| Dear Marla: I recently had a hysterectomy due to severe endometriosis. My doctor started me on estrogen. I asked him if I needed to start progesterone as well and he said, "Since you had your uterus removed, you do not need progesterone". Is this correct? Allison Dear Allison, Your question is an excellent one. Estrogen therapy for hysterectomy patients is often prescribed to help with osteoporosis prevention and enhancement of quality of life. A respected pioneer in menopause research, Dr. Wulf H. Utian (pdf format) recently wrote in Menopause Management, "Estrogen-only therapy for symptomatic relief, especially in younger women after hysterectomy and bilateral ovariectomy, has been demonstrated to be remarkably safe." The benefits of progesterone therapy for hysterectomy patients is not as well established in the medical community. It is true that progesterone does play a vital role in protecting the uterus from the effects of estrogen, and that progesterone is no longer needed for that specific reason once your uterus has been removed. However, what is also true is that progesterone also has many other positive effects on your body. Progesterone has anti-depressant, mood-enhancing, and calming effects, all of which can enhance how you function daily and your over-all sense of well-being. Conversely, low levels of progesterone in your body can cause you to feel more anxious and irritable. Progesterone also plays a role in maintaining strong, healthy bones by stimulating the bone-building cells known as osteoclasts. Other important progesterone-related activities are balancing and regulation of body fluids and blood sugars, enhancement of thyroid function, and relief of menopausal symptoms, which can occur after a hysterectomy-even if your ovaries were not removed. So you can see, even after a hysterectomy, progesterone still has a vital role to play and may be a good addition to your hormone therapy. The only way to know for sure is to measure your hormone levels to see if they fall within the therapeutic range. Saliva hormone therapy is a convenient and inexpensive way to do this and take the guesswork out of your hormone therapy.
Educating women on health care options is the personal mission of Marla Ahlgrimm, R.Ph., founder and CEO of Women's Health America. If you have a women's health care question, send it to Marla at
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