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Hysterectomy 8 Yrs Ago. Still Need Estrogen?
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Hysterectomy 8 Yrs Ago. Still Need Estrogen?

This is for my mother. She just turned 59 years old and has had a very healthy and active life until her recent birthday. She was hospitalized with a severe brain bleed that led to the neurosurgeon drilling holes in her skull to remove the blood. After she was home for a month, she started having heart problems (pauses between heart beats of 3 1/2 to 4 seconds) and the cardiologist is considering a pace maker (which she does not want). This has all been very hard on such an active person with little health problems. Mom had a total hysterectomy 8 years ago and is still on estradiol. Her family doctor recommended that since she is past the typical menopausal age and because of the recent problems that she stop the estrogen therapy. She went to her gynocologist and he was very against her stopping the estradiol and changed her from an oral dose to a patch. Her gyno was very adamant about the benefits of estrogen therapy and totally against stopping it at all. To mom, it felt like he plans on keeping her on the estrogen for the rest of her life. She is feeling very torn between the two doctors who both want her to do different things. How do you stay a good and compliant patient to both doctors with opposing opinions? Are there really benefits to continuing estrogen therapy after a natural menopausal age? Is it a trend to continue the therapy indefinitely? Does anyone have any experience on how long after a total hysterectomy and menopausal age you continued estrogen therapy? I want to help my mom get back to being the person she was, and her neurosurgeon and family doctor seem to think that she can do this. How do we get the gyno to accept it or what should we suggest to help?
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So your Moms doctor wants her to have brittle bones on top of her other problems? My mother has been on hormone replacement since she was 38 and she is now 78. I am so glad her Cardiologist And Ob/Gyn talked and decided that poor bone density would have the biggest impact on her quality of live. Your mother GYN is right. Good for him for taking a tough stance.

My mothers lives a much richer life because of her strong bones. She doesn't walk around in fear that she will fall and break bones, or her hip is going to break. I plan on take HRT the rest of my life.

A friend of mine was upset because her doctor told her she needed to stop hormone replacement because it had been 5 years. I told her to ask her doctor, who is post menopause if she was on HMR. Yes she was and still is! If women doctors are staying on hormone replacement that says a lot..

While everyone is different you really need to weigh the risk factors. Cancer and Heart Disease create a big scare, but osteoporosis is terrible to liive with, and with longer life's it creates a painful frightening existence.

Your Mom should get a second opinion on her heart problem. It could be somehow related to her recent brain injury. Also, if she started any new meds they could be causing the heart problem. That is not uncommon at all.
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Actually we are having a lot of problems with the medication she is on now. She has had bone density scans and her bones are fine. She has not stopped taking any medications as of yet. She was switched from an oral estrogen pill to a patch. Her family physician and her gyn are now ok with her either continuing her estrogen or discontinuing as she sees fit. Right now that is not at the top of her list.
Right now her biggest concern is getting off of the keppra that is causing her heart to slow and skip beats. Her neurosurgeon was pretty much a jerk and told her to follow up with another doctor - a neurologist. So, we are playing the bounce around between doctors game. She is also pretty upset that she asked for a copy of her medical record and upon reading it found a lot of incorrect information charted.
I think that once she gets all of this sorted out and gets back to a more normal routine for her, that we can then address any further medical issues. She is pretty healthy and only has a thyroid condition which is kept under control with her synthroid. I think that as long as her bone density scans are coming back normal it is up to her to continue the estrogen or not. It is true that people are living a lot longer than ever before and the quality of that life matters more than the quantity. As long as health remains good, there is no reason to add medications including hormones that would not occur naturally for the rest of life. If there is a valid reason to medicate, then so be it, but taking medication just for the sake of having a medication is not really necessary. As for the risks vs. the benefits, since there is little reason to suspect that cancer or other problems will develop with no family history or signs, then continuing a naturally occurring hormone for protection is moot. There is no "cancer protection" pill or hormone out there. There is no way to say that taking estrogen will guarantee that you will never develop certain conditions. There is no 100% protection.
Taking charge of your own healthcare is the best course of action anyone can take. Ultimately you are responsible for you and you should take care of you and know your own body. Don't wait until problems are out of control to seek help. Knowing your own body and what is normal and what is not is the best way to lead a quality life.
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st. louis, MO