Interactive FAQs Endometriosis Question: I had a hysterectomy and removal of ovaries last November. I started taking Premarin 2 months ago with great success. I want to know how long I should continue. I would also like to know what the success rate women have had with hysterectomies in ridding them of endometriosis problems and what I should expect or anticipate in the years to come. Thank you. Jocelyn H. Pennsylvania Answer: The use of hormone replacement therapy (HRT) is particularly important in young women who have undergone hysterectomy and removal of the ovaries. The precipitous loss of estrogen following surgery greatly increases the side effects associated with estrogen deprivation. These side effects include: hot flashes, sleep difficulties, memory problems and moodiness. Estrogen deprivation is also associated with bone calcium loss (osteoporosis) which can increase the risk of spine and hip fractures. Estrogen is also cardio-protective lowering the lifetime risk of heart disease in most patients. While the use of estrogen may slightly increase the risk of breast cancer occurring at an early age for those women with a strong family history, studies have repeatedly shown that cure rates are dramatically improved if women were taking estrogen when a cancer was found. As such, I don't believe there is any reason to stop after so many years or at a given age unless your physician makes that recommendation. But, I am concerned about the use of estrogen replacement without progesterone for women who have endometriosis. Initially hormone replacement regimens included only estrogen. Unfortunately, we learned that that approach increased the risk of uterine (endometrial) cancer for many women. The addition of progesterone corrected that problem and even lowered the risk of uterine cancer compared to women taking no hormone replacement therapy. Physicians understood that if the uterus was absent, there was no need to replace progesterone to prevent cancer in an organ no longer present. My experience has been that endometriosis may recur if incompletely excised at hysterectomy, or if estrogen only hormone replacement protocols are used. As such, for women who have undergone hysterectomy and removal of the ovaries for endometriosis, I find that HRT protocols that include a daily combination of estrogen and progesterone give the best chance of avoiding future recurrence of endometriosis symptoms. Dr. Perloe FAQ archives: IVF PCOS Clomiphene Ovulation Ovulation Induction Injections Age Related Infertility Endometriosis Donor Egg Donor Sperm Male Factor Infertility Fallopian Tube Reanastomosis Tubal Infertility Unexplained Infertility Endometrial Factor Miscellaneous Return to the IVF Homepage This page, and all contents, are Copyright © 2003 by IVF.com, Atlanta, GA, USA.