Total Hysterectomy and on HRT

by Krista
(Lakeland FL)

I am 36 years of age. I had a total abdominal hysterectomy in 2006, and since then have been taking Premarin 1.25 mg/day.

I have noticed weight gain, cravings of more foods, and binge eating. Even though I was told that I wouldnt gain weight, I have >10lbs. I was told that it was not necessary to take progesterone because my uterus is gone.

I take my Premarin faithfully without question but still need a better explaination why progesterone is not needed. How could I benefit from progesterone supplement? What are the side effects/ what harm could it do if taken with my Premarin? Do I still need progesterone? I am well aware of the dangers of taking Premarin, but would progesteron increase these risk?

Is the progesterone necessary?

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Comments for Total Hysterectomy and on HRT

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May 31, 2008
HRT and progesterone
by: Wray

Hi Krista. Oestrogen does cause an upset in blood sugar. This is one of the reasons farmers give it to cattle... it makes them eat more. Oestrogen also increases fat cells, good for farmers not for women! Fat cells generate more oestrogen, so a vicious cycle is started.

Oestrogen is also known to cause insulin resistance. This, amongst other things, can cause binge eating, tiredness, weight gain. Progesterone helps to correct an imbalance in blood sugar and it cannot increase fat cells. Oestrogen and only oestrogen stimulates cells to grow, hence it's danger. Without progesterone there is nothing to stop it stimulating the cells in your breasts.

Another study on the increased risks has just been released in Germany, link below. So no harm or adverse side affects would occur using progesterone with Premarin, although I would prefer you did not use HRT. Everything in the body works in balance, there is always an opposing force or bio-chemical to maintain this. Muscles, hormones, minerals, neurotransmitters, they must work in pairs. To give only oestrogen and not progesterone will cause an imbalance.

Unfortunately they are over 90 oestrogen mimics on this planet now. We can't avoid them. In our food, air, water, the skin care we rub all over ourselves, and more. We all have an overload of oestrogen, hence the need for progesterone. What we need is organic food and skin care, clean air and water, then there would be no need for supplemental progesterone! Take care Wray

International Journal of Cancer 2008, DOI 10.1002/ijc.23655
Risk of Different Histological Types of Postmenopausal Breast Cancer by Type and Regimen of Menopausal Hormone Therapy.

Endocrine disruptors:
Our Stolen Future

Oct 30, 2008
TAH-BSO at age 36, six years ago
by: Lori

I tried and tried to keep the estrogen low, right after the less than hoped for results of the WHI study... and after a year or so started Premarin at .9 mg daily. I still felt a little creaky and stiff in the joints, so increased to 1.25 mg, which my doctor pointed out was probably much lower than what my ovaries used to do on their own.

I wanted to stick up for you and your choice. It's so easy for people with their ovaries or going through a normal menopause at a normal age to make blanket statements like "you should not take hormones". You are young and your body was intended to have the estrogen at least til 40 if not 50.

You can't consider just the breast cancer risk... my breast doctor (who performed a surgical biopsy on a lump a year before the hysterectomy) was completely in favor of ERT until normal menopause age. In her words, "you have to treat the whole person" and not just her breasts. Unless you have serious family history or the gene... you have lots of other body parts to take care of that are gonna miss the estrogen in ways you will be amazed by.

I'm 43 now, and just took the dose back down to .9 mg daily. I plan to stay on Premarin at least until I retire from my stressful job at 47. Then, we'll see. I think it's reasonable to expect to taper off in the 50's, and I hope they'll know more and someone will study women like us... who need more than a little black cohosh and red clover.

I gained about 10 pounds too, and lost some muscle to fat since the surgery. Like women who've had kids, I've had to accept I'll never get that old body back. Be gentle and accepting with the one you have now, and take good care of it and cut yourself some slack.

There's a web site... look up hyster-sisters. Not all accurate info but a lot of support if it would help to hear other stories a lot like yours.

Good luck, and hang on to your sense of humor.

