Is a hysterectomy after menopause the best answer for hormone therapy if you have uterine fibroids?

It depends: Most fibroids shrink in menopause, even if you are treated with low-dose hormone therapy. If, however, fibroids grow during menopause, that is a red flag for possible trouble. Hysterectomy will be your best bet to rule out the possibility of a cancerous growth, and to prevent further fibroid growth. Furthermore, you can then use estrogen alone which may be safer than estrogen plus progesterone.

Not necessarily: Hysterectomy is one method of treating fibroids. Other methods include myomectomy (removal of only the fibriods), uterine artery ablation (to cut off the blood supply), and hormone manipulation. Fibriods tend to be less of a problem after menopause because their growth depends upon hormones; when hormone levels decrease after menopause, fibriods usually shrink.Periods stop, so bleeding does too.

Generally no: Once menopause occurs usually fibroids will start to shrink or at least not grow. Usually, the low doses available for hormone replacement of menopausal symptoms are so low they do no cause regrowth in the fibroid tumors. It is possible, however, for some fibroids to grow despite the low doses. Follow their growth with serial ultrasounds, perhaps.

Maybe: If the fibroids are still causing you problems then that may be the best answer. It is not the only option. It depends how many, the size and location, and how you feel.