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How To Wean Off The Estradiol With The Least Side Effects?
I had a complete hysterectomy in January 2010 and have been on Estradiol pretty much since. I currently take 1 mg by mouth as I am allergic to patches. I also take calcium/Vit.D as well as other vitamins/supplements. I am now considering bariatric surgery (sometime around July/August) due to my long-term diabetes and the surgeon says I must go off the Estradiol. My concerns include becoming a raving mad woman, hot flashes, vaginal dryness and loss of libido as I am in a sexual relationship. What would be the best way to wean off the Estradiol with the (hopefully) least side effects? Thank you
Wed, 7 Jun 2017
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.
Get another surgeon because this is not generally required for bariatric surgery. Considerations would be increased appetite which is mainly false and increased risk of blood clots which can be ameliorated.
Vaginal estradiol like string is another option without much risk. There will still be the psychological issues to a lesser extent.
Actually, exercise and weight loss increase libido at amounts you will achieve. Exercise and weight loss stop menopausal symptoms BUT it has to be at Olympic levels to be able to do that (doubtful).
So, first, get a second opinion about whether to even stop the drug. It is a theoretical impossibility to be able to get new drugs that will do as well as established treatments (that took some time to find the right one or combination or dosing). Then, the best alternative will be to get something close to the previous.
The results on non-hormonal treatments for post-menopausal symptoms show it is hard to do better than placebo. A therapeutic milieu of taking charge of your health (one way of looking at placebo) has a huge beneficial effect on all the symptoms you mention. Anti-depressants and herbals do not do better. We're talking a 50% reduction of symptoms in most women with placebo; most women feeling mostly okay.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Matt Wachsman
I have reviewed your query and here is my advice.
Get another surgeon because this is not generally required for bariatric surgery. Considerations would be increased appetite which is mainly false and increased risk of blood clots which can be ameliorated.
Vaginal estradiol like string is another option without much risk. There will still be the psychological issues to a lesser extent.
Actually, exercise and weight loss increase libido at amounts you will achieve. Exercise and weight loss stop menopausal symptoms BUT it has to be at Olympic levels to be able to do that (doubtful).
So, first, get a second opinion about whether to even stop the drug. It is a theoretical impossibility to be able to get new drugs that will do as well as established treatments (that took some time to find the right one or combination or dosing). Then, the best alternative will be to get something close to the previous.
The results on non-hormonal treatments for post-menopausal symptoms show it is hard to do better than placebo. A therapeutic milieu of taking charge of your health (one way of looking at placebo) has a huge beneficial effect on all the symptoms you mention. Anti-depressants and herbals do not do better. We're talking a 50% reduction of symptoms in most women with placebo; most women feeling mostly okay.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Matt Wachsman
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