Question and Answer from Dr. John Lee

Q: I am writing with questions about the options for a prolapsed uterus. I am 40 years old and have been diagnosed with a cystocele, uterine prolapse and rectocele. My urologist said that he can repair my bladder and to see a gynecologist concerning the repair of the vaginal wall. The gynecologist suggested a hysterectomy because of the prolapsed uterus and said he felt that the bladder repair would be more successful if I did so. My urologist said that I don’t necessarily have to have a hysterectomy with my bladder repair. I would really like to keep my uterus and would like any information from you that might be helpful in this situation.

A: Prolapsed uterus, bladder and rectum generally comes about because of two factors—multiple pregnancies that stretch out the supporting ligaments and connective tissue, and lack of progesterone and testosterone—the hormones that keep these ligaments strong. If you have the surgery done before you correct your underlying hormone deficiency, it is likely that the repair will not hold.

To help your doctor understand this, it would be wise to obtain a saliva hormone test [or blood spot test], measuring estradiol, progesterone and testosterone. I would bet that it will show you are deficient in progesterone and testosterone.

The progesterone is available over the counter. The usual dose is just 10 to 12 mg per day for 25 to 26 days of the calendar month.

Restoring proper testosterone levels is also easy, except for the fact that it requires a doctor’s prescription, and the chances are that your doctor does not know the correct dose. The right dose for most testosterone-deficient women is just 0.25 or 0.5 mg per day, when taken by transdermal skin cream. If you are testosterone-deficient, your doctor can write a prescription for any good compounding pharmacist to make up a cream that provides the correct dose.

Once you restore proper levels of progesterone and testosterone, then you can proceed with the surgical repair and have a good chance of success with the surgery without losing your uterus.

Note to Reader from Virginia Hopkins
This Q&A was originally published in the John R. Lee M.D. Medical Letter. Dr. John Lee was my great friend, mentor, co-author and business partner. This website is dedicated to continuing the work that Dr. Lee and I did together to educate and inform women and men about natural hormones, hormone balance and achieving optimal health. Dr. John Lee was a courageous pioneer who changed the face of medicine by introducing the concepts of natural progesterone, estrogen dominance and hormone balance to a large audience of women and men seeking answers to their hormone questions. Dr. Lee has left us a wonderful collection of writings from his newsletters that are, in large part, freely shared on this website. Enjoy!