Whether or not you can take hormone replacement therapy (HRT) after surgery depends on the type of surgery and your specific medical circumstances. In general, most surgeons recommend waiting at least 6 weeks after any major surgery before starting or resuming HRT. This allows your body time to heal before introducing new medications.
However, the specifics will vary based on the type of gender affirming surgery, your hormone regimen, and guidance from your healthcare providers. Here are some key considerations:
Genital Surgery
For bottom surgery like vaginoplasty, phalloplasty, or metoidioplasty, you will need to stop taking any feminizing or masculinizing hormones before surgery. Your surgeon will provide guidance on when to discontinue HRT prior to surgery and when you can resume.
Most surgeons recommend waiting 6-12 weeks after genital surgery before restarting HRT. This allows time for surgical wounds to close, swelling to subside, and any post-surgical complications to be addressed. It is essential to have your surgeon's clearance before restarting hormones.
Chest Surgery
For trans men getting top surgery like double incision with nipple grafts, surgeons typically recommend stopping testosterone use 2-4 weeks before surgery. Testosterone can interfere with blood vessel development in the surgical site.
Most surgeons allow resuming testosterone 2-6 weeks after top surgery, once drains and sutures are removed and you have clearance from your surgical team.
For trans women getting breast augmentation or implants, a short break from estrogen may be required pre-surgery depending on your surgeon. You can generally resume estrogen HRT once you have recovered from surgery.
Facial Surgery
For procedures like facial feminization surgery or masculinization surgery, your surgeon may request stopping HRT 2-4 weeks beforehand to reduce risks of bleeding or other complications.
You can generally restart HRT about 2 weeks after facial surgery once initial swelling has resolved and you are healing well.
Hair Removal Surgery
Electrolysis or laser hair removal procedures are usually not impacted by HRT use. However, your technician may request adjusting medication timing to reduce bleeding or skin irritation risks during treatment.
Checks with Your Provider
The exact timeline for stopping and restarting HRT around surgery will depend on your specific situation. Have an open discussion with your surgeon and hormone prescribing provider.
Some key questions to ask:
- How long before surgery should I stop taking hormones?
- When is it safe to resume HRT after surgery?
- Should my hormone doses be adjusted post-surgery?
- What signs or symptoms should I watch for after restarting HRT?
Be sure to schedule regular follow-up visits with your surgical team and hormone provider after any major procedure to ensure you are healing well. Monitoring your progress is crucial.
Ongoing HRT Management
It is common to need adjustments to your hormone regimens both during the peri-operative period and as you recover. Your endocrinologist can help determine the ideal dosages and forms of estrogen, testosterone, or other medications to optimize your transition goals and healing after surgery.
Having your hormone levels tested periodically is wise to aim for the right hormone balance. Be patient with your body as it recovers and do not hesitate to contact your care team with any concerns.
If you require surgery for non-transition related reasons, discuss HRT management with your surgical and hormone providers as well. Stopping hormones temporarily may be necessary for procedures like cancer or heart surgery.
At Rejuvenate Hormone Clinic, our compassionate medical staff is here to provide personalized guidance on optimizing your HRT regimen before and after any planned procedures. We offer state of the art hormone testing and work closely with you and your surgeons to support your transition goals. Contact us today to schedule a consultation!