Jun 04, 2009
by: Anonymous

I had a complete Hysterectomy in 2003. I never have taken any estrogen replacement. I have no sex drive and its very difficult to have sex because of pain. Can you help me?

Jan 11, 2010
Compound progesterone
by: kim

I too have had a total Hysterectomy and on Estradiol
Transdermal 0.075 for about 5 years. My new ob doctor has lowered the dosage for Estradiol 0.05 and compound 100mg progesterone. Still not feeling all that.

Jan 19, 2010
Compound progesterone
by: Wray

Hi Kim. I think you'll find the reason you're not feeling all that good is the oestrogen. Please consider using only the progesterone and see how you feel. I do hope the 100mg is not oral progesterone, this is the least effective delivery system. Most of it is destroyed as it passes through the gut and liver. If it is, and it's in an oil filled capsule, rather use it as a suppository/pessary. You will get the full benefit then. Take care, Wray

Apr 22, 2010
Estrogen is a must for us
by: Annie

To those of you going thru the hysterectomy process, take it from a 56 yr. old, do not forget to take the estrogen, especially if you are married. I had a hysterectomy in May of 2000, 3 wks shy of ten years now. Took 1.25mg estrogen for a few months. Quit because I had angina, abnormal EKG, and weight gain. Have been in frighteneing pain over the last month. Could not even walk at times. Vagina prolapsing, bladder incontinence, pubic osteitis, and intercourse impossible. But, I do have a normal EKG! I still have a cervix, but no ovaries. Had no children of my own. I received .750mg estrogen three days ago. My husband quit his OTR job to help me out. I pray things will get better. Please learn from this. Bless you!

Apr 24, 2010
Estrogen is a must for us
by: Wray

Hi Annie. Yes oestrogen is a must for us, but only small amounts. Oestrogen is a mitogen, it stimulates cells to grow, including fat cells, which in turn make oestrogen. It's vital during puberty when it causes our breasts and hips to develop, and the fatty layer women have. Vital once a month when it stimulates an egg/eggs to grow and mature. Vital too in stimulating the endometrium each month to grow and thicken ready for a possible fertilised egg.

But in excess it stimulates cells to continue growing, and grow they will with no progesterone to suppress the oestrogen. Our bodies must be kept in balance. But without a check, the excitatory hormones like oestrogen would continue stimulating. Oestrogen causes inflammation, as it stimulates matrix metalloproteinases (MMP?s), these are enzymes that break down protein. They play a role in the breakdown of endometrial tissues at the end of the menstrual cycle. If they are over active, as would be the case with excess oestrogen in the body, as oestrogen stimulates their production, the result is a pathological reaction. A high level of MMP?s can lead to inflammation and excessive bleeding in the uterus. High levels of both oestrogen and MMP's are found in arthritis and other autoimmune diseases. Progesterone suppresses both oestrogen and MMP's, it's also an excellent anti-inflammatory as it raises levels of IL-10 and other anti-inflammatory cytokines. There is always a risk in taking oestrogen, even bio-identical oestrogen, please see here and here. Take care, Wray

Jan 24, 2011
by: Anonymous

i'm 36 years old and had total hysterectomy and was prescribed HRT but i stopped taking it due to the side effects but now i started having joints pain on my knees most especially when standing up and feels my hands were numb when waking up, don't know what to do.Your advice will be much appreciated. Thank you

Jan 29, 2011
by: Wray

Hi there I'm relieved you have stopped the HRT. Unfortunately when removing the ovaries, not only do oestrogen levels drop, but progesterone too. We continue making oestrogen in our fat cells, but the amount of progesterone made in other areas of the body is insufficient to be of benefit in the reproductive cycle. It's evident your progesterone levels are too low, please consider using it. As you are now in Menopause, please read through this page we have on it. But before you start using it please read this page on Oestrogen Dominance. Unless you use sufficient progesterone the pain could get worse initially. I recommend 100-200mg/day progesterone, I suggest you start at the higher end, then once symptoms have resolved, the amount can be reduced slowly. I've found rubbing the cream directly on to any sore area has a quicker effect. Take care Wray

Mar 04, 2012
by: Anonymous

Hi Wray,
I have just had a Hysterectomy where my uterus as well as ovaries was removed. I was given tablets by my Dr, but after reading all the side effects on the leaflet, do not want to take them. What is the alternative... how do I keep healthy without this. I have read so many different things, yet the answer seems a bit vague. Can you help?

