HRT After Hysterectomy for Endometriosis: Side Effects and Osteoporosis Concerns

Question
Dear SIr,

Recently my wife underwent hysterectomy due to endometriosis( 3 months back). The doctors wanted to put her on HRT but we declined because of the side effects - cancer for one.

She seem to take it well except for occasional hot flushes ( about 2-3 times per night, she is not very bothered about those that come during the day)and short temper (She is a carm person but now snaps accasionally).

Now we are concerned about osteoperosis. She is taking more milk and calcium tablets.

Due you think we are dong is enough? Is there anything else?

Please advice.  

Answer
If your wife is over 50 years of age, she should have a bone density study (using a DEXA machine). That will show the status of her bones. If she shows evidence of osteopenia (Low bone density) or osteoporosis (very low bone density) she should go on medication for it (Fosamax or Actonel). By the way, HRT does not cause cancer. The study showed that in women taking both Estrogen and progesterone (Prempro) there were 6 more women (out of 10,000 women) who developed breast cancer.  However, in the study of Estrogen replacement alone (without progesterone) there was no increase in risk of breast cancer at all.  In the last few months, 25% of the women who had stopped using estrogen/progesterone (becaue were worried about Cancer) went back on HRT.  The current data shows a beneficial effect of HRT.  However, we now do know that HRT does not protect a woman against heart disease. In women who have had hysterectomy, no progesterone is needed in HRT. Only estrogen (which also protects against bone loss).