Teenager struggling to get a hysterectomy

[TheletterZ]

But she is having to really fight for it and from the article wont get it until much older.

www.bbc.co.uk/news/stories-44439735

Simple solution, identify as a man. Go down that route as it will probably be quicker then identify back again.

Does all seem a bit odd that she might get the treatment she needs quicker.

Hmm... I tend to think the same rules apply though.

Clearly she has a really life altering and difficult medical condition.

15 is still too young to make that decision though IMO.

Wow, those symptoms are just hideous and no one should have to suffer like that. Hysterectomy surely isn't the answer though? What are the repercussions of having the menopause at 15?

Stories like this really highlight how poor women's healthcare is and how much we're expected to suffer (be it horrific periods, birth injuries, pelvic organ prolapse, etc).

I too think it is symptomatic of poor healthcare for women. Hysterectomy (and presumably oophorectomy too) should not be an answer.

Some women are intolerant of their own progesterone and hormones. It can be a big problem at menopause. I think they ignore it as it 'goes away' eventually, but in an age where you have to work to 67 to get your pension, women cannot sit in a cupboard waiting for that to happen - they need to be able to function.

15 is still too young to make that decision though IMO.

Why?

We let 15 year olds consent to heart surgery / heart transplants / other transplants / take life altering drugs.

I don’t believe 15 is an age where a child can be expected to make a reliable decision regarding treatment that offers symptomatic relief but results in permanent impact on fertility. For many reasons.

This is not life saving treatment like heart surgery. It’s a treatment of choice re relief of symptoms and the result is massively damaging to fertility.

The legal age of majority at 18 does not guarantee a sensible or reliable decision nor does it imply that children younger than 18 are not capable of making sensible or reliable decisions.

18 is pragmatic.

And let's not forget that it's a 'cis privilege' to have periods.

Is it true that women feel 'less of a woman' (I had never used so many inverted commas in my life till I came across the trans bollox) if they have a hysterectomy? Or is this something we are told we will feel and haven't really questioned it? Still have my bits, but my sister was so glad to get rid of her uterus and tried to persuade me to do the same.

I'm still bleeding in my 60s - yes, I'm an outlier - and asked for a hysterectomy two years ago as I was bleeding very heavily for weeks on end, suffering from PMT/PMDD, terrible cramps, the whole shebang. Investigations showed nothing nasty so I was given a Mirena instead, which has at least stopped most of the bleeding, but has made the cramps worse. I'm very resentful that I wasn't offered a hysterectomy but haven't the time or energy to keep pushing for one...

Contraception is always supposed to be the answer, isn't it? Take the pill, get a coil. Never mind the side effects.

I would love to be sterilised. Can't tolerate hormonal contraceptives at all. Picked up a leaflet at the GP surgery saying "Considering female sterilisation?" and all it said was "get a coil instead"

Then I read about the Essure technique for sterilisation and it seems that's going to be a scandal like those affected by vaginal mesh surgery.

Men would never be fobbed off and butchered like women are.

Gosh, I’m terrified of losing my natural hormone production via surgery at 41* due to the life long consequences (osteoporosis etc).

Informed consent is key though. You can’t even have a tattoo until you are 18.

Poor outcomes/minimum options for womens’ health care is one of many reasons we need to ensure sex stays as a protected characteristic. Still so much to fight for in this arena.

*currently participating in genetic counselling for potential BRACA gene faults.

Poor kid!

Yes Betty - I had a surgical menopause for BRCA at 38 and the long term implications for lack of oestrogen at such a young age make pretty sobering reading. I completely agree that women should have agency over their bodies, but the implications of a hysterectomy/oopherectomy at 15 are pretty significant.

@borntobequiet: I'm still bleeding in my 60s - yes, I'm an outlier - and asked for a hysterectomy two years ago as I was bleeding very heavily for weeks on end, suffering from PMT/PMDD, terrible cramps, the whole shebang. Investigations showed nothing nasty so I was given a Mirena instead, which has at least stopped most of the bleeding, but has made the cramps worse.

