Stopping Estrogen Patch and Progesterone Before Surgery
Yes, you can and should stop both your estrogen patch and progesterone abruptly ("cold turkey") 30 days before surgery—there is no medical requirement to taper hormone replacement therapy, and immediate discontinuation is the standard approach for preoperative hormone cessation. 1, 2
Why Immediate Discontinuation Is Safe and Appropriate
FDA labeling for both estrogen and progesterone explicitly states that hormone therapy should be discontinued 4 to 6 weeks before surgery associated with increased thromboembolism risk or during prolonged immobilization—your 30-day timeline exceeds this minimum safety window. 1, 2
The primary concern is venous thromboembolism (VTE) risk during and after surgery, which is elevated by estrogen exposure; stopping 30 days prior allows hormone levels to clear and clotting risk to normalize before your procedure. 1, 2
Research comparing tapering versus abrupt cessation found that while tapering may reduce recurrence of menopausal symptoms, there is no medical contraindication to stopping cold turkey—the choice relates only to symptom management, not safety. 3
What to Expect After Abrupt Cessation
Menopausal symptoms (hot flashes, night sweats, mood changes) may return within days to weeks after stopping, but these are temporary and not medically dangerous. 3
One study found that 75% of women stopped hormone therapy cold turkey without medical complications, though taperers reported slightly lower symptom scores after discontinuation. 3
The recurrence of symptoms does not indicate harm—it simply reflects the return to your pre-treatment hormonal state. 3
Critical Surgical Safety Considerations
Do not restart your hormones until your surgeon explicitly clears you postoperatively—the FDA warns that hormone therapy should remain discontinued during hospitalization and bedrest periods. 4, 1
The increased VTE risk from combined estrogen-progesterone therapy (35 versus 17 per 10,000 women-years compared to placebo) makes preoperative discontinuation non-negotiable for surgical safety. 1, 2
Your surgical team needs to know you were on hormone therapy even after stopping, as this affects your baseline thrombosis risk assessment. 1, 2
Common Pitfalls to Avoid
Do not attempt to "wean down" by cutting patches or skipping doses intermittently—this provides no medical benefit and may confuse your hormone levels during the critical preoperative period. 3
Do not assume you need to stop progesterone earlier or later than estrogen—both should be discontinued simultaneously 30 days before surgery. 1, 2
If severe menopausal symptoms become intolerable during the 30-day hormone-free period, contact your prescribing physician to discuss non-hormonal symptom management options (not restarting hormones). 3