In surgical menopause, the current recommendation is to maintain the level of ERT that keeps vasomotor symptoms (hot flashes, night sweats) at bay.  At the present time, there is no evidence supporting a “correct” or “optimal” level of ERT dosing (or blood level of estrogen) that protects bones in everyone; it appears that the optimal dosing of ERT is unique to each individual.  

Therefore, experts recommend that ERT dose be adjusted on an individual basis to:

(1) achieve remission of menopausal symptoms (especially hot flashes and night sweats) while also

(2) minimizing any risks of ERT (taking into consideration each person’s individual risk profile).

There are lots of additional ways to protect your bone health, including staying active, weight-bearing & high impact exercise, resistance exercise, and a healthy balanced diet rich in calcium and vitamin D. Quitting smoking and reducing alcohol intake are also important for reducing the risk of osteoporosis. 

Visit www.iapmd.org/surgery for lots of evidence-based information and resources for those considering, going through or recovering from surgery for PMDD/PME.