to have a hysterectomy aged 25?

[Kimberly343]

I have two DCs, I always imagined my life with two children. We live in a 3 bedroomed home with no wish to move and love that the DCs each have their own 'space'. Another DC is definatley off the cards, my second DC was born with a genetic disease that limits their life dramatically so any further children we would either need to pay privatley for PGD IVF or run the risk of another child affected/terminate a pregnancy after testing. All of these would be a great strain on us all.

I spoke to my GP about a hysterectomy as I don't get on well with hormonal contraception, had a coil fall out and have horrendous periods. The GP practically laughed it off and said I am far too young to be considered and I am likely to change my mind. I definatley will not, regardless of my circumstances I 100% don't want any more children, shall I see another GP or am I silly to do this?

It's not just about being sued though - it's about the doctor's professional duty not to carry out an operation which the patient might later feel has had devastating permanent consequences. All the paperwork in the world won't protect you from the guilt of a patient who's suffering terrible emotional pain - and the gynaecologists who perform sterilisations are also the ones who have to see older women looking for reversals, and see their faces when they're told the odds.

And that's before you even get to the physical problems potentially caused by actual hysterectomy.

Please do push harder for consultation on your periods - that sounds grim.

Hysterectomy is not a form of contraception or sterilisation. It is major major surgery with not only risks but long term implications. Your uterus is a major organ, not to be disposed of willy nilly.

"Regret, leading to a request for reversal of female sterilisation which is usually unavailable on the
National Health Service. Regret is common, and more common if sterilisation is undertaken below 30 years of age, if the woman is childless, or if there is conflict between the woman and her partner. Regret is also more common when sterilisation is undertaken at the time of an abortion."

from RCOG consent form but no numbers.

Abstract from a study

Interesting, US stats

I think you're ignoring the fact that this is MAJOR surgery

I have had FIVE MAJOR surgeries all a result of having a hysterectomy at 28

Why would you potentially do that to yourself

Another lovely side effect is the lack of vaginal fluid ... every single time I've had sex since i was 28 I've had to use lubricant

I haven't had a normal bowel movement since my bowel collapsed

It is not a one off solution to your problems

One thing you do need to know - that I did not know before I had mine at age 42 - is that it can bring forward the "menopause" (even if your ovaries are left) and make you more prone to such things as osteoporosis at a younger age.

I do not regret the hysterectomy - there were sound medical reasons for it and it improved my life immeasurably.

I tried to get sterilised at 41 and although my GP was very reluctant she referred me to a hospital. When I went to have it done the surgeon was also so reluctant because of my age that she talked me out of it and offered me the coil under general anaesthetic instead (as I had tried several times to have it fitted with local anaesthetic and failed). I haven't had any problems really with the coil since then luckily. But am just telling you this story as a warning about how doctors might react. They thought I was too young at 41! It was a little frustrating as I was sure about my decision but they clearly had experience of lots of people who had change their minds later on. Best of luck with it all though.

^^ this .. there must be sound medical reasons

Please understand how serious this is and the fact that you would be more or less guaranteed having further medical issues in the future ...

READ what I am still going through

Have you discussed a vasectomy??

Thanks Pacific. No actual numbers then? That abstract looks promising if anybody has access to the full article.

I don't have access, sorry.

And the American site, while interesting, seem to imply that 'regret' only happens because women were not given appropriate information before going for their sterilisation aka did not give informed consent.

I am not much of an academic, and my searching does not go much beyond using Google Scholar, so others might have more luck try harder

I've heard a few things about dodgy birth control projects that have happened to some communities in the US.

It's not just about being sued though - it's about the doctor's professional duty not to carry out an operation which the patient might later feel has had devastating permanent consequences. All the paperwork in the world won't protect you from the guilt of a patient who's suffering terrible emotional pain - and the gynaecologists who perform sterilisations are also the ones who have to see older women looking for reversals, and see their faces when they're told the odds.

That all sounds like emotional blackmail to me, Winter. I want to know how often it actually happens that women have serious regrets.

I went into it knowing that it was possible I might have regrets at some point, but so what? Lots of major choices in life close off other possibilities. We all live with the risk of regret when choosing life options.

For me one of the big advantages of sterilisation was precisely that it definitively ended my childbearing years. It made it easier to focus fully on the next chapter(s).

Pencils, it's not about emotional blackmail, but to feel that one has done ones professional best to make sure the decision has been made looking at all aspects, good and bad.

