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Ablation vs. hysterectomy
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bacshops posted:
I am 39 years old and have a long history of heavy and painful cycles. I just found out that I cannot have kids and the possibility of having kids was the only reason I have hung in this long. I am trying to decide between an EA and a hysterectomy. I've looked at medical research and read brochures, but I also want to know what women that have experienced this have to say. It seems like most women have a very smooth procedure, but then things go downhill at about six months to a year and they end needing a hysterectomy anyway. I don't want to hurt or surfer anymore and would be very upset if this were the case. Any advice?
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Anon_6061 responded:
Sorry for your suffering! Have you tried all the various hormonal and non-hormonal meds to reduce the bleeding and pain? Here's a handy table of the different meds and their effectiveness - http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0015970/table/ch8.t1/?report=objectonly. The "master" article that includes this link is http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0015970/.

The uterus, ovaries, and fallopian tubes work together so any procedure that disrupts their normal functioning can cause problems. And you're stuck with the good and the bad. At least with meds, you can stop taking them.

You may have already seen the discussion on endometrial ablation side effects that gives a lot of insight - http://forums.webmd.com/3/gynecology-exchange/forum/12649. As you can see, a number of women were very pleased with the results but then later (as long as 1-2 years out) developed debilitating pain.

This study http://www.ncbi.nlm.nih.gov/pubmed/19037028 on "probability of hysterectomy after endometrial ablation" says "Cox regression analysis found that compared with women aged older than 45 years, women aged 45 years or younger were 2.1 times more likely to have hysterectomy (95% confidence interval 1.8-2.4). Hysterectomy risk increased with each decreasing stratum of age and exceeded 40% in women aged 40 years or younger. Overall, type of endometrial ablation procedure, setting of endometrial ablation procedure, and presence of leiomyomas were not predictors of hysterectomy."

Hysterectomy isn't without side effects either. The uterine ligaments are the support structures for the pelvis. When they're severed, pelvic integrity is compromised. Removal of the uterus can also alter bladder and bowel function and result in prolapse and fistula. Sex drive and response can also suffer. Just as with ablation, the side effects may not occur in the short-term but may take longer to develop.

And of course there are the typical risks of pelvic surgery as well as the risks associated with adhesions that form post-surgery. These can cause pelvic pain and even bowel obstructions.

I had a hysterectomy and wish I had a do-over. I hope you find a solution that restores and maintains good health.
 
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CathyK responded:
I, too had a long history of heavy, painful and long cycles. I was told they would be better after having children, but after 3 I was still having the same problems. In May, 2005, at age 50 I had an ablation. The recovery was relatively painless, just a few days off of work. Within a week I was in St. Thomas for my oldest daughter's wedding. I have NOT had a period since, and barely any spotting within a few months of the procedure. My doctor gave me all the options and let me choose. I have never looked back and have not been sorry for a minute! Good luck.
 
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DDiamond responded:
Hi,
My procedure has been about 7 years ago and I am doing wondeful. The procedure was painless and haven't had any problems. I don't have a cycle which is great for me. I am 53 now and doing wonderful.
 
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LaurentG responded:
I was exactly 39 years old when I found out that I had uterine fibroids (which caused heavy and painful cycles). I was given the choice of having the EA or a hysterectomy. I chose to have a hysterectomy for two reasons: 1. I was finished having children and 2. I didn't want to have to go back for another procedure if the fibroids returned. I wanted it to be over with for good. I asked my doctor to allow me to keep my ovaries (to avoid surgical menopause). He agreed to allow me to keep them IF they were in good condition and not affected by the fibroids. Luckily for me my ovaries were in good shape. So I had the hysterectomy and have been feeling great ever since. As long as you have a good doctor and you follow his/her post-op instructions to the letter you should be just fine afterwards. Good luck! p.s. look into this site: www.hystersister.com
 
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cmtedi2463 responded:
I had an EA on 2/8. I've suffered from Uterine fibroids for years and my Dr. first mentioned the procedure about 10 yrs ago, with the warning that, at that age (39), it would probably be a temporary procedure, so, I waited. I turned 50 a few days before the procedure and am hoping that I am close enough to menopause that it will be all that is needed. Very smooth procedure. I did so much research before, and it seems that, the women who had the procedure, knowing it may only be a "fix", were ok with having a hysterectomy later.
 
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kshepp535 responded:
Hi,
I am sorry you are suffering. I too had alot of problems and ended up with a hysterectomy. But I already had children, so that part wasn't a concern for me. However, I have fibroids all through my body, and that could be what is the source of all your pain. Have you had an ultrasound yet?
If you haven't had an ultrasound I would suggest you talk to your doctor about scheduling one. I too had endometriosis, and when I had my hysterectomy, my Dr. said it was a miracle I even got pregnant, (after 7 pregnancies).
If it were me and I was faced with the choice, I would have a D&C so your uterus could grow a new lining. Because you didn't say specificly why you cannot have children, my thought is if you have a D&C it could remove scar tissue from your uterus and maybe give you a better chance.
You could always have an egg taken from your ovaries and fertilized outside your body, and then replanted in your uterus after you have the D&C and that could work. I am not a Dr. but I think you need to investigate this thouroughly before you do something permenant. If I could have 5 miracles, there's a good possibility you could have one or two.
Good Luck, take care and stay healthy.
 
