Too fat for a hysterectomy?

[RedDoughnut]

I've had problems with very heavy bleeding for well over a year.
A fibroid was thought to be to blame but that's been vaginally removed and the bleeding/clots is just as bad
The mirena coil came out.
I can only think the next step will be hysterectomy
My womb was described as bulky. I've had c sections years ago.
But my BMI is nearly 40.

That’s isn’t the case with everyone.

OP what has your dr said to you about the situation?

It’s really difficult to loose weight whilst really anemic. In fact it’s really difficult to do anything.
Are you taking any medication? I have to take a specific medication and all it does is increase my appetite and cause me to gain weight.

I hear you @RedDoughnut
I am on the waiting list for a hysterectomy (fibroids and polyps and now possibly an ovarian cyst) and it's been over a year now.
I am on hrt and have depo provera injections and thought at the start of this year that combination had finally stopped my bleeding. That was until 12 days ago whilst out of a dog walk the tell tale cramps started and 5 mins walk from home I flooded. I had no coat to cover up and used the dogs water bowl as a slight distraction. I had blood down my legs into my socks. This has happened several times in the past almost 2 weeks with no real warning and the clots are terrifyingly huge.
I hope you have a good appointment this week and something is decided. From the first few comments about losing weight will help, I am sure it will, but in the meantime, when you are losing so much blood you need a transfusion you literally don't have the energy to exercise. I felt like I had run a marathon walking up the stairs or getting up from getting something out of a low down cupboard.

I was on Zoladex for over a year, I thought it was meant to be for a short time, but it's until you have the operation. Mine also didn't stop the bleeding despite having depo provera injections. I think my body hates me :(

By weight loss vaccinations do you mean ozempic? I've taken it for 9 months and lost only 6 kgs. BMI in the 40s I imagine. It did help reduce my hunger and made alcohol repugnant but I need to loose 40kg not 6. The doctor won't prescribe any more because it's to dangerous. I'm in France.

I had a GA for an colonoscopy earlier this month. I had to be intubated because I'm fat.

The female morbidly obese aesthetician was an absolute cow in my pre-op appointment. Asked if I'd considered having a gastric sleeve. Happily she was nowhere to be seen on the day.

So personally I think this is a NHS excuse to ration medicine and I think elsewhere you'd get the operation.

Generally the morbidly obese have tried every diet you can imagine including WW, slimming world, VLCD, low carb, 5:2, paleo every fucking thing. And as a result of it our metabolism are totally and utterly fucked.

Thank you to all those that offered supportive comments.
I woke up at 4am with a small flood, no clots this time. I also feel swollen and sore.

I haven't been offered any treatment since the fibroid was removed 3 weeks ago but I do have Norethisterone
It used to turn the bleeding off but it hasn't worked this time, although I think I'm passing far less clots.

I will ask about ablation or injections to stop the bleeding when I have my appointment this week.
I'd rather NOT have a hysterectomy but I do need the bleeding and pains to stop.

I am on a diet as of now. ( again)

I can’t remember if it is on this thread or another gynae one I am on but there are a few of us who have had failed ablations with a bulky uterus/Adenomyosis so I’d ask to rule it out before you go down that route.

My womb is very bulky, I have been advised that I will have a vertical cut and it will need to be big/increased recovery time, hence I am not scheduling it in yet.

It is grim OP and you have my every sympathy. Ignore any ignorance, there’s no other way.

Do you take vitamins? I take Solgar’s Formulated for women. Have you had a raft of blood tests? I’ve got pernicious anaemia as well as iron deficient and have 8 weekly injections as well as pills, but after one particularly grim period towards the end of last year I had a load of blood tests. My folate levels were dire and I was vitamin D deficient - both could have been a result of the zoladex, but its worth asking for a range of blood tests to rule other things out.

Give the OP a break. She is unwell and obviously knows she is over weight. Losing weight does not automatically mean the bleeding will lessen. I suffer with heavy periods, have tried everything including losing weight and there was no improvement. My next step is ablation.

OP try and take care of yourself on a day to day basis and do things that make you feel good.