Mar 04, 2012
by: Wray

Hi there I'm pleased you're reluctant to take the HRT, I don't believe the risks are worth it. Many women have benefitted from using progesterone. I recommend 100-200mg/day, more if symptoms are severe. We have more info on our Menopause page. If you use the search bar you can look for others who've had a hyst, or used to use HRT, and get an idea of their journeys with progesterone. It can be a bumpy ride in the beginning, it is essential to use sufficient. Many are advised to use a low amount, which merely makes symptoms worse. If you should consider using it, please see our page on Oestrogen Dominance first. Progesterone and oestrogen stimulate each other, so if using too low an amount of progesterone it stimulates oestrogen. It's essential to use enough to overcome this, and make progesterone the dominant hormone.

Mar 31, 2012
by: Anonymous

but the question we would like to PROGESTERONE dangerous once the uterus and ovaries have been removed??

Apr 02, 2012
by: Wray

Hi there This whole website is devoted to progesterone, it's use and it's safety. It's been used safely for over 60 years now, for pre-term infants with respiratory distress syndrome, for PMS, PND, Peri-menopause, Menopause, Traumatic Brain Injury and much more. There are over 3000 pages on it, with many comments too. For instance if you read the answer I gave above, I suggested to the enquirer to use the search bar to read about the journeys of other users who've had a hyst. Why should a hormone that men and women make on a daily basis, suddenly be dangerous after having a hyst. Take care Wray

Jun 03, 2013
Need of HRT or not
by: Elizabeth

I had a total hysterectomy when I was 32 in 1991 (24 yrs ago.) I was immediately put on Premerin and lowered some time later at .0625mg. I'm curious in this: IF a woman goes thru menopause at say 50 yrs old, is put on a HRT, is she expected to stay on it as long as I have till she is 74 yrs old??? I mean that'de be the same amount of time I've been on Premarin! I personally feel that as long as I take Calcium with Vitamin D & "Estroven"....a menopause supplement, shouldn't that be suffice? Thanks in advance to everyone :)

Jun 05, 2013
Need of HRT or not
by: Wray

Hi Elizabeth I wouldn't recommend HRT to any woman, I don't believe it has any benefits and plenty of risks. If there are any adverse symptoms due to Peri-menopause or Menopause it's far safer to use progesterone, which has no risks. I wouldn't take calcium either, unless you eat a very low calcium diet. One of the roles vitamin D plays is to draw calcium from the gut and put it in the blood. But the most important co-factor for vitamin D is magnesium. With insufficient magnesium the calcium will remain in circulation, where some is needed, but it won't go into the bones where it's also needed. Another important co-factor is vitamin K2. For more info on vitamin D levels, test kits etc see the following websites, Vitamin D Council, GrassrootsHealth and Birmingham Hospital. Blood levels should be 70-100ng/ml or 175-250nmol/L, and not the 30ng/ml or 75nmol/L most labs and doctors regard as adequate. The minimum daily dose should be 5000iu's per day, although the latest research indicates it should be 10,000iu's per day, see here. The Estroven contains black cohosh and soy isoflavones, both are oestrogenic, so don't advise them. For more info on soy please see here. Take care Wray

Jul 30, 2014
by: Tammi

I have been on estrogenmtest for about 20 years, I now take half of the half strength pill. What do you suggest to get off of estrogenmtest all together, I can handle hot flashes but not the anxiety. I already have problems with anxiety. I am pretty much an all natural girl, no drugs , not even asprin. This half a pill of estrogenmtest is all I take. I am 51 should I continue or ween off. Thank you for your time.

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