HORMONE REPLACEMENT THERAPY [HRT]

The main purpose of hormone replacement is due to menopause. Menopause is a phase of woman’s life; it occurs when periods stop. It is nothing special or as a disease it is just a normal part of aging. Years before or during menopause, the levels of female hormones go up and down.

It is also known as menopausal hormone therapy or post-menopausal hormone therapy. Hormone replacement therapy is used to treat symptoms that are associated with female menopause. Symptoms include accelerated skin aging, hot flashes, vaginal dryness, decreased muscle mass, vaginal atrophy (inflammation), sexual dysfunction, moodiness, sleep problems, anxiety and bone loss.

The main medications used for hormone replacement therapy are estrogens and progestogens.

AVOID HRT IF –

  • You think you are pregnant
  • Have a liver disease
  • Have blood clots
  • Have had certain kinds of cancers
  • Have had a stroke or heart attack
  • You have problems with vaginal bleeding

RISKS OF HRT

  • Stroke
  • Blood clots
  • Heart disease
  • Breast cancer

BENEFITS OF HRT

  • Increase energy
  • Rediscover mental focus and clarity
  • Increase muscle and bone mass
  • Decreases dryness in the skin
  • Reduce risk of osteoporosis
  • Reduce risk of heart disease
  • Effectively treats depression and anxiety
  • Regain your healthy sense of well being

PENILE RECONSTRUCTION

Phalloplasty is the construction or reconstruction of penis. It is a surgical procedure that helps reconstruct the penis in case of trauma, cancer, or congenital defect. It is a common surgical choice for no binary or transgender people who are interested in gender confirmation surgery.

It is a complex procedure that often involves more than a surgery. The purpose of this surgical procedure is to build a cosmetically appealing penis of a sufficient size which is capable of feeling sensations and releasing urine from a standing position.

PROCEDURE

A flap of skin is removed from the donor area of your body. This flap will either be entirely removed or partially attached. This tissue is used to make both the urethra and the shaft of the penis, in a tube-within-a-tube structure. The larger tube is usually rolled up around the inside tube. Skin grafts are taken from few areas of the body where it leaves no visible scars, and grafted on to the donation site.

Female urethra is shorter than the male urethra. The urethra is lengthened and attached to the female urethra so that the urine will flow from the tip of the penis.

Few procedures are:

  • An oophorectomy procedure that removes ovaries
  • A vaginectomy or vaginal ablation to remove or partially remove the vagina
  • A hysterectomy is a procedure where uterus is removed
  • Penile implant allow erection
  • A phalloplasty to turn a flap of donor skin into a phallus
  • A urethroplasty to lengthen and hook up the urethra inside the new phallus
  • A glansplasty to sculpt the appearance of an uncircumcised tip

There is no time line or single order for these procedures. Not everyone prefers all of them. Some people do some of them together while some others spread them out over many years.

RISKS


Few complications of phalloplasty include:

 Lack of sensation
 Pelvic bleeding or pain
 Urethral fistulas
 Urethral structure
 Flap failure and loss (the death of the transferred tissue)
 Wound breakdown (ruptures along the incision lines)

Donation site also involves few risks

 Pain
 Bruising
 Decreased sensation
 Decreased mobility
 Tissue granulation
 Wound breakdown
 Decreased mobility
 Unsightly scarring or discoloration

RECOVERY

It may take up to four to six weeks to get back to normal routine. If your job requires a strenuous activity, then you might wait for six to eight weeks. Avoid exercise and lifting during first few weeks. Depending on the type of surgery you underwent you may never have erotic sensation in your phallus, as it takes a longer time for the nerve tissue to heal. Full healing can take up to two years.

AFTERCARE

 Avoid putting pressure on the phallus
 Do not shower for the first two weeks, unless recommended
 Do not apply ice to the area
 Itching, swelling, bruising, blood in the urine, nausea and constipation are all normal in the first few weeks

HYSTERECTOMY

It is a surgical procedure to remove a women’s uterus. Hysterectomy is needed for many reasons; it is used to treat chronic pain conditions as well as certain types of cancer and infections. The extent of this surgery depends on the reason for the surgery.

In some cases the entire uterus is removed. In some cases, fallopian tubes and ovaries are also removed during the procedure. Once you have undergone hysterectomy you will stop having periods and unable to get pregnant.

TYPES

PARTIAL HYSTERECTOMY

Only a portion of the uterus is removed leaving your cervix intact.

TOTAL HYSTERECTOMY

The entire uterus is removed including cervix. You should continue to have regular pelvic examinations.

SALPHINGO-OOPHERECTOMY

In this type uterus along with one or both of the ovaries and fallopian tubes are removed.

RISKS

 Heavy bleeding
 Infection around the incision site
 Surrounding tissues or organs also get infected including bladder, intestines and blood vessels

RECOVERY

After the surgery you will have to stay two to five days in the hospital itself. Encouragement to walk around the hospitals will help prevent blood clots from forming in the legs. You may return to your normal activities in about three to four weeks.

OOPHERECTOMY

It is a surgical procedure to remove ovaries. It is called unilateral oophorectomy when one ovary is removed. It is called bilateral when both the ovaries are removed.

PROCEDURE

Vertical or abdominal incision is used in the procedure. Horizontal incisions leave a less obvious scar whereas vertical incisions offer the doctor a better view.

Abdominal muscles are separated to reveal the ovaries. Next, blood vessels are tied to prevent bleeding. After ovaries are removed, staples are used to stich close the incision. The procedure is performed under general anesthesia. This surgery can also be performed with a laparoscope; a thin instrument with a small camera on the end.

The procedure may last from one to four hours depending on the specifics of the surgery.

SIDE EFFECTS

 Infection
 Bleeding
 Allergic reaction to anesthesia
 Blood clots
 Damage to any nearby organs

RECOVERY

Recovery time is different for every individual. Immediately after the procedure, you will have to spend an hour or two in the recovery room. You will be transferred to regular room once the anesthesia wears off.

After few hours of surgery if you can sit up, stand and take a brief walk you may go home on the same day. You may stay in the hospital for a day or two post abdominal surgery. Laparoscopic surgery may require you to spend one complete night in the hospital.
Do follow post-operative instructions given by the doctor.