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32 and early menopausal
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sugarbooger4182 posted:
I had a full hysterectomy in 2006, and have been taking Estradiol ever since. I had three ovaries so my hormone levels were higher than normal to begin with. I was on up to 3 mg and now am down to 1 mg, I have awful hot flashes, I do keep my room very cool at night, take supplements, etc. I am worried what will happen with my mood if i stop the hormone therapy all together. When I was first put on hormones the dosage was off and I had a nervous breakdown. Are there any suggestions of what to expect once I stop taking them? Or maybe advice of any kind? I am really scared of feeling so crazy again. Any help would b greatly appreciated.
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Anon_6061 responded:
I've heard of having more than two ovaries. I assume all three were removed? Any certain reason why you've reduced your dosage and plan to taper off completely?

Ovary removal increases risk for many health problems as well as a reduced quality of life. The ovaries of intact women produce hormones into their 80's so I personally plan to take estrogen for the rest of my life.

I know what you mean about your hysterectomy causing a "nervous breakdown." I became suicidal (not to mention all the other awful problems). I NEVER want to feel that way again. I'm definitely nowhere near the person I was before my organs were removed but I'm WAY better than I was the first couple of years post-op.

2mg of (oral) estradiol would be a typical dose for a woman without ovaries. And I know some women who need more than that.
 
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Mary Jane Minkin, MD responded:
Dear Sugarbooger4182,
Some women metabolize hormones differently than others. And indeed the standard dose of estrogen in Europe for many years was 2 mg of estradiol. It is easy to measure your blood estrogen (estradiol) level; just a tube of blood-and you could see what your blood level is on different doses. One other option you could consider is transdermal estrogen, With patches there is less variation in the metabolism; and I'll bet with a 0.1 transdermal patch you'd be comfortable (now I certainly have had an occasional patient who has indeed needed to wear two patches at a time, but that's unusual.) So don't be afraid to discuss your symptoms with your health care provider; discuss whether a level would be helpful to manage things, and consider the possibility of a patch.
Good luck,
Mary Jane