Hysterectomy - what should I do?

[justsotired]

Had heavy painful periods 5 years ago which led to me having a Mirena Coil fitted. The extra hormones haven't been too pleasant but it stopped me having to have a hysterectomy at 35. Now I'm 40 and it is running out and I've been to the Gynae who has offered me the operation or I could have another coil fitted and make the decision later.

I will have to go through an operation with GA for the coil anyway, as I need to have a D&C and Biopsy at the same time. I also had an abnormal smear in October so am waiting for a follow up in a couple of months.

Should I go for the hysterectomy now rather than ponce around with the coil again as it will also prevent any potential cervical problems. I'm just not sure if I'm ready to give up my womb yet but I am pretty fed up with the side effects of the mirena.

I would really appreciate your views on this.

If I were you I'd go for option B- another Mirena, or ablation.

You don't HAVE to have a D&C for a biopsy- you coul have a vaginal ultrasound and a biopy as an outpatient if that would show them what they need- presume fibroids have been ruled out?

D&Cs are becoming obselete as other less invasive methods can show as much.

I'd ask about all these option and see anotehr gynae if necessary for 2nd opinion.
Hysterectomy does bring on an earlier menopause and it's not an op to have if you can do without .

I think the D&C is to give my insides a clean out as my womb is laid back so doesn't empty properly (sorry, bit graphic!). It's the build up that causes pain and then heavy periods that go on and on and on .... Someone said to me today that I may as well go for the hysterectomy but it's just the thought of giving up ever being able to have any babies (not that I have any intention of ever getting pregnant again!)

Have you been offered any medication for the pain- metafemic acid? I can't see that a D&C is the asnwer, otherwise you would need this doing regularly until you are menopausal. Why not ask about endometrial ablation? Honestly, hysterectomy for heavy periods is really outdated- there are other options- is your gynae good and up to date?

p.sp- have you been offered the Pill as an option?
Do you mean your uterus is retroverted (laid back?) Mine is too but have never had either painful or heavy periods.

Yes - my womb is retroverted. I understood that it caused the back aches and pain that I get because it wasn't emptying properly. Never heard of metafemic acid and haven't been offered the pill. My Gynae has been in the game for a long time (so I do trust her) but was concerned as she wants to do an abdominal hysterectomy rather than laparascopic which I thought was a bit "newer". Not really sure what to do

I had a hysterectomy fo the same reasons as you justso-a very retroverted womb,plus a moderate prolapse both made my life a misery with horrendous periods.

I was offered the mirena but wasn't interested in the hormone side thing to it,plus I had a prolapse and wasn't too happy with the wires dangling about there.

I felt the same-I was 31,even though dh and I have completed our family (dh had the snip after ds was born 7 yrs ago)the thought of not having a womb made me think I would turn into a barren old lady after the op -I didn't! I had the lot out including cervix.

I've had no problems since,although I've had my hormones tested as my gp thought I was going through a early menopause (you have a 50% chance of your ovaries shutting down after the op) but my results were within range.I've not put weight on and my hair hasn't gone grey .

I 'm just glad that I don't flood,vomit or have to stay in bed every month now due to the pain.It's fab.

Only you can decide justso,look up all the pro's and con's to it and take your time with thinking it over.

I had a hysterectomy (wonb and cervix) last year at the age of 35 after 6 years of abnormal smears and treatments. Recovered fine and back at the gym in 12 weeks.

If you really are likely to need the op in the future then sooner may be better. I think I recovered so well as I was fairly young and very fit, I wouldn't have bounced back so well had I been older.

en.wikipedia.org/wiki/Mefenamic_acid

sorry- spelling- but itis good for period pain and heavy periods.

justsotired - why does she want to do an abdominal hysterectomy? Does she think there are, eg, large fibroids in there that would make getting it out the other way an impossibility? It's just that the recovery time for abdominal surgery is quite a bit longer, so there is always a good reason for doing it this way (or certainly should be!).

I did ask why and she said that the recovery period was the same for both but just slightly longer in hospital for an abdominal. Also, apparently, my uterus is "chunky"! Other than that, I do think it is the way she prefers to do it.

Has she considered a TCRE or a microwave endometrial ablation?

These should be considered before a hysterectomy. (Both can be done as daycases). Just the lining of the womb is removed.

Re what agedknees said, I've just read the following BBC news website article:

news.bbc.co.uk/1/hi/health/8249146.stm

I would have another Mirena. The hormonal effects for me would be better than the emotional side of forever loosing my fertility, even though we don't want more kids. Hard to explain.

Why can't you have an ablation?

I think it's definitely worth you querying the reasons for her advice again, if only to set your mind at rest that her recommendation isn't just based on her being rather old fashioned in her treatment choices.

I would look for alternatives to a hysterectomy. I am not sure that the reasons are logical but I would think that you are very young to go through such a procedure unless it is the last available option.

I also have a retroverted uterus but haven't had any issues with heavy periods--yet.

I hope you get lots of helpful advice.

I have supposedly had a retroverted uterus all my life but only found out at 50+. No problems ever with heavy bleeding or weird periods.

Please be aware that hyster. even leaving ovaries in can result in an earlier menopause.

Unless on balance with your dodgy smear etc you feel it is the better option, then I'd certainly ask about meds for the bleeding and ablation etc.

Hysterectomy for heavy bleeding is now old -hat.

Also it's possible for attempts to be made to shrink the fibroids (usually with drugs) so that a hyster can be performed with lap assistance rather than total abdominal.

I'd get a second opinion on this.

My sister had ablation about 5 years ago and never looked back. Mirena just didn't agree with her - the depression and absolute lack of sex drive were just not acceptable.

Ablation is cheaper, too.

