Very interesting. I am on HRT and have had a hysterectomy with both ovaries removed. Recently having issues of excess breast tissue growth. Some of this article sounds familiar to what I’ve been going through and praying for an answer. This article mostly addresses those who still have menstrual cycles. But I think things got worse when my gall bladder was removed. Would love more information (or be pointed to where I can find information) about after total hysterectomy and HRT. Is it still important for progesterone to work with estrogen even though no uterus? I’ve always felt better with HRT, but with recent problems wondering about going off it. I find it so confusing and feel like I don’t really get the information I need from any doctor I’ve seen.
You're connecting the right dots. Yes, progesterone matters even without a uterus. The mainstream idea that it's only needed to protect the endometrium is one of the biggest oversights in HRT prescribing. Progesterone opposes estrogen at the tissue level everywhere: breasts, brain, bone, liver. Estrogen-only HRT after hysterectomy means unopposed estrogen in every tissue. Excess breast tissue growth is a classic sign of exactly that.
The gallbladder removal compounds it. Bile is how your body excretes estrogen. Without a gallbladder, that clearance pathway is impaired. So estrogen goes in from HRT but less comes out.
Worth discussing with your prescriber: adding bioidentical progesterone, ox bile with meals to compensate for gallbladder loss, and getting estrogen metabolites tested. Adjusting the protocol is almost always a better step than stopping HRT entirely when you have no ovaries
Good point Mary. Some women do react differently to supplemental progesterone often depending on dose, formulation and overall hormonal/metabolic state they are starting from
I turned 50, 4 yrs ago, and I have gained weight in my breast, hips and stomach and continue to eat the same when I was 45lbs lighter. Your article has shined light on a path to resolving the lack of energy, vitality, & why the sudden weight gain.
My doctor suggested the possibility of liposuction and gave me a prescription for Tirzepatide. I don’t want to get it filled, because I know it’s not the solution to regaining balanced hormones and a strong, healthy body.
Thank you, I’m really glad it helped clarify things for you! What you’re describing is very common around this stage- the transition around 50 is usually not a clean drop in hormones but a shift where ovulation becomes irregular and progesterone falls earlier and harder than estrogen. That alone can change fat distribution, energy, and how your body handles food.
You’re also right that approaches like liposuction or medications don’t address the underlying physiology. I would focus on understanding a few key pieces first: 1. whether you’re still ovulating at all and producing progesterone 2. what your thyroid function looks like (TSH, free T3, free T4) 3. insulin sensitivity and basic metabolic markers (fasting glucose, fasting insulin, HbA1c) 4. how well your digestion is working, including bile flow . Those four tend to explain most of the pattern you’re describing. Once you see which piece is off, the path forward becomes much clearer
great article! i’m still young but years of birth control in my late teens has led to irregular ovulation and progesterone deficiency :( would love more articles addressing these
Thank you! Birth control suppresses your own hormone production for years so post–birth control ovulation instability is actually very common and deserves more attention than it gets. I'll definitely be covering this. In the meantime, thyroid support, blood sugar stability and adequate nutrition are the foundations for getting ovulation back on track.
Such an important and informative article. Thank you.
Very interesting. I am on HRT and have had a hysterectomy with both ovaries removed. Recently having issues of excess breast tissue growth. Some of this article sounds familiar to what I’ve been going through and praying for an answer. This article mostly addresses those who still have menstrual cycles. But I think things got worse when my gall bladder was removed. Would love more information (or be pointed to where I can find information) about after total hysterectomy and HRT. Is it still important for progesterone to work with estrogen even though no uterus? I’ve always felt better with HRT, but with recent problems wondering about going off it. I find it so confusing and feel like I don’t really get the information I need from any doctor I’ve seen.
You're connecting the right dots. Yes, progesterone matters even without a uterus. The mainstream idea that it's only needed to protect the endometrium is one of the biggest oversights in HRT prescribing. Progesterone opposes estrogen at the tissue level everywhere: breasts, brain, bone, liver. Estrogen-only HRT after hysterectomy means unopposed estrogen in every tissue. Excess breast tissue growth is a classic sign of exactly that.
The gallbladder removal compounds it. Bile is how your body excretes estrogen. Without a gallbladder, that clearance pathway is impaired. So estrogen goes in from HRT but less comes out.
Worth discussing with your prescriber: adding bioidentical progesterone, ox bile with meals to compensate for gallbladder loss, and getting estrogen metabolites tested. Adjusting the protocol is almost always a better step than stopping HRT entirely when you have no ovaries
Very well done, thank you. Exogenous Progesterone Intolerance adds another layer to the complexity.
Good point Mary. Some women do react differently to supplemental progesterone often depending on dose, formulation and overall hormonal/metabolic state they are starting from
Oh, Thank you!!! Thank you!!!
I turned 50, 4 yrs ago, and I have gained weight in my breast, hips and stomach and continue to eat the same when I was 45lbs lighter. Your article has shined light on a path to resolving the lack of energy, vitality, & why the sudden weight gain.
My doctor suggested the possibility of liposuction and gave me a prescription for Tirzepatide. I don’t want to get it filled, because I know it’s not the solution to regaining balanced hormones and a strong, healthy body.
Thank you, I’m really glad it helped clarify things for you! What you’re describing is very common around this stage- the transition around 50 is usually not a clean drop in hormones but a shift where ovulation becomes irregular and progesterone falls earlier and harder than estrogen. That alone can change fat distribution, energy, and how your body handles food.
You’re also right that approaches like liposuction or medications don’t address the underlying physiology. I would focus on understanding a few key pieces first: 1. whether you’re still ovulating at all and producing progesterone 2. what your thyroid function looks like (TSH, free T3, free T4) 3. insulin sensitivity and basic metabolic markers (fasting glucose, fasting insulin, HbA1c) 4. how well your digestion is working, including bile flow . Those four tend to explain most of the pattern you’re describing. Once you see which piece is off, the path forward becomes much clearer
great article! i’m still young but years of birth control in my late teens has led to irregular ovulation and progesterone deficiency :( would love more articles addressing these
Thank you! Birth control suppresses your own hormone production for years so post–birth control ovulation instability is actually very common and deserves more attention than it gets. I'll definitely be covering this. In the meantime, thyroid support, blood sugar stability and adequate nutrition are the foundations for getting ovulation back on track.
Excellent article. Thank you.
Did the transdermal work or did you simply use the patch for convenience?
Yes it helped relieve my symptoms while I was working on restoring my metabolism. As things improved, I gradually tapered off the patch.
Such an interesting article! Thank you :)
Thank you, Hannah!