I'm having a total hysterectomy next Friday (aged 38) due to severe endometriosis (previously had excision via lap 18mths ago). This means I will go into premature menopause. I've been given the option of HRT patches until I'm 50 but want to explore natural alternatives to any symptoms I'll experience. I am a therapist so very open to natural remedies/herbs/nutrition etc. What do you recommend? I'd be interested to hear from other women my age with a similar profile

I can understand your wish to use natural remedies where possible, but unfortunately a total hysterectomy is not something that lends itself to natural treatment because oestrogen levels plunge dramatically overnight.

I do try to recommend natural treatments where possible, but this is one situation where I would say HRT is a sensible option. Endometriosis involves high oestrogen levels, as you'll know, so the change from all to nothing would be very severe.
 
If you want to minimise your time on HRT you can ensure that your adrenal health is good (once you're over the stress of the op!), because that will enable your adrenals to make back-up hormones for oestrogen when you start to come off HRT. I suggest that you don't do this until everything has stabilised after the op, which may take quite a while.

Then discuss a slow withdrawal from HRT with your doctor - 6 months to a year would be ideal, to give the body time to adapt. In the meantime you would also be supplementing phyto-oestrogens (plant oestrogens), which don't have anything like the power of HRT, but at least give some support as the HRT is withdrawn. These aren't going to be strong enough to support you right after the op, but give support whilst coming off HRT. I recommend soya isoflavones for this purpose, as they are well researched and usually work for women low in oestrogen.
 
You may also benefit from doing some liver support work, as your liver will have been struggling under the weight of the oestrogen dominance, and will then have to deal with the HRT. I would suggest Milk Thistle Complex because it's a tincture and gets delivered to the liver in the bloodstream, and you can take it alongside medication such as HRT. You can use dietary support too - no alcohol or caffeine, no highly refined foods, lots of veg, wholegrains, more fish than meat and lots of water.

Eileen Durward