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annie5995 responded:
After suffering for years with extremely painful periods due to fibroid tumors and ovarian cysts, I had a total hysterectomy over 14 years ago. After the intial recovery of 4-6 weeks, the side effects were mild - hot flashes being the worst and those are easily managed with a low dose estrogen only medication. No sexual side effects to speak of. No more worries about uterine cancer or overian cancer, no more horrible pain once a month, no more periods or mood swings. I've always said it was one of the best things I ever did for myself - but that's just me and everyone is different. Good luck with whatever you choose to do.
 
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larsen responded:
I had a laproscopic partial hysterectomy 6 months ago. It was a breeze and I would do it again and I recommend it. In hospital overnight, pain was not too bad -- always less than 5. I had one fibroid that was making my periods a monthly hell. I was severely anemic. I went in a few months prior for the ablasion but they couldn't perform the procedure due to the location of the fibroid. I kept my ovaries but lost the uterus and cervix. I'm just about back to 100%. I have more energy and feel great. I would make sure you are working out regularly prior to surgery and as soon after begin working out -- I've found that i've put on a little weight (5 lbs or so) since the surgery. I'm hoping it's winter fat.
 
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An_250490 responded:
I had an ablation done in 2008 at the age of 48. Was plague with heavy periods complete with passing large blood clots. The procedure was done in less than an hour and I have never been so happy with the procedure. My doctor told me that I might have some issues in the years to come but menopause might come into plan which would stop it from happening...so far, 52, no periods, no problems over than slight spotting the first year, nothing major...I wish I would have only had done the procedure a year or two before. I would recommend it highly
 
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Anon_6061 replied to larsen's response:
Weight gain is fairly common after hysterectomy as can be seen by a web search. I don't eat nearly as much since my hysterectomy so I've been able to maintain my weight. But I have the post-hysterectomy midsection "fat" and big belly.
 
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Anon_6061 replied to annie5995's response:
I have suffered sexual side effects. I have absolutely no libido and almost no sensation so orgasms are few and far between. And when I do have them, they pale in comparison to the uterine orgasms I had before my hysterectomy. Little did I know how important the uterus and cervix can be to sexual response...and all those nerves and blood vessels connecting our sex organs. Sometimes we don't know what we've got 'til it's gone.
 
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stillaround responded:
In 2000, I got the most horrible pain imaginable. Rushed to emergency surgery, the Dr discovered gangreen from a cyst that had burst (a couple yrs before) that hadn't flushed. One of my fallopian tubes and ovary were removed. This didn't stop my periods, however, which were (since I was 15, now 53) extremely painful and heavy...very heavy! In 2004, my OB/GYN suggested the EA. A Hysterectomy is a very evasive, painful and possibly dangerous operation, depending on your health, etc. An ablation is extremely simple, quick and for 93% (at the time) full-proof. It's the most wonderful thing I ever did. I wished it was available when I was 25! Before going through full blown menopause, I would have slight spotting, for just a couple hours, every 7-9 months...only for the first couple years. Nothing after. No problems, no pain, and definitely no regrets. Unless your 'female organs' are 'bad', why push yourself into early menopause and all the 'crap and hell' that goes with it, when EA is basically the same thing, without flashes and major attitude changes!!!
 
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An_250499 replied to kshepp535's response:
Dear Kshepp535, Godbless you for writing such a warm and compassionate response to our Dear Sister Bacshops' post. Dear Bacshops, I am also sorry to hear you are suffering from so much pain. I am 37years old, have uterine fibroids, fibromyalgia and suffer from a lot of pain. I am however, very hopeful that I shall someday, be rid of all this pain. For now however, I am seeing a Consultant Gynaecologist and other Doctors to treat the pain. I work in faith with my Doctors to take the right medications they prescribe and work towards my total healing.Please kindly consider the option of taking medicines before doing any surgeries. Like another lady said, a hysterectomy sounds so final. At least with medicines, you still have options to change your mind and the gift of hind sight. From your post it sounds like you may one day like to have children. Please don't lose faith. Hang in there. There are many true stories of women who have been blessed with the miracle of motherhood even when the chances were nil. Please look into other options aside from surgery, to control the heavy bleeding and pain. I sincerely wish you the very best and hope you'll be happy and well. Warm Regards. BlancaShalom
 
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biginagua responded:
I had laser ablation about ten years ago. My heavy periods came back after about 7 years. I know several people who have had both partial and complete hysterectomies. In talking to them and my doctors, I have convinced myself to live with the heavy cycles. I started exercising about four years ago. That turned into a love for running and subsequent weight loss of 30 pounds. The excercise helps with the pain, although I still have some months where I cramp. My periods still can get quite heavy for a day or two. My doctors keep a check on my iron levels, and I occassionally use iron supplements. I have just decided to wait it out until menopause.


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