I had the same problems, that the Mirena frame was too big for my uterus and aggravated my cramps went to Belgium and got a Fibroplant privately. Dr Wildemeersch will fit them in his office in Ghent. Email him. The cost was under €300 for the device when I went, plus travel. IMO it was worth it to be pain-free.

Also, paging any UK gynecologists on here: please see if you can find a legal way to fit these in private practice over here. The NHS doesn't offer them. I will chip into any crowdfunder to pay for your training in the insertion technique.

Poor girl!

Btw nobody is giving trans kids under 18 hysterectomies! Where on earth did you get that idea from? I know a non binary adult who keeps trying to get a sterilisation but the doctors won't do it as they are under 30.

@bd67th - thanks, very useful information!
A trip to Belgium would be nice as well!

No-one under 25 should be given a hysterectomy, unless they have a life threatening condition. Clearly this girl needs help with her intolerance to progesterone, and support for her extreme PMS, not her uterus removed ! Agree it shows up how absolutely inadequate womens’s health care can be.

RE the article, it's possible to induce menopause with histrelin, it stops ovulation, but it's not licensed in the UK for anything other than palliative care of prostate cancer patients. It feels like women living with PMDD aren't as worth treating as men dying from prostate cancer.

I'm intolerant to progesterone and the more the months go on the worse it gets, the latest 'delight' is severe shortness of breath in the week leading up to bleeding.
My mood swings are getting worse and at its peak I've been suicidal.
The GP doesn't want to know. There's nothing that can reasonably be done apparently. I'd bite someone's hand off for a solution even if it was radical surgery.

It does show the paucity of long term solutions for contraception and the way that women’s healthcare issues are minimised.
A hysterectomy has serious effects and one at 15 is a big deal - what’s needed in an ideal world is much better understanding and better methods for dealing with this sort of condition.

Progesterone sensitivity isn’t extremely rare - I know several women who exhibit symptoms of this. NONE have been able to access treatment.

Histrelin is a pretty powerful drug by the way - it will have lifelong negative effects on the patient. Cognitive damage equivalent to about 8 IQ points, osteoporosis, altered metabolic processes for fat metabolism. We dont even know the full range of adverse effects because so few young people have historically taken this (although that will change as its used as a puberty blocker so there’s your experimental population.. :( )

As for essure - yeah, next vaginal mesh scandal? I would be zero percent surprised at that.

That poor girl.

I am not sure about only allowing surgery if she's going to die. If your quality of life is impacted severly enough then you can feel you'd rather be / might as well be dead.

The idea that having kids is the be all and end all for women and girls to the extent that they have to put up with this is not right IMO.

Concerns about the side effects of sudden menopause at such a young age would be more of a concern.

I think from a medical POV sardine yes but from an informed consent perspective I think asking a 15 year old to understand medical risks is easier than asking a 15 year old to be sure they do not want children ever. Though medical risks is also a difficult one.

I just think there are worse things in the workd than not having kids and she sounds like she's there.

Women's fertility is over-invested in because we as a society still view having babies as the pinnacle of a woman's life and otherwise what's the point, to an extent.

If she tops herself then it won't have been much use, for e.g., which surely needs to be a serious consideration. The stuff about putting her in a pshychiatric facility away from her family... If I were her I'd want it gone as well (medical considerations around side effects notwithstanding).

Probably a lot of this depends on the reader. I was never "broody" or felt I desperately wanted kids so will probably have a different view to someone who was keen.

Also spent a lot of time in hosp as a kid (secondary school) often with children who had quite serious / life changing stuff wrong with them so may be over empathising there as well.

I don’t think hysterectomy is the only way to deal with those issues though.

I think it’s important not to go so far in being angry about the ‘pinnacle of womanhood’ stuff that we end up making dodgy decisions re children (or women).

After all a significant amount of the distress written about in the article has been down to lack of social support and poor management. Obviously the actual condition is distressing itself. I don’t think it would be good to end up with women getting hysterectomy because society CBA to provide social/medical support and so their conditions are unmanageable.

Medicine will be viewing this via evidence base and potential future medico-legal issues, not just with this patient.

Intolerable more than unmanageable...