Ask the Nurse

I am 54 years old and just had a total hysterectomy with ovaries removed a month ago. My menopausal symptoms (hot flashes, night sweats) are not bad and I can tolerate them. My doctor has not put me on HRT yet, but I am worried about osteoporosis and I am experiencing some depression, vaginal dryness and dry skin and hair. I will be seeing my doctor soon, and would like to ask for estrogen replacement therapy. My concern is that I have high blood pressure, which is under control by medication. I take plavix as I was diagnosed with TIA 4 years ago (blurred speech, last few seconds; no damage done). Since then I follow a good diet and exercise regularly. My last blood test was excellent. My mom had a mild stroke when she was 74 due to poor diet and she recovered from it. My question is: Is it ok for me to go on estrogen therapy? I am not quite myself. Please help.

It is important you keep your physician appointment to get an evaluation and treatment. You should strongly consider estrogen therapy as women who use estrogen post-hysterectomy live longer, feel better and die from all causes less likely.

Estrogen will relieve:

  • Hot flashes
  • Night sweats
  • Help the vagina
  • Help the bones
  • Help the skin
  • Improve hair health
  • Improve mood

In women under age 60, there is NO increase risk of stroke in women on oral estrogen. After age 65 or with uncontrolled high blood pressure or concerns about clot transdermal, estrogen (via patch, gel or spray) can be used.

The “TIA” you had in past could have been migraine related and you should have a carotid Ultrasound to see if there is any hardening of the arteries of the neck because if you have this you should be on aspirin and a statin/cholesterol-lowering medicine and avoid cardiovascular risks.

Women who have risks for cardiovascular disease and have had a hysterectomy can still take estrogen after their cardiovascular risk factors are controlled. Most all women can use vaginal estrogen for vaginal dryness and pain with intercourse.

All my best,
Speaking of Women’s Health nurse

July 23, 2015 at 10:19am