Medical Questions » Menopause Questions » Question No. 669
| Question: | I heard recently that women who could not produce hormones naturally, either due to the change of life or after a total hysterectomy should have hormone replacement therapy to prevent osteoporosis. What is your opinion? |
| Answer: | Women who have a total hysterectomy (removal of the womb and both ovaries) will age prematurely, and have an increased risk of osteoporosis, particularly if die surgery is performed at an early age. Unfortunately, the most common reason for a total (as opposed to sub-total) hysterectomy, is cancer in the area of the ovaries or womb.
Any hormones given to these women in the future may rarely cause a recurrence of their cancer. These women are therefore caught in a cleft stick, and will need to discuss their individual problems carefully with their gynaecologist. The treatment will depend on what type of cancer they had, where it was, how advanced it was, and how severe the symptoms caused by the lack of hormones.
Fortunately, most women who have a hysterectomy have a sub-total one, where at least one ovary is left behind. These women can be treated the same way as those who have never had any surgery.
Women who are going through the menopause and who are suffering from significant effects of this natural change can be helped by regular hormone supplements. This usually involves taking oestrogen either constantly or for three weeks a month, and those who have not had a hysterectomy will need a course of progestetone for ten days or so every month.
If the symptoms of the menopause are not severe, the family history should be checked, and if the patient' s mother or grandmothers suffered from osteoporosis, again hormone supplementation is advisable. If there is no history of osteoporosis, and no significant effects from the menopause, hormone supplementation can still be beneficial by reducing the incidence of strokes and heart attacks, and improving skin tone and appearance.
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