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Surgical removal of reproductive organs creates an abrupt hormonal shift that requires thoughtful planning and preventive care. Dr. Christine Vaccaro discusses the importance of pre-surgical hormone replacement therapy planning and the significant risks of delaying treatment after ovary removal.

• Prevention is key—proactive planning can help avoid the "six weeks of awful" many women experience after surgery
• Transdermal estrogen products do not cause blood clots, contrary to some medical misconceptions
• Bone health suffers dramatically with hormonal depletion—even perimenopause can cause 10% bone density loss
• Sleep disruption without hormones can lead to cascading health problems including depression and chronic illness
• Starting hormone therapy immediately after surgery prevents suffering and protects long-term health
• Some patients with already low testosterone may benefit from starting replacement before surgery
• Withholding hormone replacement makes as little sense as withholding insulin from a diabetic

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