Hello,

Thanks for writing to us.

It is good to hear that you are well recovered after total hysterectomy (TAH). You have also done overall check up to your doctor.

Above clinical feature is mostly suggestive of postmenopausal symptoms. It is more common immediately after undergoing XXXXXXX (surgical menopause). These are known as vasomotor symptoms. These include hot flushes, headache, insomnia, night sweating, palpitation, abdominal bloating, tiredness etc.

Underlying causes are low estrogen hormone and high FSH level. Mental stress or depression is also an important cause. However, exact cause of vasomotor symptoms is absolutely unknown. It is thought that low estrogen level affects hypothalamus and dilates blood vessels with affecting sympathetic nervous system. It is seen in 80% women after menopause.

TREATMENT: HRT) is the gold standard treatment for post menopausal women to get symptomatic relief.

I prefer low dose conjugated estrogen therapy to treat my patients. It is given maximally 5 years continuously if there is no associated risks like breast cancer/ venous thrombosis/ heart disease/ obesity/ hypertension/ diabetes etc. It is recommended to perform health check up yearly basis for patient on HRT. Kindly, procure a complete prescription from your doctor.

Some other drugs like tibolone/ phytoestrogen (plant estrogen)/ low dose paroxetine are very much useful as adjunct treatment option.

In addition, you need to take calcium supplements, take balanced diet, sound sleep and maintain overall healthy life style.

Hope, above information is quite helpful for understanding. Feel free to ask any other query.

Wish your good health and take care yourself.

Regards,
Dr Soumen

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Hello,

Thanks for follow up queries. Followings are my comments:

1) Yes, you can take it easy if you feel better slightly. Otherwise, you need to take medication after consultation with your doctor.

2) You went through menopause with ovary intact before this operation and you got support from ovarian hormone. Now, your ovaries are removed by XXXXXXX So, there is low level of estrogen hormone in your body which causes moderate to severe menopausal symptoms in comparison to earlier menopause. Here, HRT is advisable to restore body hormone.

3) You can undergo some blood work like FSH level, thyroid hormone, estradiol and blood sugar. It helps to rule out other pathology. You can consult with your treating doctor regarding this for proper guidance.

4) You can take phytoestrogen like isoflavone (plant based estrogen) instead of steroidal conjugated estrogen. It is very much effective to reduce menopausal symptoms. Low dose progesterone can be given. You can take soy, beans, peas, lentils, whole grains, rye, millet etc which contain plant estrogen.

Hope, I have answered your all queries. If you do not have other queries, you can close the discussion.

Be well and stay healthy. Good luck.

Regards,
Dr Soumen

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