Question 64
Dear Doctor N:
I was wondering if you could please give me some additional information. My mother will be 50 this year, and had a full hysterectomy 2.5 years ago. Prior to the surgery, no hormone levels were acquired, so she is now in the middle of a guessing game with her doctor. She is still suffering from hotflashes and mood swings. Every female over the age of 35 is giving advice, but that's becoming a problem as well. She is now beginning to wonder about her testosterone level as well as estrogen. She is concerned about gaining weight and becoming "thick" (from increased testosterone). It seems that since the sx, she as not been able to loose any weight, and has also had repeated UTI. Could you give me some information of any side effects of testosterone, and may what are normal reference ranges for hormone replacement patients( estrogen: testosterone ratio).
Thank you very much.
Reply:
I am sorry that your mother is having so much difficulty. Actually, the pre surgical levels are not likely a relevant issue. The real issue is getting the specific hormones required into the blood stream in a manner that does not alter their chemical structure and/or produce substances that interfere with their intended affect.
The bottom line is that many women who have had their ovaries removed do not respond well to the more commonly use HRT regimens. Almost all women who have had their ovaries removed are testosterone deficient as the ovaries are the major source of this hormone.
I would recommend that you read the sections of the web site, Hysterectomy Overview, Menopausal Symptoms, Methods of HRT, Menopause & Weight Gain and any of the Ask Dr N questions that seem to apply, as this will provide considerable insight for you as they address the issues of your concern. You can access these sections from their links on the Main Menu of the home page. www.drn4u.com
The normal pre menopausal range of serum testosterone is 35-95 ng depending on the individual test used, but the effectiveness of replacement is often more closely related to the route of administration of the hormone than the actual blood level.
The most productive strategy may be for your mother to find a physician who specializes in the treatment of post menopausal women. If you want, you can email the area that she lives in to see if I know of anyone in her area. If you have questions after reading of the sections, let me know.
Oh ... and you're a good daughter.
Dr N