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Hormone Replacement Question

By March 22, 2013 - 1:26pm

I had a total hysterectomy when I was 36 and I am now 42. I have finally found something to control my hot flashes (Lexapro) but the side effect is no sex drive. Like I really am not interested in it at all! I cannot live with the hot flashes and my spouse is not happy about the side effect. He even asked me at lunch today if I had a boyfriend! Any advice??

By July 19, 2013 - 5:46pm

Lexapro does not treat hot flashes. I'm not sure why someone would take a drug to treat an estrogen deficiency issue. Why address the symptoms at all when you can restore estrogen back to healthy levels and get rid of the symptoms for good?

July 19, 2013 - 5:46pm
By June 20, 2013 - 5:57pm

Why take just estrogen to manage symptoms? Doctors are taught to give the lowest dose to treat the maximum amount of symptoms. Doctors treat symptoms but so not get to the root of the problem. Why not restore the estrogen to prevent bone disease and retain heart health?

June 20, 2013 - 5:57pm
By Expert HERWriter Blogger May 6, 2013 - 5:21am

Without a uterus, you do NOT need to take progesterone. It doesn't mean you can't, but you don't need it (women with a uterus must take progesterone in combination with the estrogen to 'protect' the lining of the uterus, the endometrium). I see very few patients who benefit from progesterone, but that doesn't mean you wouldn't. A detailed history will help determine which replacement options are likely to most benefit your symptoms. Testosterone can be of help to many women, and certainly thyroid if you are known to be hypothyroid.

May 6, 2013 - 5:21am
By May 4, 2013 - 1:17pm

Dr. DePree has is partially correct. Using estrogen is the answer but not in the way Dr. DePree describes. Unless Dr. DePree has had additional training outside medical school, they don't teach hormone replacement therapy, not even to OB-Gyn's. What bozo would give you an anti-depressant to treat a hormone deficiency symptom?

If you want your hot flashes to go away, treat them at the cause. You don't have a Lexapro deficiency so why are you treating your hot flashes with something that has nothing to do with the reason you have hot flashes to begin with? All Lexarpo does is numb you so you don't really care.


But it's not just estrogen you need; you need progesterone as well, and maybe some testosterone and thyroid. When you have a hysterectomy, even if they leave your ovaries in tact, you wil go into a hormonal decline in one to three years. If your ovaries have no function, they'll shrivel up like raisins . You never want to take estrogen without progesterone; think of it like yin and yang.

You need to find a doctor who is interested in getting to the root cause of your hot flashes, not just mask the symptoms. You probably have a lot of other symptoms of low estrogen and don't even know it. You want to find someone who has formal training outside of medical school, who already has a hormone replacement practice, and knows how to optimize bioidentical hormones in a rhythmic fashion. Google the article "The Initial Visit" and "The 50 Symptoms of Menopause".

May 4, 2013 - 1:17pm
By Expert HERWriter Blogger April 11, 2013 - 8:39pm

As a gynecologist I must say it is in your best interest to use estrogen to manage your symptoms. Women who experience a premature menopause, as a result of surgery, have significantly increased risk for bone disease and heart disease, not to mention vaginal health and other health risks, if they are without estrogen. Remember, the average age of menopause is 51, so it is not natural or normal for a 42 year old to be without estrogen, let alone a 36 year old. So unless you condition has a significant contraindication to using estrogen, that should be your approach to therapy.

April 11, 2013 - 8:39pm
By March 30, 2013 - 4:16am

But I am open to ideas

March 30, 2013 - 4:16am
By March 30, 2013 - 4:15am

Lexapro is the ONLY thing that has worked for hot flashes, unfortunately the side effect is low libido

March 30, 2013 - 4:15am
By March 29, 2013 - 6:59pm

Sislandgirl71, are you open to using herbs as alternatives to balance your nerves (why you are using lexipro) in addition to stopping the hot flashes. There is a solution.
I've seen so many women be able to balance their hormones without using meds. It is possible.
Going into menopause when you are in your 30's leaves you with little to no sex hormones but that shouldn't be messing with your libido.


March 29, 2013 - 6:59pm

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