Dr N:
Hi, I am a 36yr old female.
I am going to a total hysterectomy with removal of my ovaries in less
than two weeks. I have to admit I am really scared about this surgery.
I have had endometriosis for several years. It is now at the point where
I am in pain more than not. I am ready for the surgery, but scared at
the same time. I hear some women say it is the best thing that they
have done. What has me scared is the HRT. My doctor wants to start me
on estrogen after the surgery, but he has not said anything about testosterone.
Is this not something that is automatically part of your HRT? I have
a very patient and understanding husband who is also concerned about
the effects of surgery and HRT. Do you start on HRT right after surgery?
How soon after starting HRT do you see effects? I have read so much
and am now confused. I have read some the emails from your "Hysterectomy
and Happy" site. I hope I will be in this category.
Thank you for your time.
Reply:
Hi,
It is a frightening
prospect. Any surgery would be, but when you superimpose the hormonal
considerations, it is even more disturbing.
I can't say what
other Dr's would do, but I would start the HRT as soon as possible following
the surgery. Some Dr's delay HRT for a while, following surgery for
endometriosis. Their rationale is that it lowers the possibility of
a reoccurrence, although my own feeling is that does not make a difference.
Either there is endometriosis left behind, or there is not.
Some Dr's give an
injection at the time of surgery or even put a patch on the patient
when their done. I know some physicians in England that drop hormone
pellets in the subcutaneous tissue before they close the incision. My
own preference is to offer testosterone to any woman who does not have
ovaries.
Discuss these issues
with your Dr and see what he says.
Let me know what
happens.
Dr N