Should estrogen be used after a hysterectomy?

The article was professionally consulted with Specialist Doctor II Huynh Thi Hien - Obstetrician and Gynecologist - Department of Obstetrics and Gynecology - Vinmec Nha Trang International General Hospital.

After surgical removal of the ovaries - the main producer of the hormone estrogen - the female hormone, will cause surgical menopause. Surgery to remove the ovaries is often combined with a hysterectomy, but this is not always the case. In fact, women who have had only a hysterectomy will not experience surgical menopause. Because their ovaries are still producing estrogen. These women will enter menopause naturally as they get older, sometimes a little earlier than usual. The hormone Estrogen plays an important role throughout the body. It affects the brain, bones, skin, heart, blood vessels, and more. While estrogen levels drop gradually during natural menopause, they drop dramatically during surgical menopause. A sudden drop in estrogen can lead to quite severe menopausal symptoms.
Post-surgery hormone therapy with estrogen and progestin or only estrogen is one way to provide the estrogen you've lost. Women who have had a hysterectomy and their ovaries need both estrogen and progestin. Because estrogen alone can increase the risk of cancer in the uterus. Progestin supplements will help eliminate this risk.

Rarely, both ovaries are removed without a uterus. Normally, only one ovary can be removed, so no hormone replacement therapy is needed.

2.1. Reasons to take estrogen supplements after hysterectomy and ovaryectomy Because of surgery and not age, they need at least estrogen supplementation - hormone replacement therapy until perimenopause . Estrogen affects the body in many different ways. Many experts believe it plays an important role in protecting young women from disease. Doctors have long known that the risk of cardiovascular disease is much higher in women who had their ovaries removed before menopause. Removal of the ovaries before menopause has also been linked to a double risk of Parkinson's disease and dementia. There is growing evidence that the use of estrogen hormone therapy helps prevent these problems in young women. Women who enter menopause as a result of surgery when they are younger than 50 should use hormone replacement therapy. Then, when they reach the mean age of menopause (51 years), a decision can be made to continue use or not.

Your menopausal symptoms become severe and other treatments don't work: Some women experience menopausal symptoms such as hot flashes, vaginal dryness, and trouble sleeping that make them intolerable. and nothing seems to relieve the condition. Estrogen supplementation can be effective in preventing and reducing these symptoms. Other health benefits: hormone replacement therapy offers a number of health benefits such as slowing osteoporosis and increasing bone density. Supplementing with both estrogen and progestin seems to slightly reduce the risk of developing colorectal cancer. 2.2. When estrogen supplements should not be taken after hysterectomy and ovary removal Your menopause symptoms don't bother you, or other treatments work well. Some women have no severe menopause symptoms after surgery and don't want or need treatment. Even if you have acute symptoms, hormone therapy is not the only way to control them. You're 50 or older: Many women who enter menopause through surgery in their 50s or older - the time of natural menopause - decide not to take estrogen supplements. That's because their estrogen supply naturally decreases during menopause. There is some evidence that the older you are when you start hormone replacement therapy, the higher your risk of cardiovascular disease. You have liver disease: Estrogen supplements can overload the liver. So, if you have liver disease, don't take estrogen supplements. You are worried about side effects: Hormone replacement therapy can also cause side effects such as headache, nausea, swollen breasts.

You have a higher risk of health problems such as: Stroke: Hormone therapy may increase your risk of stroke, although your odds are still very low. Blood clots: Lowest doses of oral estrogen can also increase the risk of blood clots. Estrogen patches and creams may have a lower risk, but this is still unclear. Heart attack: The combination of estrogen and progestin supplements may slightly increase the risk of heart attack. Breast cancer: The possible link between breast cancer and hormone therapy is scary but uncertain. The evidence shows that estrogen alone treatment does not increase the risk of breast cancer, unless it is used for more than 6 years. Ovarian cancer: the evidence is uncertain, but treatment with estrogen alone may increase the risk of ovarian cancer. Choosing to use hormone replacement therapy - supplementing estrogen after hysterectomy and ovary removal is not easy. This depends on the benefits it brings as well as the risks you may face. After hysterectomy, you should have a follow-up visit to evaluate your health status and talk to your doctor to know what you need to do, from diet, exercise, rest to need to use and Supplementing with any reasonable drugs, from which to choose appropriate drugs that are safe for health.
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