As I write this, I’m just about two weeks post op from my full hysterectomy and sling procedure 💪🏻. So many of you have had questions that I’m putting it all together here (and on this video) to share everything that’s happened in case it’s helpful to you. Reminder, this is not medical advice – it’s additional info for you to have conversations with your health providers. 

If you don’t have a health practitioner that is up to date on perimenopause and menopause, I’m going to strongly recommend that you find someone who is – a lot of what we’ve been told about menopause care is, at best, outdated, and at worst, simply wrong. You deserve better. We all do. Reach out to me for recommendations. 

Starting with HRT 

I’ve been using Hormone Replacement Therapy – using an estrogen patch, progesterone pills and testosterone cream (this last one from a compound pharmacy), since 2020. It has made a profound positive impact on my health. If you have questions on the importance of these hormones and their safety profile, I suggest you do a few things: 

• Read or Listen to The New Menopause by Mary Clare Haver.  Dr Haver is a board certified ob/gyn and a certified menopause provider. The book is a bible for anyone with questions and concerns about perimenopause, menopause and treatment options. Also follow her on Instagram.
• If you want to dig deeper, read Estrogen Matters and The Menopause Brain to further understand the positive role Estrogen plays in disease prevention and quality of life. 

Is estrogen for everyone? No, nothing is. But many doctors are reluctant to discuss it because they are simply not up to speed on the latest science. Find someone who is. 

Breakthrough Bleeding 

After about a year of taking HRT, I started to experience some monthly “breakthrough bleeding” aka unexpected vaginal bleeding or spotting. This can happen due to various factors, including imbalances between estrogen and progesterone levels, or when hormone doses need adjustment. It’s also particularly common in the first 3-6 months of starting HRT or when changing dosages. 

My hormone levels were all normal (getting regular bloodwork is crucial when on HRT), and since the bleeding was out of this 3-6 month window, my gynecologist wanted to do some further investigation.

Spa Day & Testing 

This led me to a “spa” day and subsequent tests, all of which, in my opinion, are valuable services, particularly as we head into our menopause years. They included: 

• Bone density (DEXA scan), breast imaging, and ultrasound. All of these came back clear. 
• Genetic testing from Invitae. At first I was reluctant to go “looking for trouble” but my doctor told me some genetic variants result in an increased risk of ovarian cancer, and as a woman in menopause, I didn’t need mine anymore. Turns out, I tested positive for the ATM gene variant. 
• While we were at it and getting benchmarks, my functional health doctor suggested I do a cancer screening test from a company called Galleri. These came back all clear. 

My doctor, in a final effort to rule out any potential concerns around my bleeding, recommended we do a D&C, a surgical procedure where the cervix is dilated to allow a doctor to remove tissue from the uterine lining, typically performed to diagnose or treat abnormal bleeding, remove tissue after a miscarriage, or obtain samples for testing. While everything looked normal, she sent all of the cells to pathology just to be sure. Those came back as precancerous so my doctor recommended a full hysterectomy. 

I won’t lie – deciding to get a hysterectomy is emotional. I mean, you’re literally taking out your womb. So much identity and memories are tied up in our reproductive organs, and I allowed myself to really feel it all. I am so grateful that I am a woman, that I was able to have the choices to be a mother when I was ready, and that I found out all of this before it became anything to be extra concerned about. 

This is the beauty of having a thorough doctor who specializes in menopause and access to women’s reproductive healthcare. 

Hysterectomy & Sling Procedure 

I was already considering getting a sling procedure for my bladder. The procedure, for stress urinary incontinence, is a simple procedure where a surgeon places a narrow strip of synthetic mesh or natural tissue under the urethra to create hammock-like support. (Aging is fun!) The beauty of living in NYC is I could work in the same hospital and a separate surgeon could first perform the hysterectomy and then the sling procedure happened immediately afterward. 

The hysterectomy was done robotically, so the surgery included filling my stomach up with air. While most of it was taken out afterwards, a significant amount of air was in me after the procedure. This was the most uncomfortable part of the first 72 hours post-op. 

I was able to go home the day of the surgery and, 10 days later, am in great shape. I need to be very careful for a full eight weeks, refraining from any abdominal exercises and not lifting anything heavier than 10 lbs to avoid popping a stitch. I’m walking the streets of NYC like a crazy lady. 

Final Thoughts

I feel great and am grateful for all the medical professionals (all women by the way) were such great allies in this journey. To my oldest daughter Charlotte and my husband Ken who took great care of me, and to all of my friends, who sent me flowers, food, and most of all love. And all of the conversations I’ve had with so many of you about this important topic. Appreciate you, and this beautiful life, all the more. 

Let me know what questions you have! 

xoxo Tracey