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Hey Anon, we asked an Ernestine Bustamante Roman, MD, FACOG of New Horizon Women's Care for her thoughts on your post and here's what she shared with us.

"This patient needs to have a complete history and physical exam. She needs a consultation to discuss the risks and benefits of HRT.

Some of her risks of starting HRT will depend on whether she had her ovaries removed at the time of hysterectomy. If she had her ovaries removed, called a bilateral salpingoophorectomy or BSO, that would make her 6 years menopausal.

Women who are many years menopausal and then started on estrogen preparations do have an increased risks of blood clots, heart attacks and strokes. If she did not have a BSO at the time of hysterectomy, she could be perimenopausal. (average age of menopause in the United States is 48 to 52 years old.) And would be a better candidate for HRT.

There are many formulations of HRT: patch, pill, vaginal preparations. There are "bio-identical" options out there. As these are not well regulated by the FDA. I often hesitate to prescribe these.

The decision to place her on HRT would largely depend on her symptoms and her knowledge of the risks of starting HRT. The present recommendation for patients is to try the lowest dose possible for the shortest time possible. However, If I have a patient who has been on HRT for years and never had a problem and is otherwise healthy, I don't stop their HRT. These patients have proven themselves, "estrogen worthy".

Interestingly, the professional group who use HRT the most... ob/gyns."

February 5, 2009 - 9:30am

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