Should Estradiol Intake Be Stopped Prior To Knee Replacement Surgery?

Posted on Sun, 9 Feb 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sun, 9 Feb 2014 Answered on

Mon, 3 Mar 2014 Last reviewed on

Question : I will be having a knee replacement in a few weeks. I am 71 years old and have been taking unopposed Estradiol since my hysterectomy 7 years ago. The hospital will be giving me a blood thinner to prevent clots called Lovenox. Should I stop the Estradiol prior to surgery and if so, how far ahead? Am I going to get hot flashes? Yikes!

Answered by Dr. Vjollce Mbiarra (46 minutes later)

Brief Answer: Hello! Thanks for your query. Detailed Answer: Unfortunately, there is no evidence base for any of the current recommendations concerning pre‐ and perioperative management of women using HRT . A recent review of the prevention and treatment of venous thromboembolism consistently recommends the use of low molecular weight heparin(levonox) prophylaxis for elective hip or knee replacement surgery, and for hip fractures, but does not mention HRT as an additional risk factor. You shouldnt stop using HRT but you should use Levonox before surgery as recommended by your doctor. Take care for your self

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vjollce Mbiarra (3 hours later)

In reading about side-effects of estradiol and drug interactions, it said that estradiol could reduce the effectiveness of warfarin in preventing bloodclots. Nothing about Loverox. You feel confident that I should not be concerned or stop the estradiol? I only take 1 mg per day. I will be getting a spinal and nerve block for anesthesia.

Answered by Dr. Vjollce Mbiarra (23 minutes later)

Brief Answer: Need not worry Detailed Answer: Hi, You dont need to worry so much of taking estradiol before surgery because levonox is a low molecular weight heparin and its effect do not decreases by the use of estradiol. Levonox in your case serves to prevent deep vein thrombosis . Take care of your self

Above answer was peer-reviewed by : Dr. Raju A.T