After a hysterectomy and/or bilateral ovariectomy, many changes will occur in a woman's body. She may no longer have to be concerned with ovarian or uterine cysts, dysfunctional uterine bleeding, fibroids, endometriosis, or ovarian or uterine cancer. Without a menstrual cycle, many women experience an increase in energy.

However, there are other changes in your body caused by hormonal decline. These include hot flashes and lack of libido or sex drive, loss of bone mass, an increased risk for cardiovascular disease, deterioration of the urinary and genital tissues, depression, and general acceleration of the aging process.

For women who enter into menopause naturally deficiencies in estrogen and progesterone occur gradually. For women who undergo a hysterectomy and/or bilateral ovariectomy the effect of estrogen and progesterone deficiency is more profound. Women who retain one or both ovaries at the time of their hysterectomy may also face the loss of ovarian function and the onset of menopause.

For both groups, low-dose individualized hormone therapy (HT) can have life-enhancing benefits. Many women on low-dose HT experience improved bone and vaginal health. One devastating issue with hormonal imbalance is lack of sexual energy before and after menopause and hysterectomy. Analyzing hormone levels through testing can help both healthcare providers and patients determine whether low-dose hormone therapy would be a means to restoring a sense of sexual desire.

Natural Hormone Therapy

Low-dose natural hormone therapy combined with hormone level testing and ongoing case management such as Women's Health America offers through its innovative Restore Program provides an exciting therapeutic approach for healthcare providers and patients. Saliva testing, done through a laboratory, can provide your healthcare provider with accurate readings of the ''free'' hormone levels in your body. Working with Women's Health America, Inc. can provide you and your healthcare provider with over 25 years of experience in low-dose individualized natural hormone therapy and interpretation of saliva testing.

Low-dose individualized hormone therapy can make an important contribution to the quality, the energy, and the strength of a woman's physical and emotional health after hysterectomy surgery. As always, it is important to discuss treatment goals with your healthcare provider to determine what is best for you.

While there is no set combination or dosage of hormones that works for every woman, a low-dose natural hormone therapy regimen post-hysterectomy might commonly include a combination of:

• Low-dose estrogen in a capsule, cream or patch form.
• Progesterone in an extended release tablet, capsule or cream form
• And if needed, an androgen such as testosterone in capsule or cream form.

Estrogen is often used as a general term, but it is actually a category of hormones. There are many types of estrogen our bodies produce. The following three estrogens are produced in major amounts:

• Estradiol (E2) is the most potent form of estrogen, and the one produced in the largest amounts by a woman's ovaries before menopause. Estradiol levels fall after menopause.
• Estrone (E1) is the predominant estrogen in a woman's body after menopause. When ovarian function declines, the fat cells in a woman's body take over the role of synthesizing estrone; therefore women do not typically need to replace estrone.
• Estriol (E3) is known as the ''weak'' or ''forgotten'' estrogen. Produced in large amounts by the placenta during pregnancy.

Progesterone is a naturally occuring hormone that literally means ''for gestation'' - it is the hormone of pregnancy. Produced by the ovaries, progesterone prepares the lining of the uterus for the fertilized ovum and maintains pregnancy. Specifically, progesterone converts the womb lining into a soft spongy bed in order to enhance implantation of a fertilized egg. If implantation does not occur, progesterone levels fall and menstruation begins. Progesterone also enhances mood, creates a calming effect, helps with blood sugar levels and thyroid function.

Many women feel testosterone is solely a male hormone. In fact, both women and men make and need testosterone. Testosterone production declines with age. While this hormone is produced in lower amounts in women, it still serves important functions in the female body. Testosterone accelerates tissue growth and stimulates blood flow. In women, testosterone is produced mainly in the ovaries even after menopause with smaller amounts made in the adrenal glands.

In choosing the form of natural hormone therapy that is best for you, there are several factors to consider. Both low-dose customized and conventional hormone therapy are available in many dosage forms including pills, patches and creams, and determining which form is most appropriate varies based on an individual's health profile, symptoms and family history. Women's Health America and Madison Pharmacy Associates invites you and your healthcare provider to contact our registered pharmacists and Restore Clincial Specialists at 800.558.7046 to discuss your hormonal profile and determine your individualized plan of care.

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Hysterectomy Before and After