Hysterectomy and Menopause

Hysterectomy and Surgical Menopause

Hysterectomy is major surgery to remove a woman's uterus. Other reproductive organs may be removed at the same time, including one or both ovaries, the fallopian tubes, and the cervix, which is the lower part of the uterus.

Does a hysterectomy result in menopause?

Women who have had a hysterectomy no longer menstruate and cannot become pregnant, but unless both ovaries were removed, this does not mean that menopause has occurred. If one or both ovaries are retained during a hysterectomy the patient could experience:

• Continuing normal function of the ovaries until the normal onset of menopause at the usual age of menopause, or
• Early ovarian failure with the ovaries stopping hormone production sooner than expected. This loss of ovarian function can occur as early as 1-2 years after the hysterectomy. The ovarian failure may be very apparent to the patient and HCP when symptoms of estrogen deficiency occur. Or it may be silent if estrogen levels fall but symptoms do not occur.
• (Source: Menopause Matters www.menopausematters.co.uk)

On the other hand, premenopausal women who have had both ovaries surgically removed (oophorectomy) will experience an abrupt menopause and may be hit harder by menopausal symptoms like hot flashes and loss of libido than those who experience it naturally. Surgical menopause is associated with a greater decrease in androgen production than natural menopause, which may make hot flashes more severe, more frequent, and longer lasting for some women. Surgical menopause is also associated with a greater risk of heart disease and osteoporosis, and a greater chance of depression.

Self-Care

Self-care is the foundation of good health and hormone balance whether a woman's menopause occurs surgically or naturally. After the incision has healed, exercise and a healthy diet are critical. Natural Progesterone Cream, Vaginal Moisturizer, and specially formulated vitamin supplements such as ProCycle^® Gold are available without a prescription and can help support healthy hormone balance.

Natural (Natural) Hormone Therapy

Natural hormone therapy (BHT) is an option any perimenopausal, menopausal, or surgically menopausal women should consider for its life-enhancing benefits, including decreased risk of cardiovascular disease and osteoporosis, decreased menopausal symptoms such as hot flashes and insomnia, increased sense of well-being, enhanced sexual energy, and systematic anti-aging benefits. Most health care professionals recommend estrogen replacement to help prevent early aging in a premenopausal woman who has had her ovaries removed.

While there is no set combination or dosage of hormones that works for every woman, an BHRT regimen will commonly include a combination of:

• natural estrogen
• natural progesterone
• an androgen such as natural testosterone

Because most of the estrogen in a woman's body is produced by the ovaries, natural estrogen replacement is usually the focus of hormone replacement after a woman's ovaries have been removed. The best way to determine if hormone therapy is appropriate and the correct dosage and form is by testing hormone levels.

Testing to Determine Hormone Levels

Each woman's hormone profile is uniquely her own. This makes testing to measure individual hormone levels essential for taking the guesswork out of natural hormone therapy and returning a woman's hormone levels to the normal, therapeutic range.

Saliva testing is an accurate, easy, and well-established method for measuring hormone levels in the body. Saliva testing measures ''free'' hormones that are available for the body to use. This is an advantage over blood serum hormone testing that requires a visit to the lab and measures ''bound'' hormones already being used by the body in combination with ''free'' hormones.

NTx urine testing is equally convenient and equally important for monitoring development of one of the biggest concerns of women whose estrogen level has declined - osteoporosis. The NTx urine test shows changes in rate of bone loss within three months instead of the two years generally required for sequential bone densitometry (BMD) measurements. This is a distinct advantage that allows early intervention to help prevent bone loss. Hormone therapy may improve bone health in as few as three months after hormone therapy is initiated.

Both tests allow for home collection of samples that are then sent to the lab for analysis. Both tests are available through Women's Health America. Our Restore^® program includes free follow-up testing and dosage recommedations for your health care provider.