I am 44 years old woman and underwent hysterectomy. During this operation my both the ovaries have also been removed. The doctor advised me to take 1mg of Oestriol daily after the operation, if I have problems due to hot flushes. My doctor increased the dose of Oestriol to 2 mg as my hot flushes were troubling me and were not in control with 1mg of medicine. I want to know if such high dose of Oestriol will have any side effects, should I continue this dose of Oestriol? Please suggest me some other measures for controlling hot flushes.
Answer (answered by Dr. Neelam Dhamija): After removal of both the ovaries, you are likely to have hot flushes and other menopausal symptoms like vaginal dryness, sleeping problems. Appearance of menopausal symptoms after the ovaries are removed by surgery is called surgical menopause. You will like to know, as to, why do you have such symptoms. This is because ovaries produce female hormones called oestrogen and sudden deficiency of this female hormone due to removal of ovaries by surgery, gives rise to hot flushes and other troublesome menopausal symptoms which are quite severe. So as to keep these symptoms under control, hormone therapy is started if the patient is of young age i.e., if she is less than 48-50 years of age. This is called Hormone Replacement Therapy (HRT). This (HRT) is a method of counteracting the deficiency of oestrogen hormone caused due to surgery or after natural menopause. After the uterus and ovaries have been removed surgically, you will be given oestrogen only. HRT can be started, when the menopausal symptoms are to the extent, that they are unbearable and cannot be controlled with other methods. But hormone replacement therapy has few side effects, some of the side effects of HRT are nausea, headache, breast pain, increased risk of deep vein thrombosis (risk of blood clots in the veins) of legs, increased risk of pulmonary embolism (risk of blood clots in the lungs) and increased risk of heart attack in females with heart disease. Yoga, regular exercise, proper diet and some life style changes can help you to keep your weight and menopausal symptoms under control. Eat plenty of soya proteins and pulses, drink plenty of water and start Meditation. This will help in reducing hot flushes and other menopausal symptoms. If by these measures and few life style changes you find that your menopausal symptoms are not bothering you, then you can stop taking oestriol tab, but if required you can continue to take the medicine in the same dose or increase it as per your requirement as per your doctor’s advice.