Treatment after endometrosis surgery

Dear Ask The Doctor: Three months ago I done a surgery for removing both ovaries and uterus due to endometriosis cyst and adenomyosis uterus. The doctor said cyst was spread up to urine bladder. She prescribed for calcium tablets.. Now I am feeling severe headache back pain and feeling health-less. Dr also said take hormone tablets after six month and if take now the cyst if any remain may flair. If  I do not take hormone pills immediately diseases like heart problem etc may attack me?  Kindly suggest me what are the symptom arise by lack of hormone and what remedy should I take. I am aged 40 years.

Dear Basila: The removal of ovaries has resulted in a drastic reduction in the amount of sex hormones produced, namely estrogen and progesterone. These are the primary female sex hormones. A lack of these hormones results in several symptoms. Some of the more common symptoms are

• Hot flashes
• Migraine headaches
• Vaginal itching and dryness
• Back and joint pain
• Increased risk of Osteoporosis with time
• Breast tenderness
• Painful sexual intercourse
• Fatigue
• Depression
• Sleep disturbance.

Your doctor has tried to prevent some of these symptoms by prescribing calcium tablets. This will help with back, joint pain and osteoporosis. To prevent the other symptoms would require the use of hormones oestrogen in tablet form. Unfortunately these hormones also promote the growth of endometriosis cyst which explains why your doctor has suggested not taking any hormone replacement until six months after surgery. However, all is not lost. Antidepressants such as fluoxetine are useful for depression symptoms, sleep disturbance and even the treatment of hot flashes. Estrogen creams can be applied if you have vaginal itching and dryness, without the risk of developing more cysts.

Your risk of cardiovascular disease, that is heart disease and stroke increases with the absence of the hormones produced by the ovaries. However, this risk does not increase suddenly but instead gradually over time. Therefore it is best to avoid other habits which may oncrease your risk such as cigarette smoking, a high fat diet, lack of exercise and be sure to control diseases which increase your risk such as high blood pressure and diabetes.