Q: I’m scheduled for a hysterectomy in a few weeks. What should I expect?

A: Hysterectomy, or the surgical removal of the uterus, is used to treat a number of medical conditions. It is one of the most common surgeries for women, with 600,000 performed annually in the U.S.

That number is declining, however, as new options become available.

Your physician might recommend a hysterectomy, with or without the removal of your ovaries, for abnormal bleeding, fibroid tumors, or precancerous or cancerous lesions of the cervix, uterus or ovaries.

Many hysterectomies can be performed laparoscopically through tiny incisions in the abdomen.

This typically results in less pain and a shorter recovery time.

Women who have a significant amount of scar tissue from previous laparoscopic surgeries or severe endometriosis might not be candidates for this procedure.

Abdominal hysterectomy requires a longer hospital stay and recovery time.

Depending on the type of surgery you have, your recovery could range from two to eight weeks.

If your surgery includes removal of your ovaries (oophorectomy), you should discuss with your doctor the advantages and disadvantages of hormone replacement therapy.

Q: What are bioidentical hormones? Are they safer than hormone replacement therapy?

A: Bioidentical hormones are drugs made from plants, but that does not mean they are safer than synthetic drugs.

They mimic the hormones estrogen and progesterone that are found naturally in a woman’s body.

Compounded bioidentical hormones are mixed together in a pharmacy. Nearly 2.5 million women in the U.S. are currently taking FDA-approved compounded bioidentical hormones.

Hormone replacement therapy has been linked to a higher risk for breast cancer, heart disease, blood clots and stroke.

Bioidentical hormones work the same way as their synthetic counterparts, so the same risks might apply.

Compounded estrogen is no safer than the synthetic version and carries the same risks and benefits.

There are, however, benefits to taking estrogen – stronger bones, reduced cardiovascular disease for younger women and less vaginal dryness.

FDA-approved bioidentical progesterone has a lower risk for breast cancer than the synthetic version. There are no data on the benefits of compounded progesterone.

As with conventional hormone replacement therapy, bioidentical hormones should be taken in the smallest dose possible for the shortest amount of time.

Discuss all your options with your provider.

Some women find relief through lifestyle changes, such as avoiding caffeine and exercising regularly.

Dr. Joanne Price Williamson is an obstetrician/gynecologist at Provident OB/GYN Associates-Legacy Center in Okatie.