Help- Hysterectomy or not

Hi! I am a newbee seeking wisdom and guidance. I am a 31 y/o mother of 2 wonderful kids (7 and 5). I have never had a normal period in my life (as a matter of fact I am on day 75 since my last). My PMS or PMDD is getting worse and worse with each period. Plus, I am a very heavy bleeder (sorry to be gross)normally 3 solid days of praying that when I stand up it doesn't trickle down my leg. My OB/GYN (whom I love) is at the end of his rope- he tells me that my last option before hyst. is an IUD. Unfortunately, I am on an HMO and they would rather pay $6000+ for a hyst. than $600.00 for the IUD because it's considered a form of birth control- which they will not pay for. I have been on birth control pills before and had to come off due to MAJOR migraine issues. I can't decide if I am done having kids. I am beginning to think I am perimenapausal- from the description I read on different websites. Do any of you have any suggestions or can you offer advice etc....

Thanks~!!

Hi Parrothead--I literally could have written your post about 4 months ago. We have the same problems exactly, and my 2 kids are also 2 years apart. The only real difference is that I was positively not planning on having anymore children. Deciding to have this type of surgery took a lot of research and prayers. It was without a doubt the best decision for me. Knowing I can stand up, go to work, bikeride--pretty much do anything and not worry about the "gushing" has given me such piece of mind, plus I'm not exhausted from all the blood loss, I feel like I have my life back! I do have my ovaries so I still have pmdd but I can deal with it. Just thought I'd share my experience. Best of luck in whatever you choose to do!

Thanks for your quick reply. As far as kids go, today I say I am DONE! But my husband (who just went through testicular cancer) feels that he may want more. After I had laparoscopy in 2003 my OB/GYN told me that my uterus was enlarged and that it was very mushy- whatever that means- and that he wouldn't be surpprised if within the mext 5 years I was pleading for a hyst. I love kids and if the finances were so I could have another I am sure I would want another- I think. But we live in a small rural county in Florida and the public schools are NOT good so they have to go to private school- which costs more monthly than our mortgage. Sorry to just pour all this out. So anyway- Iam just not sure what to do.I know that if I keep my ovaries I will still have to deal with the depression, irritability etc when ever I ovulate, sometimes I am not sure whats worse the bleeding or the moodiness.

Have you asked your doctor about other progesterone supplements? Sometimes (and I'm not a doctor) unopposed estrogen will cause the heavy bleeds. Also, if you haven't had a period in 75 days, you're likely not ovulating. Has your doctor considered the B vitamins to help with your moods? My pharmacist told me Evening Primrose mimics hormones and can be a real lifesaver for a lot of women. Check with your doctor about non-permanent solutions for the bleeding and the moods -- there just may be something there for you.

I believe he has tried the progesterone and that made my headaches worse too. My GYN has me on provera and I am suppose to take it every 35 days- but somehow I look down and it's 45 days+ which is usually when I blow up like a big blow fish ( usually look 3 months pregnant- literally) and think 'well I should be starting anyday now...' then i look down again and it's been another 15 to 20 days. Then I take my 5 days of provera and turn in to a crazed looney- very angry and irritable, depressed, etc. That is why I joined- to hopefully find something not so perm. Thanks for your email. I will keep you posted. Can't get in to see my doc until Dec- unless there's some type of change.

Did I read that right that you can't see your Dr until December?? That seems like a very long time when you're having problems.

That's correct- December. He and I have been trying to figure something out for quite awhile. He's the best in Tallahassee and I would wait a year to see him. I love him. I could get in earlier would just have to get a referral (gotta love HMO's) from my primary. I figure since I have been dealing with it for so long a few more months isn't so bad.

my two cents... If you are not 100% sure about no more kids, you should wait until you are sure. This is an irreversible choice. Also, I'm sure that your doctor would be glad to get you a referral if he/she knew the extent of your GYN problems. December is a long way off if you are in pain. I am having trouble waiting 5 more weeks!

I hope that you think about and research your options. You may decide the hyst is the way to go, but you may not. I wish you the best, which ever you choose and I'll say a prayer for you and your family.

Hi parrothead
I had similar probs to you with heavy bleeding and my gp gave me tablets. Sorry I can't remember the name but I tried 3 different ones because some made me nauseous. They worked pretty well.
I also had the Mirena iud for 3 years. It was fantastic - light periods and aparently some people have no periods at all! I would be happily on it still if not for my huge fibroid.
I would definitely consider it if your doctor thinks it is suitable. Mind you,I didn't have to pay for mine but it does last 5 years.And it did help with pms which has come back since the hyst!(I'm back on the evening primrose again!)
good luck with your decision
Liz

Has your doctor suggested a D&C? Sometimes that can "reset" your periods so they're regular again, and it can also be used to diagnose if any "nasties" (i.e. malignancy) are present.

A "mushy" uterus can be a sign of adenomyosis, which is where the endometrial lining has grown into the uterine muscle itself. Unfortunately, that is very hard to diagnose (mine wasn't diagnosed until after my surgery, although in retrospect the signs were there). If you had c-sections, or are having clotting with your periods, those can be associated with adeno. A D&C would NOT change your symptoms if adeno is the problem.

Also, some insurers will cover the Mirena if the proper diagnosis code is used (i.e. the code for "dysfunctional uterine bleeding"). It's also been used in cases of hyperplasia with atypia (a type of pre-cancerous cells). Your doctor can appeal that decision by the company so that you can give the Mirena a try. If you are anemic, they can also use that code to prove to the company that this isn't a "birth control" issue.

Big s. I hope you get some relief soon!

Audrey