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Hormone Balance after Hysterectomy

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Hormone Balance Through BHRT After A Hysterectomy

By the age of 60 one out of every three women will have had a hysterectomy, the surgical removal of the uterus.  Hysterectomy surgery is the number two major surgery for women, second only to a cesarean section.  About half of hysterectomies also include removal of the ovaries (oophorectomy). 

Ovaries are the “factory” which manufactures the hormones estrogen and progesterone in a woman’s body.  Removal of the ovaries will result in a sudden drop in estrogen.   A hysterectomy, even without removal of the ovaries, can result in a gradual drop in estrogen levels over time leading to the same symptoms, but in a less abrupt manner.

The estrogens (estradiol, estriol and estrone) control the development and release of eggs in the ovaries and are important in maintaining the health of a woman’s reproductive system, breasts, skin and brain.  An insufficient supply of estrogen in the body can lead to:

  • hot flashes
  • vaginal dryness
  • rapid aging of the skin
  • urinary tract problems
  • excessive bone loss
  • possible acceleration of dementia

Hormone replacement therapy is a method of treatment in which a patient is given hormones to replace hormones missing from a patient’s body.  For women with symptoms of menopause these may include estrogens, progesterone or progestins, and sometimes testosterone.  A popular formulation produced by pharmaceutical companies for a number of years has included a mixture of conjugated horse-derived estrogens with progestins.  The horse-derived estrogens are produced from the urine of  pregnant horses.  The resultant compound is a synthetic estrogen; one which is not bioidentical to human female estrogens. 

On the other hand, bioidentical hormones are chemically identical to the hormones produced by the human body. Many professionals in the anti-aging field are convinced that problems with synthetic hormones used in HRT result from a different chemical structure than what is produced naturally in the human body. 

For instance, recent studies have indicated that the usual combination of progestins and horse-derived estrogens may contribute to the development of blood clots, may exacerbate problems with the gall bladder or liver, and may increase the risk of breast cancer.  The results of one clinical study reported in the Journal of the American Medical Association (JAMA) in 2004 found evidence that a conjugated horse-derived estrogen caused clotting, but a bioidentical esterified estrogen did not. 

So what is the process involved in bioidentical hormone replacement therapy (BHRT)?  First it is necessary to test the patient to determine what the level of various hormones is in the body.  For women, tests normally include current levels of:

  • total testosterone and free testosterone
  • estradiol
  • thyroid stimulating hormone
  • follicle stimulating hormone level (for women)

A hormone formulation, tailored to the specific patient and his or her individual needs can then be developed.  This will include the specific hormones to be provided and the dosage level of each hormone based upon the laboratory analysis, severity of symptoms, age, gender, and body size.

Various hormone replacement methods are available for the delivery of the tailored formulation to the patient.  These include:

  • pills
  • skin patches
  • creams
  • injections
  • pellets inserted under the skin

While any form of BHRT is a step in the right direction when your hormones are imbalanced, certain methods may work better for you than others. Be aware, a woman’s hormonal needs can change over time and treatment methods may need to be modified.

Bioidentical hormone pellet therapy is the most advanced and progressive approach to the relief of menopausal symtoms. Pellet therapy offers around-the-clock hormone release based on what each individual body needs. If a woman is exercising and needs more hormones released to work-out optimally, the body has a built-in regulation system that will find them. Similarly, if she is resting, the body will release less hormones into the body. Pellet therapy is as close as it comes to replicating how the body releases it’s own hormones.

 Hormone pellets are about the size of granules of rice.  A minor surgical procedure, which takes only a few minutes, is used to insert the pellets under the skin of the buttocks, hip or  bikini area. Only a band-aid is necessary to cover the incision and the hormone replacement pellets last for 3 to 6 months.

The hormone pellet method has several advantages.  First, you don’t have to remember to do anything – take pills, apply creams or change skin patches.  This method is also most efficient in delivering the lowest dose of hormones to your body because it releases only the amount the body needs.  Because of this efficient delivery the dosage level required is lower than with other methods.  And you can’t lose your medicine or forget to take it on a trip, which can cause fluctuations with your hormones.

For patients who prefer a more conventional treatment using pills, the formulations can be made available in this form also.  However, these normally must be taken twice a day.  They also require higher total dosages and the level of hormones in the blood vary more than using the pellet method.

Creams are also available but have similar disadvantages.  They normally have to be applied twice a day.  As with pills, creams also require higher dosage levels than pellets and have the added complication of where to apply them relative to clothing contact areas.  Like pills they also result in variations in the hormone levels in the blood. 

Skin patches have been in use for some time to relieve hot flashes.  They have their own particular problems. They sometimes come loose from the skin prematurely, and generally cannot be successfully reapplied to the skin.  This can result in a reduced dosage being received.  Also, some people find they develop some skin irritation from the patch.

You don’t have to simply live and suffer with the symptoms that will develop after menopause or a hysterectomy.  There are treatment options available that will relieve your symptoms, improve your health, and greatly improve your quality of life.  Find a qualified physician practicing BHRT and discover there really is life beyond a hysterectomy.

Disclaimer: The information provided should not be construed as medical advice but as general information. Anyone interested in BHRT should consult a physician about their specific needs.

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