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ask: If you have a total hysterectomy & immediately start HRH, what happens when you go off HRH?

By Anonymous January 16, 2009 - 11:32am
 
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I want to know if I stop taking estrogen, will I begin to experience hot flashes and other menopausal symptoms? I am 54, had the hysterectomy 7 years ago, and have been taking estrogen ever since.

 
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Diane Porter

Anon, in a word, probably. Did you also have your ovaries removed? Can you tell us what hormones you are taking?

One of my best friends had been on HRT since she had a hysterectomy (ovaries as well) about five years ago, and when she recently went off of it she had all the symptoms of menopause. Hot flashes, night sweats, the whole nine yards. However, the difference was that unlike natural menopause -- which goes rather slowly -- she transitioned really quickly, so she went through her symptoms much more quickly than I did, for instance, and then was pretty much done with them.

Have you talked with your doctor about perhaps easing off HRT, using just enough to control the symptoms you'll have? You may also want to discuss bioidentical hormones with her or him; bioidenticals have the same molecular structure as those your body made:

http://www.womentowomen.com/bioidentical-hrt/bioidenticalhormones.aspx

Yet here's another side of that:

http://www.menopause.org/bioidentical.aspx

You might also be interested in some natural methods of controlling symptoms:

http://www.menopauseatoz.com/Choosing_a_Natural_Menopause_Treatment.shtml

January 19, 2009 - 9:18am
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Anonymous (reply to Diane Porter)

Diane, thanks for your reply. I did my have ovaries removed--I had a total hysterectomy in 2001 to remove large benign tumors. I am currently taking a low dose of estrogen orally. My biggest genetic risk is either heart attack or stroke--not much cancer in my family, but lots of heart disease. When I had the hysterectomy, my doctor at that time believed that HRT would prevent strokes or heart attacks, so he put me on a large dose of both estrogen and progesterin. He told me I would take it for the rest of my life. (He did not appreciate questions about his instructions, and I was laying in the hospital bed recuperating from surgery, so it was a very short discussion.)
A year or two later, when research challenged his theory, I changed doctors and went on a lower dose of estrogen only. Since current wisdom seems to be that estrogen is only appropriate for a limited period of time, and only to treat symptoms, I am thinking I should get weaned off the estrogen. Since I never went through menopause, I wondered what other women in my situation might have experienced.

January 19, 2009 - 5:56pm
Diane Porter

Anon, you're very welcome. Hormones and whether to replace them is such a complicated, multi-layered topic. It's almost like we each need to be a scientist for our own individual bodies.

I hate the fact that your doctor was paternalistic about your hormone prescription and I'm very glad you changed doctors when you felt you needed to. However, since hysterectomy (and taking out the ovaries) puts you into menopause immediately, many doctors start quickly with HRT. To not do so, for some women, risks a quick and deep depression because so many processes are linked to those hormones. From the Mayo Clinic:

"Also, hysterectomy with removal of the ovaries can lead to an abrupt onset of menopause with more severe symptoms, including mood changes and sometimes depression."

Here's a good primer on how to decide whether HRT is for you. Because you had a hysterectomy, a couple of them do not apply to you. But it's a good place to start in gathering information about yourself and in beginning to evaluate it.

http://womenshealth.about.com/cs/azhealthtopics/ht/hrtdecision.htm

January 21, 2009 - 9:15am
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Anonymous

I've taken hormone replacement therapy twice and finally quit altogether about 10 years ago. I had my ovaries removed at the age of 40 because my mother died of ovarian cancer and I was already well into menopause. I have had hot flashes ever since I started menopause, the HRT didn't help at all. What has slowed them is the medicine I take for my blood pressure (atenolol). It has been used in Europe for hot flash control for years. It only slowed them, didn't get rid of them entirely so it may not work as well as HRT does for most people.

January 22, 2009 - 6:37pm
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Anonymous

I had my uterus removed at age 28, but kept both my ovaries. At age 45, I had my left ovary removed, and 6 months later, my right ovary, putting me into surgical menopause. I had wicked hot flashes from the night of the last surgery and my doctor started me on HRT. I took the pills for about 4 months, and then stopped because of constant migraines. To my delight, I've had very few symptoms of menopause since...the occasional hot flash, some vaginal dryness, some sleep disturbances, but nothing that I haven't been able to manage on my own.

I would suggest talking to your doctor about weaning off, to see how you manage. You may be able to stop HRT completely, and any lingering symptoms you do find might be managed with more natural solutions.

Good luck!

January 22, 2009 - 6:40pm
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Anonymous

I was on premarin .625 for 17 years. I I finally weaned myself off and had terrible cramps and burning in my legs it was awful. I went back on the premarin and it took about 6 days for the symptoms to stop. I then tried a lower dose and the same symptoms came back. I couldn't sleep and it was unbearable. I went back up the higher dose and gave up. I then tried again this time weaning myself off the premarin and going on the bio identicals right away. My symptoms went away, however my Ob-gyn told me she would prefer me to stop them completely due to a history of breast cancer in the family. since that time which is around 2 years ago I still have the same pains in my legs, it is the same identical pain. Now I have had to revert to taking sleeping pills and anti anxiety drugs. I have decided now to try and natural estrogen formula like the phyto estrogens and see what happens.

March 16, 2009 - 6:39pm
alysiak (reply to Anonymous)

Hi, Anon:

You might be interested in VIDEO - HERSTORY: Miriam Shares Her Experience On Stopping Hormone Use

and HRT study stopped early because risks seem to outweigh benefit by EmpowHer's Laurie LaRusso, MS, ELS

March 16, 2009 - 6:51pm
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Anonymous

I had a complete hysterectomy (both ovaries) in June 2009 and my doctor started me right away on Enjuvia. I took the hormone for 6 months then decided I did not want to take them anymore. I have not experienced any symptoms except my breast seem to be sore. Could this be caused by not taking my hormone?

March 20, 2010 - 5:42am
Susan Cody HERWriter Guide (reply to Anonymous)

Hi Anon

Yes, this could be a factor. Did you have breast pain before your hysterectomy? How bad is the breast pain? If it's pain on a very low scale, then it might be worth it in order to stay off hormones but if it's severe, you may need help. I just wrote about this a few minutes ago here :

http://www.empowher.com/community/ask/aching-breasts

What do you think?

March 20, 2010 - 5:55am
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Anonymous

I had a complete hysterectomy in 1990 & was put on Premarin. About 7 yrs ago my Dr lowered the dosage to 0.3. Two months ago they found out I had type a hypo displasia which is pre cancer cells of the breast & a very tiny 3.mm nodule. No history of breast cancer in family but I got so scared after surgeon told me it probably came from the estrogen. I weaned myself off by taking one every other day the first month then every two days the second & now I am totally off. I cannot sleep, hot sweats & overall feel lousy but will not go back due to the surgery on the breast which was just awful. A hard core biopsy & then a wide lobe lumpectomy which resulted in general anestetics & several stitches in the one breast. Now they have to monitor me every 6 months so assure I am not generating any more pre cancer cells. Thank goodness this was caught so early I acted so fast.

July 11, 2010 - 7:58am
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