I am on prometrium (po)& vivelle patch for perimenopausal symptoms (for 2 years). I will be 49 at time of surgery (TT, BA, BL, and lipo)- scheduled 11/2011. Gyn last year wanted to start to taper me off of my hormones at the end of this year (2011). Should I talk w/my gyn about tapering earlier? What is the recommendation about hormone replacement and surgery - does it increase the risk of blood clots? Thank you!
Hormone Replacement and Mommy Makeover?
Doctor Answers 9
Hormone replacement therapy and surgery
It is safest to be off hormone replacement therapy prior to an abdominoplasty as this will increase your risk of a deep vein thrombosis Estrogens are the source of the problem as they create a hypercoagulable state.
Risks with HRT
Deep venous thrombosis and pulmonary emboli can represent life threatening conditions. Several risk factors are associated with the formation of DVT’s including birth control pills and hormone replacement.
For these reasons we generally recommend that patients stop taking both birth control pills and hormone replacement two weeks prior to surgery. In addition every patient should be evaluated for their DVT risks.
The majority of patients are asked to use anti embolic compression stockings, maintain hydration and ambulate frequently. In patients who have multiple risk factors, anti-coagulants such as Lovenox may be necessary.
It’s important to realize that every patient’s situation is unique. For this reason, treatment needs to be individualized for every patient.
Have your GYN and Board Certified Plastic Surgeon discuss your status and make any medication alterations in plenty of time.
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Wean your Hormones
I agree with the others, I feel you should be off of the hormones as well. The extensive surgery you have planned (lipo, BA, BL, TT) will put you at a slightly higher risk of blood clot formation anyway. I am sure your surgeon will discuss with you how to minimize your risk potential with early ambulation, in bed hip, knee and ankle movement etc. Try to be off all hormones over a 6 week period tapering so that you end up off everything by one month prior to your anticipated surgical date. Good Luck.
Hormone replacement and plastic surgery or mommy makeover
You are best off discontinuing your hormone replacement therapy preoperatively. Hormone replacement can increase the chance of getting a blood clot. We ask that all our patients stop taking any form of hormone replacement, including bio-identical, over the counter, herbal, etc.
Surgery has enough risks associated with it; why take shortcuts?
Risks from hormone replacement therapy
Hormone therapy is important for many women, but can increase the risk of blood clots during and right after surgery. Other important factors in evaluating the risks include previous history of blood clots and family history of blood clots. Smioking is especially worrisome.
You are having a significant amount of surgery in terms of length of time on the operating table, during which time you will have decreased venous circulation, and also in terms of decreased mobility after surgery due to so much of you being sore. Discuss the risks with your surgeon and consider adding a regimen of blood thinners (Lovenox) for two weeks after surgery.
Hormone Replacement & Mommy Makeover
Yes. The surgery you have scheduled is extensive for a single surgery so you want to minimize any potential risks that you can. By tapering off any hormone replacement at least a month before surgery, you are minimizing your risk of blood clots.
Hormone replacement therapy, birth control pills, and many other factors increase the risk for blood clots and pulmonary emboli.
They must be stopped before any elective surgery. Hormonal therapy should be stopped one month prior to surgery. Measures should be taken to decrease the risks of blood clots always depending on your particular risk factors. That should be discussed with your plastic surgeon and GYN and internist.
Mommy Makeover and Hormone Replacement?
It is probably in your best interests to stop the hormonal replacements (under the guidance of your OB/GYN) this prior to undergoing extensive mommy makeover surgery. As you know, deep venous thrombosis and pulmonary embolism are 2 of the more devastating complications that can occur; it is wise to take every precaution.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.