Can I decline injections and opt for surgery

[imadeitnice]

I've been under Gynecology for 4 years ( after being fobbed off the previous 6 years that it was just what periods are like) with endometriosis and adenomyosis. Main symptoms being heavy bleeding and pain. 2 years ago I had an ablation and coil fit. This stopped the heavy bleeding however the pain has returned worse than ever.
I have another scan soon and the consultant said providing nothing else shows up, my next option is 6 months of Zoladex injections followed by removal of both ovaries.
Having done a lot of reading about Zoladex injections for endometriosis, I really really don't want to go down that route and would prefer to go straight to ovary removal.
So I was wondering if anyone knows if I can say I don't want the injections? I'm worried if I don't, they won't do the surgery. Does anyone have any experience of refusing such treatment?

what is the rationale for removing just ovaries? would they be leaving the uterus? seems strange

anyway, i too had endometriosis and adenomyosis (only found out after hysterectomy at histology) I too had ablation but got a severe infection from it and ended up with bad scarring, they tried a mirena coil but in the end I had a total hysterectomy at 38 as I also had ovarian cysts.

in your shoes I would be pushing for total hysterectomy, this seems to be end result in most cases I would say

oh I was never offered any injections at all

Yes, I completely agree with @WashedUpHasBeen - I wish I had had the total hysterectomy years before I actually did.

I really don't know, I asked for a hysterectomy before the ablation and he said hysterectomy is always a last resort.
I got an infection after my ablation too, it was awful and I honestly thought I was dying I felt so unwell.
I thought when I went back this time he would say I was now suitable for it but no, his letter after the appointment states "the only option I can see is 6 months Zoladex followed by removal of both ovaries"
I was blindsided because I'd never heard of ovary removal being a treatment for endo.
Incidentally I later learned that those with Adenomyosis should never have ablations as it can make it worse so I don't have much faith in him.

I think the reason is that adenomyosis decreases in severity as menopause hormone levels change - it can also go away for quite along time post-pregnancy, presumably for similar reasons. And they are trying to mimic those hormonal changes to keep the condition in check.

Generally, they try to avoid hysterectomy as it's such an extensive operation with along recuperation time.

No idea if anyone will be prepared to offer you the more extensive operation without you trying the drug treatment first

I thought removal of ovaries was actually more severe than hysterectomy alone as it immediately puts you into menopause. Have they discussed HRT after and counselling?

https://www.nhs.uk/conditions/hysterectomy/considerations/

The answer is you can decline anything you like! I certainly did when I read the effects of Zoladex. For me with endometriosis I had ablation and cyst removal, but they might have had to take an ovary, fortunately it wasn't necessary.

I was offered Zoladex but wanted to try desogestrel first to see how I got on, and it seemed to completely control the symptoms. That was in 2015, not a dicky bird since and have been back on the combined pill for over a year, fingers crossed all ok.

Oh really, I didn't know that.
Yes he said I would be put on HRT straight away.
I've been on the mini pill in the past and at one stage they doubled the dose but it didn't help. And he won't give me the combined pill due to having migraines.
I just feel like I'm running out of options. I'm getting married in late summer and worried nothing will be sorted before then. If I have a flare up I honestly feel like I could potentially miss my own wedding as it's got so bad.