If a woman is still menstruating and her ovaries are removed, this causes a big drop in estrogen that happens quickly. The effect is a real withdrawal
. Usually, the estrogen needs are greatest in the first 12 months or so. of
ten, initial dosages are higher than 0.3 mg of
Premarin and may be 0.625mg or if that doesn't work, 1.25mg daily. The goal is to get enough to make the symptoms
tolerable in the short run and to taper that dose down over the first 6-12 months or 12 to 18 months.