The need to replacement your missing hormones

I have just had a complete hysterectomy and was placed on ERT - do I need progesterone as well?

Evidence suggests, yes. Estrogen, without progesterone to inhibit proliferation of cells, is a setup for many reproductive cancers, whether you have a uterus or not.

When you consider that progesterone is a precursor of other hormones such as estrone, estriol, estradiol, testosterone, and all the important adrenal cortical hormones, you begin to understand why healthy progesterone levels are vital to achieve and sustained hormone balance following a hysterectomy.

Since my hysterectomy I?ve noticed that my vagina is always dry, and my vaginal lips have shrunk. I’ve also noticed a reduced sexual desire and inability to have deep, satisfying orgasms?

This is a common occurrence and complaint amongst women that have experienced a hysterectomy. The removal of the uterus may bring about, for some women, an inability to experience the deep contractual uterine orgasms that they may have once experienced, and their orgasmic pleasure may be less intense.

Progesterone will, in many cases, help reestablish and normalise vaginal secretions and restore normal pH levels, and often does bring about increased lubrication.

Deficiencies in the sex hormones estrogen and testosterone, however, that have a significant role to play in the changes in the structure of the vaginal wall and the outer vaginal lips can create shrinkage, tightness and pain on intercourse. So it’s advisable to use estriol vaginal cream in conjunction with progesterone to help prevent atrophy of the vaginal walls.

Additional supplementation of minute amounts of testosterone topically applied to the clitoris, and estriol inserted into the vagina 2-3 times weekly will restore lubrication and tissue integrity. The result is a more comfortable sexual intercourse and longer, satisfying orgasms.

Women also couple this with the use of pH lubricating cream formulas especially designed to balance and ‘plump up’ cells providing a twenty-four hour lubrication coverage.

Estrogen can also restore and improve blood flow circulation to the clitoris and vagina thereby restoring natural lubrication and less painful intercourse. If the vagina has shrunk and it is too small, it needs to be massaged and gently stretched using estrogen cream regularly.

I’m suffering bladder problems. Is this connected with my hysterectomy?

Women often experience bladder problems in conjunction with a hysterectomy and/or menopause.

Conditions include stress incontinence, exposure of their urethra, a little bit of agitation or irritation around the urethra, and possibly tender bladder.

They frequently complain of an urge to pass urine or difficulty in holding their urine during sudden muscle contractions such as sneezing or coughing, known as stress incontinence. This can be brought about due to the fact that hysterectomy often disrupts the hormone production and creates an early menopause.

With the use of natural hormone therapy (regular application of estriol vaginal cream and topical progesterone), diet, pelvic floor exercise, plenty of fluids, meticulous hygiene, the use of good lubrication and the restoration and balancing of their hormones and nutritional status, the bladder will, in time, respond and improve in function.

Thrush seems to partner bladder problems and vaginal changes as a result of hormone imbalance, often in conjunction with extreme stress and a diet high in sugar.

Progesterone has been reported to have a significant bearing in helping to correct women?s thrush and Candida problems, and we believe it?s because it helps to regulate the blood sugar. It also helps to restore hormone balance and perhaps stimulate more natural estrogens which will help protect and lubricate the vagina.

Progesterone is also known to be antibacterial in that is helps to improve a woman’s immune system by increasing the immunity globulin factor which helps protect against dangerous germs and bugs entering the body and targeting organs that could, in turn, create infection and disease.

What we are saying here is that it’s all interrelated. Vaginal and bladder hygiene awareness and nutritional support is of utmost importance in women?s health but perhaps not often spoken about much less incorporated in our education.

Women report being advised to stop progesterone at the first sign of bladder sensivities, infections or even thrush. These conditions are known side effects of synthetic progestogens. They have absolutely nothing to do with progesterone. In fact, progesterone, according to our women, many of whom have been chronic sufferers of thrush and cystisitis, has helped overcome such problems after 12 months use. But don’t ever assume your bladder problems are necessarily linked to hormone imbalance. Seek medical advice.

What changes can a woman expect to notice after a hysterectomy?

