First time poster, though I've spend lots of time reading....

I have the mother's consent to post.

28 yr. old. mom, exclusively breastfeeding 5 1/2 old son.  She has already had 
one ovary removed - dermoid.

She was scheduled for additional surgery - she says 'half' of her remaining 
ovary is also dermoid, and the Dr. can't say for sure whether he will need to 
remove the entire ovary until they do the surgery.  She canceled over 
concerns about breastfeeding and the possible effects of the HRT, but needs 
to reschedule soon.  She stated that the Dr. will try to leave any healthy 
portion of her ovary intact, to keep her from going into menopause.

I've not been able to find much on this, on PubMed or here on the archives, or 
any of the standard breastfeeding information sources.  

I did find this case study 
http://humrep.oxfordjournals.org/cgi/content/full/20/2/397
 
Based upon this, a case or two mentioned in the archives and knowledge of 
the physiology of breastmilk production, I was pretty confident in 
communicating to her that it is unlikely that her milk supply will be 
compromised by the removal of the ovary.  I'm hoping some of you have 
worked with women in her situation so I can be reassure her a bit more.

Additionally, assuming the entire ovary does need to be removed, any 
information about when HRT should be initiated would be greatly appreciated - 
she would like to make as informed of a decision as she possibly can.

I quote part a six year old message from the archive (but couldn't find any of 
the responses, if there were any at the time):  "I think that early and exclusive
lactation has some similarities with peri-menopause as far as a 
hormonal "climate" goes anyway, but once six weeks has passed, will she
need some form of estrogen to keep other menopausal symptoms at bay? 
When is the safest time to resume HRT (if it becomes necessary) without
compromising her milk supply and endangering the infant to high extrinsic
estrogen exposure? Do estrogen and progesterone play any role in
maintenance of lactation? What will happen to her bone
density if she does not resume HRT until after weaning (whenever that may
be)?"


Respectfully,
Laura Kemp

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