@RedCrestedDragon that's interesting. I have just read through a few old MN posts on ablations.
Can't find much on bulky wombs though.
Need to look for posts on Zoladex next.

What has struck me as how many of us are enduring extraordinarily heavy bleeding and still functioning.

I have been on vitamins. I've also had an iron infusion a few weeks after my emergency transfusion.

Yes, we are still functioning despite it all.

Read this. I ended up with severe cyclical pain, crippling pain for a week-ten days around ovulation and the same again at period time, in otherwise, almost permanent 7+/10 abdominal pain.

I took naproxen because you can still drive and function on it, unlike some of the other options available. Had a job getting it on repeat from my GP because I am asthmatic. But I’m ok on it despite that.

Bulky uterus is just that though, bigger because of fibroids and Adenomyosis in my case. My fibroids are large and in the uterine wall.

No one told me the cause of the "bulky" I assume it's because I'm fat? The fibroid is gone but it's just made things worse.

No, it isn’t necessarily because you are fat at all. It is just your womb, bigger than usual, normally because of fibroids/Adenomyosis.

Mine has been labelled bulky for 15 years, size 10 - size 18.

My adenomyosis was described as bulky.

The surgeon even commented about just how bulky it was after she removed it 🤔🫣

It was still able to removed with robotic vaginal surgery and I was in and out on the same day.

Op go back to the doctor and talk through your options. You shouldn’t have to suffer like this.

I had a hysterectomy when I was 45. The bleeding I had before was indescribable. I'd tried the mirena, like you it just exited with everyone else. By the time I got to a consultant I looked 7 months pregnant.
I had the op within 4 weeks of seeing consultant because the couldn't rule out cancer without it. My bmi was around 32 but I did manage to lose a stone in those 4 weeks. I was told by the consultant that he had lots of overweight women that he did not recommend for surgery because the risk/benefit thing was too high. In my case it was worth it. There was also risk of damaged bladder because of thr size of the fibroid.
I hope they offer you the surgery. Genuinely it was the best day of my life x

Losing weight does not automatically mean the bleeding will lessen. I suffer with heavy periods, have tried everything including losing weight and there was no improvement.

Same. I lost two stone recently to get my BMI under 30 and the bleeding (and especially the clots) has got even worse.

A bulky uterus is unrelated to your weight. The most common causes are adenomyosis (in which case I wouldn't recommend an ablation) or fibroids.

@Ashemark would adenomyosis show on a hysteroscopy?
I had one in December.
The report said patches of white endrometritis ( not endometriosis) which hasn't been mentioned since. It didn't mention the size of my uterus.

My adenomyosis showed on an ultrasound.

This was only done because my coil string disappeared and they were checking its position. It was abdominal although I'd been booked into vaginal I was bleeding heavily (as per normal then!)

It very often doesn't show up on ultrasound and no idea of a vaginal scan would have picked it up.

But if they've said it bulky then I suspect they already suspect adenomyosis.

The only cure for that is hysterectomy.

So worthwhile asking the consultant next week.

That inflammation of the uterus lining. Did they treat it?

There is a higher risk with surgery if you are overweight but it isn't high in absolute terms.

You need to feel well and the op is likely to achieve it. Be firm that you want it, be firm that it will help you continue in work and to continue funding the NHS. Be firm that you know you are overweight but feel it will be easier to manage weight loss once you are feeling better and can engage in gentle exercise.

Good luck.

@itsgettingweird No it was never mentioned. I only know about it as I got a copy of the letter to my GP. It was almost mentioned in passing.
I never followed it up as I was very anaemic by now and pining all my hopes on the fibroid removal

I feel for you OP. I too had the most ridiculous amount of bleeding. Tried the Mirena coil - it came out in a clot the size of a dinner plate.

I only ever dared wear black trousers and barely left the house for 6 months. What some women have to put up with is extraordinary.

Was told hysterectomy only solution but there was an 18 month wait. So I paid for a private op out of savings. Was a lifesaver.

If you put your mind to it you will be able to get your BMI down fairly quickly. Good luck OP.

It's absolutely true. You cleqrly have a great understanding and anatomy and physiology to made such bold statements.