Hormone replacement after hysterectomy.

Question on Hysterectomy

I had a total hysterectomy six years ago. I am now 34 and just recently decided to stop Premarin. I have been off for about two months. I feel great — I noticed I don’t have bouts with depression as bad as I did on Premarin. My alternative doctor has put me on Pregnenolone powder, 10g a week, and also Progest. I want to know if this is the best way to fight against bone and heart and other diseases. I feel good about not putting Premarin in my body, but I want to make sure I don’t cause any other problems in my body.


Generally I think that premenopausal women with total hysterectomy should have hormone replacement at least until they reach menopausal age. Women’s bodies are designed to have these hormones present until menopause and early hysterectomy is associated with a higher risk of osteoporosis. Of course, there are contraindications to hormone replacement including a history of uterine or breast cancer. Contrary to popular opinion, I feel all women who receive hormone replacement, whether they have a uterus or not, should get both estrogen and progesterone since both are normally produced in the body. Provera is the most popular progestin, but natural Progesterone has fewer side effects. Talk with your doctor about using the more natural alternatives to Premarin and Provera.

If you are absolutely against using hormones, don’t tolerate the more natural ones or have a contraindication to using them, ask your doctor about your risk for osteoporosis. A bone density scan can establish the strength of your bones. If your risk is high you may want to use another medication to help prevent bone loss. Of course, exercise and calcium supplementation are also very important.

Pregnenolone is the precursor hormone for all the steroid hormones including p
rogesterone, estrogen, androstenedione, testosterone, cortisol and aldosterone. It is synthesized in the body from cholesterol. However, since the main production of estrogen and progesterone occurs in the ovaries, it is doubtful whether increasing pregnenalone will significantly increase the levels of either. The Progest may be a good natural progesterone product, but it must be a prescription strength to provide the levels of progesterone needed. And of course, you will still need a natural estrogen product . Talk these issues over with both your regular physician and your alternative doctor.


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