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Woman wonders about therapy after radical hysterectomy

January 26, 2011

Question: I had a radical hysterectomy when I was 40 years old because of fibroids and ovarian cysts. I have been on Estrace for the past five years and was told I didn’t need progesterone since I had my uterus removed. I hear mixed opinions on this issue. Would you give me your naturopathic perspective?

Answer: At 40 years of age, the removal of your ovaries as well as your uterus would have put you into instant menopause.

Estrogen replacement therapy alone in women with their uterus intact will result in an increased risk of endometrial cancer. So progestins or progesterone are given to decrease the increased risk of cancerous growths caused by estrogen. If your uterus has been removed this risk is obviously taken away.

However, you still have hormone receptors for progesterone (not progestins) in your brain, breast and bone tissue. In your brain, progesterone binds GABA receptors to give you a calm feeling and help with sleep. Progesterone is needed for hormone balance in the breast tissue. Progesterone stimulates your bone building cells called osteoblasts. Progesterone and thyroid hormones have a synergistic relationship.

Progestin is chemically different than your own body’s progesterone and the only action it really has in common with the real McCoy is its action on your uterus. Progestins cannot convert into other hormones as progesterone can nor do they share any of its benefits and, in fact, can cause a whole host of negative side effects, some life-threatening. The incidence of many conditions increase such as anxiety, insomnia, fibrocystic breast disease, breast cancer, ovarian cysts, endometriosis, uterine fibroids and hypothyroidism increase when estrogen is too dominant as compared to progesterone levels.

So while Estrace is estradiol, identical to the kind your body makes and far superior to Premarin, I would prefer not to see you on it without also using progesterone cream or prometrium as a second choice, if you are indeed interested in the needs of your brain, breasts, bones and thyroid. Your entire reproductive life, estrogen and progesterone have a balanced dance. Women’s bodies are meant to have estrogen dominate progesterone about 25 per cent of the time. In your current situation it is dominating 100 per cent of the time.

Question: I have been taking the Depo shot for birth control and haven’t felt well on it. What do you think of it?

Answer: I am not a fan of birth control medications in general as they disrupt your entire endocrine system. The Depo injection, which suppresses the menstrual cycle continuously for three months, is in a league of horrid all by itself.

Once you are on it you have no choice but to just wait it out until it wears off, and some of the negative effects extend beyond its presence in your body. There is an ongoing lawsuit for women who experienced bone loss while on Depo. It is used to control heavy bleeding and/or for contraception.

Ironically, if you end up with any of its many side effects such as depression, acne, unwanted hair growth, weight gain, decreased libido or stroke you may not be in the mood for intimacy.

Kali Simmonds, ND is a doctor of naturopathic medicine who practices in Charlottetown. The information provided is not intended to diagnose or substitute the advice of your healthcare professional. Please consult with your healthcare provider before making any changes. She welcomes questions for this column, which is published every second Tuesday in The Guardian.

 She can be reached by mail at 34 Queen St., Charlottetown, C1A 4A3 or by email at kali@drkalisimmonds.com.

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