I keep posting on childbirth threads about my 4 very different deliveries and that I honestly believe they were all 'good' experiences because I was on board for all decisions made - good and bad.

I am a doctor and a patient and I do often see both sides of it tbh.

You need treatment for your heavy periods.
There may be many other ways to help with this apart from just the coil, ablation or pill. You may need a full hormonal profile to see why you are bleeding so much, not simply a procedure to stop the bleeding. Your periods weren't top of the list in your first post- it was more about having a completed family and no room for any more due to the number of bedrooms. The period issue seems a bit of a 'convenient reason' when posters pressed you a bit more.

As others have said, you cannot, just cannot, see into the future. Although at the moment you cannot imagine life without DH and DCs, if the worst occurred or you split up and met another man, you may think differently. At 25, you cannot know how you would feel emotionally 10 years into the future. look at it this way- do you think that the 40% of marriages that end in divorce were 'predictable' ? No. People change their minds. Stuff happens. It's not something anyone can foresee. You are, sorry to say, showing your immaturity now by not being able to understand how life can change and how what people want can change.

It's not about 'replacing' the deceased or an ex-partner. It's about keeping the door open in case anything changes.

@pacificdogwood I always value your posts because of your profession and I find you're really fair and rational with your responses.

I had very heavy periods for years and my womb was abnormally large. So much so, they put me under a general to look to see if every thing was ok. Dr suggested a coil, hysterectomy, or having the inside of my womb burnt. I had acupuncture for three months and I have just had a scan and my womb is now back to a normal size.

No, come on Pacific, men are not made to consider how the doctor might feel having to look at their sad face when they are older and suffering from terrible emotional pain and regret (OK, I know vasectomies have a much higher successful reversal rate but presumably he'd have to pay for that and it's still not 100%)

I can't find anything on NICE either except for here where it's listed as a theoretical adverse event.

It seems the standard practice is to discourage as many women as possible from seeking a sterilisation by strongly emphasising the risk of regret. I'm wondering what guidance HCPs are following when they do this and what evidence backs up that guidance.

For all I know there might be massive numbers of women who regret having it done, in which case fair enough. It's not unreasonable to want to know the figures on this though is it? Aside from anything else it should form part of the informed consent for women who do manage to get a sterilisation.

Not so much about emotional blackmail, more about the fact that doctors have (rightly or wrongly, but I'd say wrongly) a massive bias against harming someone by their own actions rather than leaving them to suffer by inaction.

When it comes to statistics on sterilisation regret, they mostly come from countries which use sterilisation a lot, such as Brazil, and where their criteria are much looser than they are here. Because very few woman are sterilised in the UK, and very few women suffer the death of their children, the statistics for women's feelings in that particular situation aren't reliable for the UK - most statistics by their nature come from very different countries with higher child mortality rates. Ditto only a tiny number of women in their early twenties are sterilised in the Uk, and normally only with absolutely overwhelming reasons for wanting it, so that there are no real statistics on how many would want reversal if the criteria were loosened here.

A divorce would in no way affect my decisions. I have thought about if I met someone else, but even if I take away all the other factors in not wanting more children I won't be wanting to start a new family when my children are almost fully grown. I appreciate some do, but I would not want to start again with a new baby with grown up children.

My DC will largely need a huge amount of support from me and we already struggle with hospital stays and appointments with one other child, I could not add another to the mix. This will be life long and they will to some extent need my support for a long while yet. No one can 100% see what they will 'want' in the future but my DC would suffer with another child and that would always outweigh what I may want down the line.

It takes 3 months to fully recover from this.

My children were older and family like was unaffected by me being 'on bed rest'.

Horrific periods shouldn't be tolerated but asking for life changing surgery at 25 is too much too soon.

*life

I found some actual stats:

The American College of Obstetricians and Gynecologists (ACOG) suggests that the incidence of regret following tubal occlusion is between 0.9% and 26%.

So they look reliable.

They're US stats too, (although it's a UK doc) and I'm not sure they are that relevant to the UK. Risk factors for regret included 'desire to have children' and 'coercion by health professional or partner/spouse'. No shit sherlock.

Discussions of regret were strangely absent from the sections on vasectomy but it's a very long document so maybe I missed it or wasn't using the right search terms.

OP I think you should be pushing for a referral to a gynaecologist to discuss all your options. Sterilisation + ablation sounds like it could be a good option.