Each and every menopausal woman has hormonal requirements, which may be two to four times higher than other women. Thin women tend to have higher needs because they tend to have very little production of estrogen from their fatty tissue. Furthermore, it is the thin, fine-boned menopausal woman who has a greater risk of osteoporosis and may need to take a greater amount of estrogen to prevent this.
Modern-day hormone replacement therapy has become so safe and effective in the prevention of many problems that every menopausal woman should be aware of its benefits. As long as no medical risk is identified, this form of treatment is an option about which you are entitled to make your own informed decision. However, it is true that menopausal women differ in their for hormone replacement. Some women say that they can't live without it - they feel ancient, decrepit and lifeless without estrogen in their bodies - while others hardly seem to notice when their ovaries finally stop producing estrogen. There are also some menopausal and postmenopausal women who actually feel worse on hormone replacement, no matter what different forms and dosages are tried. Menopausal women should not be made to feel they must take hormone replacement or else terrible things will happen to them. Rather, they should be given the information they need to make an informed decision. The benefits of hormone replacement therapy vary for different individuals.
More than half of American women have a hysterectomy by the age of sixty-five. Hormone replacement therapy is simpler for women who have had a hysterectomy. In these cases, most experts agree that progesterone tablets are not necessary. An exemption here is the woman who has a past history of endometriosis, a disease in which cells from the endometrium (the lining of the uterus) are found growing outside the uterus and grows instead in the abdominal cavity. Endometriosis can be reactivated by estrogen replacement unless sufficient progesterone is taken to balance the estrogen therapy. Women with a past history of endometriosis should take low-dose progesterone tablet continually along with estrogen. If a woman has no past history of endometriosis, she can take estrogen by itself in the form of estrogen tablets, patches, or injections.
If the ovaries are spared during hysterectomy (surgical removal of the uterus) in a woman not yet approaching menopause, they will usually function normally for many years after the operation. On the other hand, menopause may arrive two or three years earlier than it would have otherwise. It is not uncommon for a woman to find that after hysterectomy, her ovaries do not work as well as they did before. She may complain of symptoms of estrogen deficiency. This is because the removal of the uterus causes a reduction in the blood supply to the ovaries and thus the ovaries no longer secrete adequate amounts of sex hormones. If this happens, a woman can accurately be called premenopausal.
If the ovaries are removed during hysterectomy, then the arrival of menopause is abrupt and often severe symptoms of estrogen deficiency occur. This is particularly evident in younger women. Thankfully, estrogen replacement in the form of tablets, patches, can stop unpleasant menopausal symptoms.
Michael Russell Your Independent guide to Menopause