Should I take Estrogen after having a full hysterectomy?

Hi. I can tell you there is now a relatively easy answer to this question: the current recommendation for a 31 year old woman is TAKE ESTROGEN! The studies have gone back and forth on this issue, but they have almost exclusively focused on naturally post-menopausal women (over age 50, and usually considerably older) taking estrogen. However, a recent big study looking at women who have become surgically menopausal stunned many: it very clearly showed that going without hormones at your age puts you at much greater risk of a variety of diseases, and shortens lifespan noticeably. Here are the study results: http://www.medscape.com/viewarticle/544956

But I don't want to dis' your doctor for saying otherwise--the data he is using is for women of menopausal age, who are naturally menopausal, as shown in the HERS study: http://medschool.ucsf.edu/news/features/patient_ca...

It's key to see this distinction. The woman's body is SUPPOSED TO have these hormones at your age. Estrogen is involved in over 200 different bodily functions, as you've no doubt seen from taking Lupron. Also, you'll find that Lupron has been said to have numerous side effects and risks--these are identical to the problems and risks you'll have when you get your ovaries out, but while the risks are described as problems when caused by Lupron, the identical risks have largely been ignored in conjunction with ovary removal.

I personally wouldn't go to that doctor for your hormone needs--see if you can find a menopausal specialist. Unfortunately, they're still not going to know things 100%--it's a totally different matter to read about results of hormones in some dry medical journal, and to experience them on a daily basis by taking the hormones. That's why your own research is important--you're going to care about this way more than them. Plus, doctors are focused on disease prevention, and taking hormones is more a matter of wellness than disease prevention, and is therefore subtler.

As for breast cancer: this is definitely a valid concern. You might want to find out in more detail what your risk is, but getting genetic testing, perhaps. But something to keep in mind: risk of breast cancer is directly related to lifetime estrogen exposure amounts. The more estrogen you've been exposed to in your life, the greater the risk. This means that if you don't take hormones, your risks are automatically decreased, fairly significantly, from what they were before you had your ovaries removed. So while taking hormones will increase your risk, it's NOT more than natural risk if you didn't have your ovaries removed. In fact, it's probably lower than that, because even if you use estrogen, you'll still be using less than your body would otherwise have naturally if you still had ovaries. When docs talk about increased risk from taking hormone replacement, they're talking about risk increasing for a woman who is naturally menopausal, and who is therefore extending her lifetime exposure to estrogen beyond the age of 50, when exposure would normally stop. Your lifetime exposure will be extremely lower than normal because of the surgical menopause. Another consideration: it looks like taking an artificial progesterone may increase risk of breast cancer--this is why the big HERS study of hormones ended the study of women taking Prempro (Premarin plus provera) ended earlier than a different arm of the same study that used only Premarin--the Provera (a type of artificial progesterone) may have slightly increased a variety of risks, including breast cancer. But you wouldn't need progesterone, because you will have had your uterus removed. So, yet another reason why breast cancer risk won't be elevated.

In short, there are a variety of reasons why taking estrogen right now is a good idea. You will have to reevaluate this decision later, though, because you don't want to increase risk by taking it past naturally menopausal age. But the risk profile is vastly different at 31 vs. 50. If you have any questions, email me privately.

Yes. I had an emergency hysterectomy done when I was in my forties and was put on estrogen immediately after wards.

I have a history of breast cancer in my family as well. I've had no problems with the estrogen, and really have no desire to go off of it until the docs tell me to. One reason they put you on estrogen is that after surgery, you are going through a surgical menopause, which is awful if not treated.

You can always ask another doc for a second opinion, to see what someone else might recommend.

Every patient is different and has different needs. You might do better on estrogens than Lupon or whatever else they throw at you.

By the way, any doctor who gets annoyed with you for having done research- and are trying to find out about what's best for herself, is a crappy doctor. Remember this- you are the patient and YOU HAVE THE RIGHT TO VOTE WITH YOUR POCKETBOOK AND FIND A NOW DOCTOR.

I have fired several docs in the past for being jerks and unkind.

Actually, what some studies have shown, is that HRT (hormone replacement therapy) "may" cause breast cancer. It has never actually been proven that it "does" cause breast cancer. Some women get relief with Estroven and Remifemin (?), both over the counter herbal medications. Your local health food store or GNC will have other products available. Have you checked into bio-identical hormones? They are derived from plant products and are close to what the body produces. Some gynecologists also prescribe anti-depressants to help control the hot flashes and other menopausal symptoms.

My mom had a hysterectomy and is doing fine taking estrogen. :)