When is the time for a hysterectomy?

[GrumpyCowBag]

I just don’t know.

I’m 44 and have multiple fibroids. Have done for years but every time I’m scanned there are more.

My periods are becoming more irregular. My cycle can now be as short as 12 days. Bleed for 7/8 days, off for a few days, then back on. That’s the most extreme example though and doesn’t happen often. Sometimes it can be 30 days so I have maybe 3 weeks off period. The average is probably around 21/22 days with 6/7 days bleeding.

They’re relatively heavy. Maybe 2 days of needing super plus tampon and having to change it often. I might need to get up twice during the night to change the tampon and it might overflow a bit onto a pad.

I’m regularly anaemic.

But I am coping with it. I’m not flooding through my clothes ever. So I’m not sure if I’m there yet.

I had a uterine polyp removed last year and the gynae said he would do a hysterectomy if I wanted one.

He offered to fit the coil but I said no as I suffer from vaginismus so it would’ve been impossible to remove/replace.

I would really appreciate your thoughts/experiences xx

I would get a myomectomy - surgery to remove fibrods and get the mirena coil placed at the same time whilst under so it's not painful. I would also get tranexamic acid from your GP - it reduces heavy bleeding and try NSAIDs (like naproxen, mefenamic acid and others as well) - they help with inflammation and pain. If you don't want kids and are happy to go into menopause (you can get HRT for this) then those are the main barriers to a hysterectomy but it's a personal decision and up to you.

I'd also get iron supplements or even an iron infusion which the GP can get for you, and the infusion can be done in hospital (depending on your levels).

Have you been referred to gyne yet? If do - have you gotten an appointment date? Ask your surgeon the pros and cons of myomectomy v hysterectomy v not doing anything and ask them any and all questions.

Yes you’re right, thank you. I have seen a gynae when I had the polyp and we did speak a bit about it. He said when removing the polyp he didn’t see fibroids but that’s because they’re on the outside I believe. I know I have about 40 fibroids. They’re all quite small, I think the biggest is 2cm.

He did say he would put the coil in under a general but my BUPA cover would only let me have one fitted, not removed or replaced and I really won’t cope with that being done if I’m awake.

My concern about a hysterectomy is the impact on other organs, and my friend had a hysterectomy and couldn’t then orgasm after! This is a big concern! And I know two older ladies who have had so many problems now due to scar tissue from hysterectomies.

For the orgasm issue normally low dose topical estrogen helps with that as it helps with vaginal oestrogen. Sorry I didn't realise you are going private and not NHS, anyways you can still get the mirena coil fitted and when it's time for removal you can get local, gas and air, numbing gel and licodaine injections. Your GP if you have vaginismus (I also do) can refer to a hospital with is a vulva center/pain clinic - they have speiclaist chairs and sedation as well for coil removal/insertion so I'd go for it as it can be massively beneficial. Otherwise go for a myomectomy - I don't see why not. I'd also get like I mentioned tranexamic acid - are you on this already? An NHS GP can prescibe it for you. If also get on NSAIDs from your GP and iron tablets/infusion - let them know about the cycle and heavy bleeding, they'll prescibe it, in no time.

Thank you so much.

My daughter is on Tranexamic Acid. I’ve avoided it because I worry about blood clots as I’ve always been obese but I’m a healthier weight now so will go and talk to them.

I do take iron tablets when I remember. It’s one of those situations where I take it for a while and then stop when feeling better. I should just stay on them until my periods stop for good!

Thank you so much for your help x

Yes you would need to be consistent with the iron tablets, if your levels are very low they might recommend an infusion as well. Are you on the waiting list for a myomectomy?

No not on a waiting list for anything. The last time I saw gynae was for polyp which he returned and then I’m discharged x

He removed the polyp, not returned ;-)

I was in a similar situation last year. Lots of small fibroids, too many to remove/tie off. I kept a diary and I was bleeding about half of every month even with the mirena coil. I had started estrogen patches for other peri symptoms (aged 44) which were amazing to restore my sanity but seemed to exacerbate the bleeding. It took me a while to decide but eventually my gp told me I was mad not to have the hysterectomy given I could have 10 more years of it. So I did, 6 months ago. It turned out I also had extensive endometriosis so that was removed at the same time. It's been absolutely life changing.

I had a hysterectomy and had my ovaries removed at the same time and my cervix, but I am about 10 years older than you, and honestly I wish I had it done years ago. I had at least 10 years of worsening periods that were so heavy I would flood. I was anaemic and had several iron infusions and one blood transfusion as my iron at its lowest was 3. This was all due to fibroids and polyps. I had the polyps removed twice as they grew back and apparently the fibroids weren't really large enough to cause an issue, I beg to differ, but they managed to cause the Mirena to not sit properly and eventually be pushed out.
I will also say that I did worry about the other organs and how they would be affected, but so far, apart from the atrophy which I have now got on top of with medication I should have been more religious about using, everything has been good. And, to be frank, the sex is better, but that might be more a me thing as I can no longer get pregnant and can now finally relax.

Thank you for this. I did think if I ended up bleeding more days than not, that would probably be the decider. I’ll monitor it xx have you had any negatives since having it done? x

Thank you for this! I’m so glad it’s worked for you x I’ve never even been given an iron transfusion and the lowest mine hgb has been is 8. Always tablets and they give me a bad tummy so it’s a lose lose!

Posted by accident

I suffered for many years both before and after children, ablation didn’t work, tranexamic acid made me feel awful, had keyhole hysterectomy at 50 leaving ovaries and cervix.
This made such an improvement - should have had it at 40. Never looked back, no side effects.

No, nothing to report. My appointment date was screwed up by the hospital meaning I didn't have quite as long off work afterwards as I would have preferred, but all physical recovery has been fine. I purposely took things slowly but I'm back lifting heavy weights at the gym and I started the couch to 5k as i seem to do every summer a couple of months ago. No impact on sex life, probably better given I'm not sore or bleeding all the time. The worst of it was the gas pain from the keyhole surgery and then the boredom of minding myself as I got better!

Bear in mind that if you need to have this done on the NHS, the waiting list could be years, so probably best to get on it now. I speak from experience.

Thank you all. I have private healthcare through work thank goodness. Having to wait years for something to be done is awful.

I think I’ll make an appt with the gynae again and talk options. My post was really because I keep thinking ‘I’m not at that point yet’ and I was curious if others have had a hysterectomy due to a similar situation x