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  Testosterone and Oestrogen following Hysterectomy and Bilateral Oophorectomy

Hormone therapy is required following hysterectomy and oophorectomy and it is usual for women to have low dose oestrogens prescribed for a few months to ten years. This may be adequate to prevent vasomotor symptoms and often adequate to protect the skeleton but these women have lost their ovarian androgens and frequently suffer from the female androgen deficiency syndrome (FADS). This is characterised by loss of energy, loss of libido, loss of self-confidence, depression, and an increase in headaches.

Many studies, particularly Sherwin and Gelfand, have shown the importance of the addition of testosterone. The long-term study of 200 such patients by Khastgir and Studd have shown the long-term benefits of sexuality, depression, vasomotor symptoms, general health scores, and anxiety when compared with pre-operative scores. Such patients having oestradiol and testosterone have a continuation rate of 97% at five years and 88% at 10 years indicating the health benefits experienced by the patients without the side-effects of bleeding and cyclical progestogen. Thus HRT after hysterectomy and oophorectomy should be straight-forward and, with the addition of testosterone, should produce a long-lasting improvement in quality of life.

Related Articles:

. Sherwin,BB., Gelfand, MM. (1985) Differential symptom response to parenteral estrogen and/or androgen administration in the surgical menopause. Am.J.Obstet.Gynecol. 151(2), 153-160

. Khastgir, G., Studd, JWW., Catalan, J (1999) Psychological outcome of hysterectomy. Br.J.Obstet.Gynaecol. 106 (7) 620-2

. Khastgir, G, Studd J. (2000) Patients' outlook, experience and satisfaction with hysterectomy, bilateral oophorectomy, and subsequent continuation of hormone replacement therapy. Am.J.Obstet.Gynecol. 183 (6) 1427-33


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