Do I Need Hormone Replacement Therapy?

I’ve recently had a hysterectomy. One ovary was left in place. Is one ovary capable of producing a sufficient amount of hormones, or do I have to go on hormone replacement therapy?

Yes, it’s capable. Whether it will or not and for how long is another matter.

If you’re younger than mid- to late-40s and your estrogen levels decline enough to be of long-term health concern, you’ll go into menopause. Then you will have the hormonal blood levels and possibly symptoms that indicate menopause. Without a uterus, you won’t have the actual end of menstruation that defines menopause. Nor will you have the irregular periods that often tell of its approach.

Reproductive hormones function in a complex way and the truth is, we don’t fully understand the mechanisms of menopause. Even under normal circumstances, no two women experience it in precisely the same way. Your situation may be further influenced by the health condition that prompted the surgery. Lifestyle factors, such as smoking, also play a part in determining when women will go through menopause.

According to the National Institutes of Health, most women with one ovary and no uterus go through natural menopause, as opposed to surgical menopause, which is brought on immediately by the removal of both ovaries. It’s not uncommon for a woman with one ovary to go through menopause a couple of years earlier than the average age of 51. At that point, you can make a decision about hormone replacement therapy, or HRT.

Unless there are medical reasons to the contrary, I don’t see any rush for you to go on estrogen or HRT. Surgical menopause usually happens almost immediately after the operation and the symptoms tend to be much more pronounced than those of natural menopause. So, chances are that you would know if you had gone through surgical menopause.

You might want to wait and see what happens. Don’t depend strictly on symptoms as a gauge, however, because many women don’t experience noticeable menopause symptoms. Talk with your doctor about your concerns and about monitoring your hormone levels to determine whether you’ve entered menopause prematurely.