Ablation, mirena and not being fertile any more

[Shuffleuplove]

I’m 51, regularish cycle but torrential bleeding and some menopause symptoms - saw my Gynae and he has suggested mirena and a hysteroscopy and cystoscopy and also ablation. I don’t fancy mirena at all - the thought of a foreign object or it moving etc makes me clench. So he suggested ablation and said he could do it at the same time as the hysteroscopy and said it would fix my periods. But then he said “you wouldn’t be fertile any more so there’s the psychological impact of that.” Well I wasn’t planning any more children anyway but it REALLY put me off!

So I’m going to try just HRT and am going ahead with the hysteroscopy and cystoscopy (I have recurrent bladder pain).

Am I foolish to not go ahead with the mirena/ablation?

I had a bad experience with a mirena that was meant to help with heavy bleeding but did the opposite so I'd never recommend it but I'd take an ablation if the bleeding was impacting my life badly. Why does no longer being fertile worry you at your age if you weren't planning kids anyway?

I prefer a Mirena to a GA for ablation.

The GA is no issue to me as I’ll be out for the hysteroscopy and cystoscopy anyway

@emmathedilemma I don’t fancy one either.

Don’t know why it’s got into my head about the kids thing. But it has.

I'd suggest you ask for local estrogen cream /pessary for the bladder pain (had that, terrible time for years and years.)

Many women have those investigations with no GA- it's your choice usually. Not the ablation, obviously.

It's more usual to offer you a scan for your bleeding first rather than going in for a full hysteroscopy. They can see a huge amount on a scan, including fibroids, adenomyosis, thickening, etc.

Your dr sounds a bit gung ho- straight for the most invasive stuff without looking at less invasive options.

Can you ask for a 2nd opinion from another dr?

I have already had a CT scan and an ultrasound scan and I was initially presenting with recurrent urinary tract infection which has been treated with a long course of antibiotics. I appreciate it sounds a bit full on but there is a background and some work up already done, as well as of course a physical examination by the euro gynaecologist

If you were getting all those infections, one of the classic ways to treat women your age near menopause, is vaginal estrogen. It finds its way to the bladder through the vagina, and helps prevent the bugs taking hold by building up the bladder lining which gets thin in menopause. Many women find this helps.
Your GP ought to have twigged - 'woman age 50ish, recurrent infections- needs local estrogen.' It's a treatment that's been around for ages.

GP prescribed seven courses of ABs back to back. So I asked for private referral to uro-gynae who said he was reluctant to prescribe HRT till he had had a good look and also saw some small fibroids. I have a family history of uterine carcinoma so he wanted to be very sure all is well.

@Shuffleuplove Your GP sounds a bit lacking in experience.
The products I mentioned are not classed as HRT. They are topical estrogen and can be used by all women including the very elderly (in their 90s) . There is no link with uterine cancer with them. It's so safe that (you may have heard) it's going to be available to buy over the counter soon, once the legislation is through.

www.balance-menopause.com/?s=vaginal+estrogen&post_type=menopauselibrary

Just to give my experience with the mirena.

It changed my life.

Before I had my first one fitted I had to take a change of clothes with me wherever I went because I'd never know when I was going to flood everywhere. I was also in excruciating pain and bleeding mid cycle as well as during my actual period.

Every other method of controlling my endometriosis had failed.

I have not had more than a tiny and rare bit of spotting since.

I'm 51 now and had my first one fitted when I was 36.

I had already given up on my fertility and had started the adoption process when I had it fitted. I've had a new one fitted every 5 years since.

I know not everyone gets on well with it but for me it has been amazing and I've had no issues with side effects either.

In 2018 I had ablation and asked for a Mirena to be inserted while I was under. Once the initial bleeding and cramps had died down (couple of months maybe?) I haven't bled a drop since. I'm 50 so hoping it's going to see me through menopause... would absolutely recommend it!

Do you still need to take HRT if you have had ablation?

My prescription for HRT arrived yesterday and I have been prescribed Evorel Conti patches. These have been prescribed by my gynaecologist and yet everything I have read indicates that it should only be prescribed for women who are no longer having bleeds. My gynaecologist is fully aware of my issues and incredibly heavy period so now I am wondering whether this is a dispensing error or there is some reasoning behind it. I am minded to email him but thought I would ask here first.

Do you still need to take HRT if you have had ablation?

I'm not sure why you are asking for HRT if your symptoms are flooding.

Hrt is to relieve symptoms of menopause.

HRT is not usually prescribed to control flooding. In fact it may make you bleed more because you are adding estrogen.

That's why your dr has suggested the Mirena, (and the ablation) to offset the heavier bleeding you might get with the HRT.

If you are paying for this private gynae, ask them why they have prescribed continuous HRT. They may have done so in order to try to control your bleeds. If you used the sort for women with periods you may well have heavier monthly bleeds, as it doesnt stop normal periods (it might make them happen at the same time each month, compared to being irregular.)

My symptoms are flooding, joint pain, shit hair and skin, disturbed sleep, planning to kill people, exhaustion, brain fog and vaginal tenderness.

I’ve emailed him. God this is complicated.

Everol conti is correct for when you still have periods as you need the progesterone part

@Newgirls

Everol conti is correct for when you still have periods as you need the progesterone part

@Newgirls 'Conti' = continuous progesterone (daily) and is for women whose periods have stopped.

Sequi=sequential = on a cycle- with progesterone half the month only is for women with periods.

@Shuffleuplove I think you have been given continuous as it's a daily progestin, and that is more likely to control the bleeding.

Ah sorry for any confusion. My pack has sequi and conti 50 in it?

Hope op gets the right thing soon

So, I checked with the consultant and he MEANT to prescribe the Sequi, the Conti was a mistake.

So I now have to pick up (and pay for) a second prescription.

Well spotted (see what I did there?) @JinglingHellsBells

Glad sorted now. GPs seem to have very sketchy knowledge on this whole area…

I'm 54 now. When I was 47 I ended up in hospital having a blood transfusion for heavy periods. The mirena coil had been suggested to me before and for some reason I didn't like the idea of it but things got so bad I was willing to try anything. I had uterine ablation and the mirena coli inserted, was the best thing I ever did. Periods became so.light the were barely noticeable. I'm still getting a bleed a few times a month now, due to see a gynae next week to get things checked. But anyone with heavy periods that are seriously affecting your life try everything that is suggested.