Hello. I understand from your website that even after surgical menopause (i.e. ovaries removed) estrogen can still be generated from other sources (endo lesions, fat cells, diet, etc.) For women that have undergone expert excision, had their ovaries removed and are NOT doing any estrogen HRT, do you advise taking a small dose of P (ex. the mini pill 0.35) or something else to help modulate any estrogen?
Endometriosis
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December 23, 2024
Great question!
Short answer: no, any residual endometriosis will not be producing enough estrogen to make a difference.
Long answer:
If you still have a uterus and are on HRT, you need estrogen to treat menopausal synptoms, and progesterone to protect the lining of the uterus. If you don’t have a uterus, then most OB/GYNs would tell you you can be on estrogen alone, but in the setting of significant endometriosis, most specialists would tell you you still need estrogen and progesterone (expert level opinion).
If you had expert level excision, and they took out both ovaries, I would assume you had significant endometriosis with both ovaries involved (normal ovaries should be left in place), and they hopefully they also removed your uterus (due to high risk of adenomyosis, and evidence of increased innervation of the uterus and cervix). If this is your situation, and you were premenopausal before surgery, I would recommend you be on both a estrogen patch, and oral progesterone until about age 50, which is the average age of menopause, and potentially longer, based on symptoms.