Do you have a prolapsed colon? I read an article by a doc recently that 95% of his hysterectomy had a prolapsed colon. This puts pressure on other organs. I suffered from awful pressure in my lower abdomen and recurrent UTIs until my prolapsed was discovered. The colon was massaged back into place by a kinesiologist, but 4 days later it came down again because it was so heavy and impacted (lack of fiber and water keeping me regular I think). I did 3 caster oil colon cleanses - after the 2nd one, the colon moved back up itself. I knew because the nighttime pressure in my abdomen disappeared - I used to have to take paracetamol and sleep upright in bed because the pressure was so uncomfortable.

I hope this helps.

This is the article: drhandley.com/hysterectomy.html

and this is the book on Google about prolapsed colons (page 527)

books.google.co.uk/books?id=I_KZnp4EDT8C&pg=PT520&lpg=PT520&dq=ripe+for+infection+urinary+tract+infections+prolapsed+transverse+colon&source=bl&ots=iqXIbzRCgW&sig=xpzANqG03EVvgr8t_6zaMW4yY3w&hl=en&ei=9NOATqmvKpS10QXJ-rG4CQ&sa=X&oi=book_result&ct=result&resnum=2&ved=0CCoQ6AEwAQ#v=onepage&q=ripe%20for%20infection%20urinary%20tract%20infections%20prolapsed%20transverse%20colon&f=false

Do you have a prolapsed colon? I read an article by a doc recently that 95% of his hysterectomy patients had a prolapsed colon. This puts pressure on other organs. I suffered from awful pressure in my lower abdomen and recurrent UTIs until my prolapsed was discovered. The colon was massaged back into place by a kinesiologist, but 4 days later it came down again because it was so heavy and impacted (lack of fiber and water keeping me regular I think). I did 3 caster oil colon cleanses - after the 2nd one, the colon moved back up itself. I knew because the nighttime pressure in my abdomen disappeared - I used to have to take paracetamol and sleep upright in bed because the pressure was so uncomfortable.

I hope this helps.

This is the article: drhandley.com/hysterectomy.html

and this is the book on Google about prolapsed colons (page 527)

books.google.co.uk/books?id=I_KZnp4EDT8C&pg=PT520&lpg=PT520&dq=ripe+for+infection+urinary+tract+infections+prolapsed+transverse+colon&source=bl&ots=iqXIbzRCgW&sig=xpzANqG03EVvgr8t_6zaMW4yY3w&hl=en&ei=9NOATqmvKpS10QXJ-rG4CQ&sa=X&oi=book_result&ct=result&resnum=2&ved=0CCoQ6AEwAQ#v=onepage&q=ripe%20for%20infection%20urinary%20tract%20infections%20prolapsed%20transverse%20colon&f=false

Do you have a prolapsed colon? I read an article by a doc recently that 95% of his hysterectomy patients had a prolapsed colon. This puts pressure on other organs. I suffered from awful pressure in my lower abdomen and recurrent UTIs until my prolapsed was discovered. The colon was massaged back into place by a kinesiologist, but 4 days later it came down again because it was so heavy and impacted (lack of fiber and water keeping me regular I think). I did 3 caster oil colon cleanses - after the 2nd one, the colon moved back up itself. I knew because the nighttime pressure in my abdomen disappeared - I used to have to take paracetamol and sleep upright in bed because the pressure was so uncomfortable.

A colon cleanse seems to be too simple a solution for such a problem, but please read the article, it's worth a try.

I hope this helps.

This is the article: drhandley.com/hysterectomy.html

and this is the book on Google about prolapsed colons (page 527)

books.google.co.uk/books?id=I_KZnp4EDT8C&pg=PT520&lpg=PT520&dq=ripe+for+infection+urinary+tract+infections+prolapsed+transverse+colon&source=bl&ots=iqXIbzRCgW&sig=xpzANqG03EVvgr8t_6zaMW4yY3w&hl=en&ei=9NOATqmvKpS10QXJ-rG4CQ&sa=X&oi=book_result&ct=result&resnum=2&ved=0CCoQ6AEwAQ#v=onepage&q=ripe%20for%20infection%20urinary%20tract%20infections%20prolapsed%20transverse%20colon&f=false

Do you have a prolapsed colon? I read an article by a doc recently that 95% of his hysterectomy patients had a prolapsed colon. This puts pressure on other organs. I suffered from awful pressure in my lower abdomen and recurrent UTIs until my prolapsed was discovered. The colon was massaged back into place by a kinesiologist, but 4 days later it came down again because it was so heavy and impacted (constipation due to lack of fiber and water keeping me regular I believe). I did 3 caster oil colon cleanses - after the 2nd one, the colon moved back up itself. I knew because the nighttime pressure in my abdomen disappeared - I used to have to take paracetamol and sleep upright in bed because the pressure was so uncomfortable.

A colon cleanse seems to be too simple a solution for such a problem, but please read the article, it's worth a try. I can't believe how it has sorted out 12 years of my progressively worse problems.

I hope this helps.

This is the article: drhandley.com/hysterectomy.html

and this is the book on Google about prolapsed colons (page 527)

books.google.co.uk/books?id=I_KZnp4EDT8C&pg=PT520&lpg=PT520&dq=ripe+for+infection+urinary+tract+infections+prolapsed+transverse+colon&source=bl&ots=iqXIbzRCgW&sig=xpzANqG03EVvgr8t_6zaMW4yY3w&hl=en&ei=9NOATqmvKpS10QXJ-rG4CQ&sa=X&oi=book_result&ct=result&resnum=2&ved=0CCoQ6AEwAQ#v=onepage&q=ripe%20for%20infection%20urinary%20tract%20infections%20prolapsed%20transverse%20colon&f=false