Requesting a hysterectomy

[shelley292]

So four and a half years ago I gave birth to my wonderful son. I suffered a cervical prolapse that I had physio therapy for. It never went back fully but was told to keep up with pelvic floor exercises which I have. Sex is usually an uncomfortable if not downright painful affair.
After a few unsuccessful pregnancies I have no fallopian tubes left and therefore cannot have any more children. Since my tubes have been removed I suffer from extreme ovulation pain for 48hrs each monthh which leaves me struggling to sit down, in sharp pains at either side I'm ovulation and struggling to pass a bowel movement due to discomfort and cervical prolapse seems to feel lower and heavier.

Taking into account I'm 32yrs old, cannot have children, find sex painful, have horrendous ovulation pains do you think a doctor will take my request to have a hysterectomy seriously?

I've looked into it in great detail. I believe it could go a long way into making me feel normal again. I understand it'd be a big op and tough recovery, but I'm young, I want to enjoy my sex life with my hubby, I dont want to spend 48 hours every month in agony, I just want to feel like a normal woman.
Its not like its taking away the option of having kids? I understand the NHS doesn't want to spend money unnecessarily but do you think they would consider me?

[Topseyt]

You could try, and I would hope they would consider you. I can see your reasoning and think I would feel like same in your shoes.

At the very least you need urgent referral to a gynaecologist.

Good luck. I hope you get what you need.

[Rachelover40]

Considering your circumstances, I think you would be considered for a hysterectomy on the NHS. However, why don't you compromise? You could see a gynaecologist privately for a consultation who would then refer you to his NHS ciinic. Your GP would know which consultants locally see private patients, most do.

Good luck op, your symptoms sound dreadful and you need to have something done about it. I must say I would not be keen on having ovaries removed with a hysterectomy (that is called a 'total hysterectomy'), because at your age you would definitely be recommended to take HRT. I do wonder if you would still have ovulation pain after the op if you kept ovaries. Do ask.

[shelley292]

Thanks, I'm certainly going to explore my options. I've booked an appointment to see a female doctor who has always been patient and understanding with my mum, she takes her time and really listens. It's meant I've waited over a month as I specifically requested her (she's popular)
From my history she should be able to see the appointments I've had concerning these issues so im not appearing out the blue.
I found a post earlier from a couple years back asking advice on my ovulation pains. I'll attach it. I will also show her that I'm really hoping she will consider it.
I know there are different types of hysterectomys, I'm assuming to cure the ovulation pains they'd need to remove the ovaries. I just can't imagine anything being worse than living like this for the next 20+ years. Menopause is going to get me anyway, so I'm not too worried if it's earlier than expected xx

[Greybeardy]

Taking your uterus (which is all a hysterectomy is) out won’t stop you ovulating.

A total hysterectomy is not, as suggested above, removing the ovaries as well...that would be a hysterectomy with oophorectomy (+salpingectomy if the tubes go as well).

Sounds like you need proper advice from a doctor who understands the plumbing rather than an online forum.

[Rachelover40]

Yes, you're right Greybeardy, total is just removal of uterus (sorry shelley, I was half asleep). You would need bilateral oophorectomy.

I also agree with Greybeardy that professional advice is needed as quickly as possible.

[shelley292]

Thanks, I will defo be following up with the doctor 🙏

[Nat6999]

Have you ever been checked for endometriosis? Your symptoms of painful sex are one of the symptoms. If you decide you want a hysterectomy you may have a battle on your hands because due to NHS cuts hospitals are making it more difficult to have one, you need to stick to your guns that you don't want any other treatment, just a hysterectomy.

[JinglinghellsBells]

You can have a repair to fix the prolapse and leave your womb. is it actually the cervix or the uterus that has prolapsed?

If you have a hysterectomy at a young age (or any age) it can bring on menopause even if they leave your ovaries. You'd need HRT for many years to replace the estrogen.

If you main issue is prolapse, you need a 2nd opinion on whether it's fixable with surgery.

[JinglinghellsBells]

, total is just removal of uterus

No- total is removal of uterus and ovaries.

A bilateral oophorectomy can be done with removing the uterus.

