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when to get a hysterectomy?

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I will be 51 in 2 weeks. I started having peri-menopause at about age 41. Irregular periods, bleeding for long periods of time, horrible PMS with debilitating depression and anxiety. IBS always much worse before period. This went on for years. Skip forward to age 46. I stopped having periods but would intermittently have spotting a couple of times a year. I've been on bioidentical HRT for about 4 years. Great stuff. However I still have a couple of bouts of bleeding a year which result in changing hormone doses and I've had 3 endometrial biopsies (not fun procedure at all). I got so very very depressed last week that I could not get out of bed. I upped my Lexparo but which helped but the anxiety was terrible. I started spotting and the today, I started a full blown period type bleeding. My depression and anxiety have calmed down since the bleeding started and I am feeling better. but, I am sick to death of this up and down stuff with the bleeding. I want to ask for a hysterectomy but I don't know how the doctor's community views 'elective' hysterectomies now. I consider this vital given what the irregular bleeding does to my emotional and psychological state. I am talking to my nurse practitioner on Monday about all of this. I want this uterus out once and for all. I've been dealing with this for 11 years. Any thoughts?? thanks, Tiss
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I don't know that there are any hard fast rules, but usually it is the leaving it in will cause more problems than taking it out.As well as is it something that full menopause (without hormones that can keep the uterus cycling in some fashion) will cure.With me I was getting heavier and heavier periods and when they got too heavy they did some tests to see what was going on. For me it was a fibroid they could remove easily. Until the bleeding got to the making me way too anemic stage we were trying to wait out and see if I would go into menopause before it got too bad.Luckily I didn't need a hysterectomy, just a fibroid removal.They do have a procedure where they burn off the lining. That way you don't have any tissue left to bleed. (It was one of the potential treatments I might have needed depending on what they had found in there. If it had been a lining thing rather than a fibroid thing). The advantage is you don't have the problems you get with taking the uterus out as you don't have to cut into the connections it has that hold other things in place.Anyway, good luck and I hope you feel better soon.K.
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Tiss, I've got symptoms like you do, especially the depression. The bad thing is that I'm only 28 so potentially I can be stuck with this for another 20 years. I know how it feels not to want to live like this anymore. I also most likely will not ever be able to go on hormone replacement therapy or birth control pills because I had a blood clot with my surgery a few weeks ago that was related to taking birth control pills. I too really want a hysterectomy but cannot find anyone to do one on me, especially because of my age (they seem to have this silly idea that because I have a uterus I'm going to want to use it, no freaking way! It's caused enough havoc as it is, I don't need no children causing even more havoc in my life). I hope you can get some answers and figure out what to do. It's not fun living like this. Unfortunately, doctors do not understand it.
Before you have a hysterectomy, ask you doctor about doing an endometrial ablation. I went the GYN for excessive uterine bleeding, basicly 3 days in the bed and bleeding like a stuck pig. I had the HTA (Heated Thermal Ablation) done December 2005. They did a D&C and then filled my uterus with heated fluid that scalded the surface. My doctor said 3 things could happen, 1) The bleeding would stop, 2)The volume of blood would be reduced; or 3) Nothing.My next period after the procedure was light and then nothing for 4 months. Now my periods come at regular intervals of every two months. I can manage that.Remember that perimenopause can last 5 to 15 years. Be careful if they recommend HRT. I was put on BCPs to reduce the volume of blood loss. I later found out that I have an inherited form of Thrombophilia (clotting disorder) called Factor Five Lieden. My chances of having a clot was increased by 35 fold. My GYN never asked about a family history of blood clots. If he had he would never prescribed them.
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I had a total hysterectomy when I was 35. I'm now 40. I was having a lot of symptoms like peri-menopause, at the same time I had depression, anxiety. I'd feel fine for 2 weeks, then terrible, severe depression, pain, heavy periods, confusion, no energy for 2 weeks.I tried everything over several years before I had a hysterectomy. I tried many alternative treatments, anything, and everything. I had a doctor helping me go through each treatment. Tried several types of 'mini-pill', the minera coil (sp?) which made me worse, and after all that I finally had my ovaries and womb taken out.HRT afterwards was awful. I tried all different kinds of HRT, and I'd get the same symptoms almost as before the hysterectomy (obviously not the bleeding!) So stopped HRT. My mood, concentration, mental attitude has improved and did so right away. The pain lessened. I felt much better. Way better off HRT as well.My problem now has become IBS, along with related mood problems, eg feeling depressed when I am constipated. I am sure I must have had the IBS before, but it went unrecognised due to the severe problems with the menstrual cycle. Some of the symptoms may have been IBS all along, I mean. I'd hoped, and was given to believe by the surgeon/ob-gyn that those symptoms were part of my hormone cycle and would be gone once I had a total hysterectomy. Still, I would choose to do it again. It has provided a great deal of relief.
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I had an intravaginal ultrasound today at 11am and already got my preliminary results back. I have uterine fibroids. I have read on the internet where fibroids should decrease after menopause---I have been post menopause for over 3 years (no period for 4 years). I am on my 8th day of bleeding!! I hate it! My thyroid is a mess as well as my hormone levels. I want to have this uterus out. I think it will be one less problem. Also, the ultrasound sort of hurt, like it was pushing on my cervix that made me jump and I remembered that I have doing that during sex with hub too--I think that the fibroid must be related to that. Hadn't really thought about it.
Tiss, You need to get to the doctor right away. Bleeding in postmenopausual women is not NORMAL and a sign of more serious conditions. Be sdure to mention to the doctor that the ultrasound hurt.Reta
Doc said that the fibroid was the 'size of a nickel" so she didn't think that was the problem. Ultrasound did not show thickening of the uterine lining. I am off all HRT now and am having further thyriod studies done. I have also stopped bleeding--for now. Thanks for all your responses.
Tiss,I had a laparoscopy last April and was told I had uterine fibroids and adenomyosis. My doc said I could have a hysterectomy anytime I wanted. My symptoms were the opposite of yours I guess - never had a period but had anonizing pain for months. I had the hysterectomy in Sept of 06 and don't regret it for a second. I am only 35 but have all the kids I want. Now my right ovary is giving me problems. I can feel myself ovulate every month (painfull!!) and develop a cyst every month. It is coming out on Wednesday the 25th. Hopefully this is my last surgery as I am getting tired of it all.Mindy
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