Hormones After Hysterectomy

Kelly Anne Spratt, D.O., Director of Women's Cardiovascular Health at the University of Pennsylvania Presbyterian Medical Center, answers your questions.

Q. What hormones are replaced after a hysterectomy? I have had an estrogen patch since surgery. However, I have noticed great physical changes since the procedure.

A. Hormone replacement therapy (HRT) refers to regular doses of hormones to replace the natural hormones that decrease at menopause or hysterectomy. When your uterus is removed, you only need to take estrogen. If you go through natural menopause, both estrogen and progesterone are necessary since estrogen alone can cause a slight increase in cancer of the uterus. (No uterus means no worry of cancer of the uterus). Estrogen is recommended to relieve symptoms associated with menopause and estrogen loss: hot flashes, sleeplessness, and vaginal dryness. In addition, estrogen is recommended if you are at risk for osteoporosis or coronary heart disease.

Estrogen can be given in oral tablets, vaginal cream, or skin patches. If you are still having physical changes, you may benefit from switching from the patch to pills. You do not mention how long it has been since your surgery but remember that it may take several months for your body to adjust to any surgery, especially hysterectomy.