[Greybeardy]

Removing a uterus doesn’t cause menopause so long as at least one ovary is still working. A total hysterectomy does not routinely involve removing ovaries (but a radical hysterectomy may).

[JinglinghellsBells]

@Greybeardy I

Removing the uterus often causes the ovaries to fail within 2-3 years.

www.sciencedaily.com/releases/2011/11/111114112311.htm

[Greybeardy]

Association and causation are not necessarily the same thing.

[PookieDo]

I am 39 and can’t have one for various reasons I have a thread above so please don’t assume they will do this for you

[ScreamingValenta]

I think you need advice as to whether a hysterectomy would actually help your prolapse. I think you should look into endometriosis as your ovulation symptoms sound typical of that. It might be that an oophorectomy is a better option - but that will thrust you into menopause immediately, so you'd need to consider how you'd manage that. I had a TAH/BSO at 42 and going from not being in the menopause at all to 100% menopausal was a shock to my system.

[JinglinghellsBells]

@greybeardy If you care to read about this, it's well established that a hysterectomy usually causes earlier menopause. It's not worth arguing over this because every piece of research says the same thing (obviously it doesn't affect all women that way but for women in their 40s it usually brings menopause forward by 2-3 years.)

@shelley292 If you have a prolapse of the uterus (not just the cervix) having a hysterectomy can make things worse. You can read about this. One risk is you get vaginal prolapse - called vaginal vault prolapse- because the uterus is actually holding the upper walls in place a little.

It sounds as if you have a rectocele too - prolapse of the back wall which is making have a poo difficult.

A very good urogynaecologist can do surgery to try to prevent this, but you need someone good.

If you lose your ovaries, you risk having more prolapse as you will lose estrogen which supports the pelvic floor.

What may be best would be a good pelvic repair where they lift your uterus back into place and do any repair work on the vaginal wall at the same time.

The operation- a hysterectomy- is not that major these days and can often be done vaginally. Recovery time is 6 weeks but it's no lifting or anything remotely heavy for that time.

First thing is to get your GP to refer you to a gynae who has expertise in fixing prolapses and getting their opinion.

[JinglinghellsBells]

You could also take the Pill to prevent ovulation even though you aren't using it as birth control.

[shelley292]

I've been checked for endometriosis, I bleed after sex regularly so had smears and scans etc.
I'll defo see if I can hey recommend something else for the prolapse, I've just got it in my head that's the only solution xx

[JinglinghellsBells]

@shelley292 They prefer to do repairs if at all possible, these days. Hysterectomies are usually for much older women where the prolapse is very bad and cannot be fixed and where there is no impact on ovaries as they are post menopause. But even with older women they will repair if they can as a hysterectomy can make things worse for prolapse.
I had a repair at 37 after DC2.

When you say you were checked for endo was this with keyhole surgery and not just a scan?

They can't diagnose endo with a scan- it needs a laparoscopy to look inside.

[shelley292]

Ah no they didn't, I've had a laproscopy following the the two ectopics, then the smears and scans in the months following it.
Im happy if they can do a repair. I just hate feeling like at 32 I'm unable to enjoy what should be a healthy sex life for the next few decades and then in pain for a few days each month when I ovulate xx

[bobbypinseverywhere]

GP here - you need proper medical advice so its good you've booked an appointment - pls just go in with an open mind and listen. don't go in demanding a hysterectomy as i think you may have some misinformation.

from what you've put here - a hysterectomy is not a good idea. @jingling is completely right with her advice....its likely in the future to make your prolapse worse (vault prolapse) and removing your ovaries at 32 is a terrible idea (- which is a BSO)

i get you're in pain but there are more appropriate treatment options. surgical menopause at 32 will have all sorts of long term consequences that "just taking hrt" won't necessarily fix. ultimately i don think a hysterectomy + BSO will actually improve your symptoms, and will cause a lot of problems.

also the gynae advice on MN can sometimes be completely unfactual and downright unhelpful, so pls speak to a professional!

[shelley292]

Don't worry bobbypinseverywhere I'm going in open minded and wouldn't dream of making demands. It's just what I thought would be the solution and the Dr I'm waiting to see is a wonderful lady I know her advice would be sound xx