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Suggest Treatment For Weight Gain And Low Libido Post Progesterone Withdrawal
Hi, my name is Kim. I am 54 years old and I had a partial hysterectomy 9 years ago. 2 years ago, I was feeling exhausted, weight gain, low libdo, not sleeping having hot flashes, night sweats and brain fog, so I went to an anti-aging specialist who put me on HRT that included estrogen and progesterone. Since that time, I have lost 30 pounds, my energy has come back and the other symptoms had improved. I recently went to my OB/GYn and he took me off everything. He told me I didn t need to be on HRT if I was having symptoms and that I shouldn t be taking progesterone since I didn t have a uterus. So I went off of the therapy and now 8 weeks later, all the symptoms have come back. Could you clarify why I shouldn t be on HRT? I am at a loss as to who s advice and treatment I should follow and I don t like having these symptoms again. Thank you
posted on
Tue, 14 Nov 2017
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sun, 5 Aug 2018
Answered on
Tue, 7 Aug 2018
Last reviewed on
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.
First of all we need to know what operation you had for your uterus. Does partial hysterectomy mean that you had the body of the uterus removed and the cervix (neck of the womb) is still there? Most of the symptoms that you were prescribed estrogen and progesterone are common in menopause. Clearly HRT (Hormone replacement therapy) suited you. Progesterone will not be required if the uterus has been removed completely. You could try estrogen replacement therapy alone for three months to see if it keeps away the symptoms of hormone deficiency. I would suggest having ultrasound to establish whether the whole of uterus has been removed with cervix with or without ovaries. It is important to continue HRT under regular follow up with review with gynecologist as the HRT can have their own set of long and short term side effects. Regarding weight gain - you will need to improve your nutrition. The female hormones can cause weight gain. It is important that you pay attention to the protein component of your diet, as weight loss in later years of life may be due to loss of muscle mass. It is the estrogen part of the HRT that helps improve libido, clear brain fog, etc. The progesterone is given to avoid thickening of the lining of the womb under the influence of estrogen alone. It would not be needed if the uterus has been removed completely. This is the reason why the gynecologist you saw said that progesterone is not necessary in your case.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Shinas Hussain
I have reviewed your query and here is my advice.
First of all we need to know what operation you had for your uterus. Does partial hysterectomy mean that you had the body of the uterus removed and the cervix (neck of the womb) is still there? Most of the symptoms that you were prescribed estrogen and progesterone are common in menopause. Clearly HRT (Hormone replacement therapy) suited you. Progesterone will not be required if the uterus has been removed completely. You could try estrogen replacement therapy alone for three months to see if it keeps away the symptoms of hormone deficiency. I would suggest having ultrasound to establish whether the whole of uterus has been removed with cervix with or without ovaries. It is important to continue HRT under regular follow up with review with gynecologist as the HRT can have their own set of long and short term side effects. Regarding weight gain - you will need to improve your nutrition. The female hormones can cause weight gain. It is important that you pay attention to the protein component of your diet, as weight loss in later years of life may be due to loss of muscle mass. It is the estrogen part of the HRT that helps improve libido, clear brain fog, etc. The progesterone is given to avoid thickening of the lining of the womb under the influence of estrogen alone. It would not be needed if the uterus has been removed completely. This is the reason why the gynecologist you saw said that progesterone is not necessary in your case.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Shinas Hussain
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