I had a hysterectomy in 1992. Would I be considered “post menopause,” or does the fact that I will not go through natural menopause mean that articles about menopause don’t apply to me? Also, at what point, if ever, do you stop taking estrogen?
—P. Reddick, Florida
Gladstar responds: Just because a woman has had a hysterectomy doesn’t mean that she will not have the opportunity to experience menopause, a natural and important cycle for women.
When the reproductive organs are removed, the remainder of the body/ mind/spirit re-sponds and in some manner takes over for the missing parts. Though there are certainly women who need to take estrogen following a hysterectomy, there are countless others who have cut back or eliminated the need for synthetic hormones by using herbs and incorporating dietary changes to support their systems.
My suggestion to women who have had hysterectomies is to relate to their bodies as if all the parts were there—to envision the rich landscape of their beings as whole and complete and to treat them as such. Follow the suggestions for menopause outlined in herb books or, better yet, see a holistic practitioner who can customize a program for you. Everyone will not necessarily respond to natural therapies in the same way, and not everyone responds to synthetic forms of estrogen. We must continuously educate ourselves and then listen and respond to the inherent wisdom of our bodies.
Stansbury responds: You don’t say your age and whether it’s time for natural menopause, or whether your hysterectomy included removal of the ovaries. Regardless, menopause still applies to you. Even if you’ve had a hysterectomy, the menopausal transition affects the skeletal, cardiovascular, mental/ emotional and urinary systems.
Hormone replacement therapy (HRT) is thought to help protect you from all these ailments, though it’s not the entire solution for heart, bone or emotional health. The issue of estrogen replacement therapy is controversial. There are many types of estrogen on the market—some synthetic, some natural, some are of estradiol only and some are a combination of all the body’s estrogens. Although the effects are weaker, herbs may sometimes be used instead of pharmaceuticals for some individuals.
With my patients, we base our discussion around risk factors for heart disease, osteoporosis, breast cancer, and uterine cancer, plus tolerance of hormonal medications, and so on. There are no black-and-white answers. Someone with a strong history of poor estrogen metabolism—such as uterine fibroids, ovarian cysts, endometriosis, a personal or family history of breast cancer, or intolerance of birth control pills or other estrogens in the past may be better off without HRT. Someone at high risk for heart disease or osteoporosis may be better off using hormones. I suggest you discuss your options with a knowledgeable practitioner who is aware of the newer types of natural estrogens and progesterone medications now available.
Rosemary Gladstar, author of Herbal Healing for Women (Simon & Schuster, 1993) and several other books on herbalism, runs Sage Mountain Retreat Center and Native Plant Preserve in East Barre, Vermont. Her experience includes more than twenty years in the herbal community as a healer, teacher, visionary and organizer of herbal events.
Jill Stansbury has been a naturopathic physician for more than ten years, with a private practice in Battleground, Washington. She is the chair of the Botanical Medicine Department at the National College of Naturopathic Medicine in Portland, Oregon, and the author of many books, including Herbs for Health and Healing (Publication International, 1997).
The information offered in “Q & A” is not intended to be a substitute for advice from your health-care provider.