3 Surgery Details to Bring to an HRT Discussion

If a past operation has made your hormone history hard to explain, bring the surgery record to the appointment if you have it. You do not need to remember every term before asking what the record means for today’s symptoms.

Three history details to clarify

1. Were the ovaries removed? Removal of both ovaries before natural menopause causes immediate surgical menopause. Hysterectomy alone does not automatically stop ovarian hormone production, although menopause can occur earlier. Ask the clinician to confirm your operation.¹
2. Was it a total or subtotal hysterectomy? After a subtotal operation, some uterine lining may remain near the cervix. That can affect whether progestogen is needed with estrogen. Ask how your record informs the prescription.¹
3. Was severe endometriosis part of the history? Some people need added progestogen after hysterectomy because of severe endometriosis. Bring this history into the HRT discussion.¹

Explain what has changed now

Without periods after hysterectomy, recognizing the menopause transition can be harder. If you are worried, discuss the symptoms and your age with a clinician. Blood testing is not always reliable during the transition.¹

Write the changes you want help with in your own words. Include their timing and the parts of the day they interrupt. Put your medication list and any surgery information beside that account.

Ask the prescriber to explain why the proposed hormones fit your history, what the review will cover and whom to contact if a problem develops. Keep the explanation with the medication instructions.

If the surgery record is unavailable, ask the healthcare team how to obtain it. The next step can include confirming the operation before resolving the prescribing question.

My Body Changed. Now What? includes a ChangeMap and a VisitBrief. Use them to organize your symptoms, history and hormone questions for the appointment. See the book.