• For women already in menopause, ovarian testosterone and ovarian estrogen are decreased.
• For pre-menopausal ladies, ovarian testosterone, ovarian estrogen and ovarian progesterone are decreased.
• Hot flashes and dry vagina can come with decreased estrogen.
• Bladder instability, bone loss and osteoporosis are also related to decreased estrogen.
• High estrogen can cause breast tenderness and water retention.
• Energy, concentration, and sexuality may require testosterone.
• DHEA or progesterone may also be needed.
• The plan after surgery is to try to produce a general feeling of being balanced.
• Emotions and mood are influenced by hormones and stress.
• These are most commonly secondary problems and can be the cause of the most distress.

The need to replacement your missing hormones

Estrogen

The ovaries produce the bulk of the estrogens during the years leading up to the menopause and substantially less post-menopause.
A woman will continue to produce some estrogen via her body after after menopause. Unless, of course, she’s overweight, in which case the more she weighs, the higher her levels of a form of estrogen called estradiol.

Additionally, she will be exposed to (phyto) estrogens via her diet, and foreign (xeno) estrogens via the environment in which she lives, to a greater or lesser degree, depending on her efforts to reduce explosure to powerful endocrine disruptors.

Estrogen deficiency is indicated when a woman experiences hot flashes and vaginal dryness. However, because progesterone is a biochemical precursor to estrogen, it alone is often sufficient to restore estrogen levels to normal and eliminate these symptoms.

If three months trial of progesterone plus proper diet and supplements of magnesium and B6 do not relieve hot flashes, the low-dose natural estrogen many be helpful.

Please note, estrogen is NOT recommended in those women with a history of breast or uterine cancer, obesity, diabetes, or a history of clotting or vascular disorders.

Progesterone

Progesterone is produced at ovulation during your reproductive years.

Progesterone ceases to be produced by the ovaries when the ovaries are removed, or when ovulation winds down naturally at menopause. Worth mentioning here is the fact many women are surprised to learn that ovulation might not occur every month despite the presence of a period (anovulatory cycles), and this can happen years before they reach menopause.

Bioidentical progesterone supplementation is the only means by which a woman can top up her progesterone levels. Evidence suggests humans lack the enzyme in the body than can convert a raw substance in the plant kingdom [such as diosgenin] into a human hormone once it enters the body.

Progesterone instructs a cell to mature and die - (apoptosis) - which is an opposing action to estrogen’s proliferative effect on a cell. A example of apoptosis is the sloughing off of the inner lining of the uterus (the endometrium) at the start of menstruation.

Testosterone

Testosterone in women is predominately produced by the ovaries. It is produced on a continual basis and levels rise slightly around the time of ovulation. With a decline in ovarian function testosterone production similarly will decline.

Women produce testosterone in their ovaries and adrenal glands and are believed to require sufficient levels of the hormone for proper sexual functioning. About half of a woman’s testosterone comes from the ovaries, and as a result women whose ovaries are removed before menopause lose about half their natural testosterone, along with 80 percent of their natural estrogens.

Although testosterone is generally considered “the male hormone,” it is also an important hormone for women. Testosterone is vital in the preservation of bone, for its positive effect on libido and maintenance of energy levels.

Testosterone is recommended for use when ovarian function declines and especially in young women who have had surgical removal of the ovaries.

“We know that women who have gone through menopause after surgical removal of their ovaries have decreased testosterone levels,” says lead author of the New England Journal of Medicine (NEJM) study, Dr Jan Shifren, of the Massachusetts General Hospital.

Length of Treatment

Homo sapiens suddenly emerged some 150,000 years ago. Natural selection adapted woman to this unique environment. However, there is little, if any, adaptive evolutionary preparation for menopause. Even though it is normal to have a menopause due to the failure of the ovaries if one lives that long, humans are the only species that lives much past reproduction.

This longevity is comparatively new and comes from our great mental powers that have allowed us to evade the usual things that carry off aging individuals: hemorrhage, infection, birth accidents, and natural predators.

Half of our lives happens after reproduction is over, and we have no evolutionary adaptation for this. Women who go through menopause at 45?55 years of age now live to be 85 or 90 years old.

Based on these life expectancy trends, women face the prospect of spending the last one-third to one-half of their lives in a state of hormonal imbalance. The quality and quantity of life for these women will be determined by how well they (and their doctors) manage hormone replacement.