In fact, women who have had their ovaries removed, so that the source of estrogen disappears abruptly, may have hot flashes as soon as they awaken from anesthesia. For this reason, many gynecologists start prescribing hormone replacement immediately after surgery. The other effects of estrogen loss take place more slowly, often over a period of years. These include thinning of the membranes in the vagina, thinning of the lining of the uterus, loss of breast size, osteoporosis, and changes in cholesterol levels. These changes occur gradually and can have serious long-term effects.
Osteoporosis can result in a high risk of bone fractures and collapse of the vertebrae.
Changes in cholesterol, along with other factors, greatly increase the risk that a woman will develop coronary heart disease and a heart attack. Heart disease is the number one killer of older women, far exceeding breast cancer as a cause of death. Fortunately, hormone replacement therapy has been shown to lower the risk of dying from a heart attack by about 50 percent The Prempro that you are taking is a fixed combination of Premarin 0.625mg and hydroxyprogesterone 2.5mg. Most women will stop having hot flashes on this dosage, but not all. Premarin comes in three larger dosages for just this reason.