 years.
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When To Seek Help
Its common and normal to experience irregular periods when youre perimenopausal.
- suddenly experience very heavy periods or periods with blood clots
- have periods lasting longer than usual
- spot or bleed after sex
- spot or bleed after your period
- have periods close together
Osteoporosis and heart disease are long-term health risks associated with menopause. Thats because estrogen plays a significant role in protecting your bones and your heart. Without estrogen, youre at an increased risk for both diseases.
Youre also at an increased risk of urinary tract infections because menopause can cause your urethra to become dry, irritated, or inflamed. Vaginal infections can also occur more frequently because your vagina has become dryer and thinner.
Report menopausal symptoms when visiting the doctor. Get assessed by your physician if you continue to have menopausal symptoms that are unbearable or last more than five years after your last menstrual period.
Although menopause can cause uncomfortable symptoms for some women, this natural process has possible upsides, too. There are several potential benefits of menopause to consider:
You will still need to protect yourself from sexually transmitted diseases.
Will I Still Enjoy Sex After Menopause
You should still be able to enjoy sex after menopause. Sometimes, decreased sex drive is related to discomfort and painful intercourse. After treating the source of this pain , many people enjoy intimacy again. Hormone therapy can also help many people. If you are having difficulties enjoying sex after menopause, talk to your healthcare provider.
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What Is Surgical Menopause
The ovaries are the main source of estrogen production in the female body. Their removal triggers immediate menopause, despite the age of the person having surgery.
While surgery to remove the ovaries can operate as a stand-alone procedure, its sometimes performed in addition to hysterectomy to reduce the risk of developing chronic diseases. A hysterectomy is surgical removal of the uterus.
Periods stop after a hysterectomy. But having a hysterectomy doesnt lead to menopause unless the ovaries are removed too.
- vaginal dryness
Surgical menopause also causes hormonal imbalances. The ovaries and adrenal glands produce progesterone and estrogen, the female sex hormones. When both ovaries are removed, the adrenal glands cant produce enough hormones to maintain balance.
For that reason, and depending on your medical history, some doctors may or may not recommend hormone replacement therapy after an oophorectomy to reduce the risk of disease. Doctors will avoid giving estrogen to women who have a history of breast or ovarian cancer.
What Are The Long
There are several conditions that you could be at a higher risk of after menopause. Your risk for any condition depends on many things like your family history, your health before menopause and lifestyle factors . Two conditions that affect your health after menopause are osteoporosis and coronary artery disease.
Osteoporosis, a “brittle-bone” disease, occurs when the inside of bones become less dense, making them more fragile and likely to fracture. Estrogen plays an important role in preserving bone mass. Estrogen signals cells in the bones to stop breaking down.
People lose an average of 25% of their bone mass from the time of menopause to age 60. This is largely because of the loss of estrogen. Over time, this loss of bone can lead to bone fractures. Your healthcare provider may want to test the strength of your bones over time. Bone mineral density testing, also called bone densitometry, is a quick way to see how much calcium you have in certain parts of your bones. The test is used to detectosteoporosis and osteopenia. Osteopenia is a disease where bone density is decreased and this can be a precursor to later osteoporosis.
If you have osteoporosis or osteopenia, your treatment options could include estrogen therapy.
Coronary artery disease
- The loss of estrogen .
- Increased blood pressure.
- A decrease in physical activity.
- Bad habits from your past catching up with you .
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What Are Some Of The Treatments Offered For Menopause After A Hysterectomy
There are various treatments that can be given to ease the symptoms of menopause. For vaginal dryness, a vaginal moisturizer is recommended by doctors while for hot flashes and other related symptoms menopause hormone therapy can be administered.
Its also advisable to lead a healthy lifestyle by changing your diet and exercising regularly. Additionally, joining a support group consisting of women who have undergone the same surgical procedure will help in alleviating the psychological effects.
Can I Get Pregnant During Menopause
The possibility of pregnancy disappears once you are postmenopausal, you have been without your period for an entire year . However, you can get pregnant during the menopause transition . If you dont want to become pregnant, you should continue to use some form of birth control until you have gone fully through menopause. Ask your healthcare provider before you stop using contraception.
For some people, getting pregnant can be difficult once theyre in their late 30s and 40s because of a decline in fertility. However, if becoming pregnant is the goal, there are fertility-enhancing treatments and techniques that can help you get pregnant. Make sure to speak to your healthcare provider about these options.
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