Looking at options - thinking of hysterectomy

I'm currently looking into the possibility of a hysterectomy as a way of managing hormonal therapy - it seems terribly drastic, and I'm scared of jumping from the frying pan into the fire BUT it also has the potential of making life much simpler.

In 2011, I was diagnosed with Stage 1 breast cancer. I received treatment consisting of surgery, chemotherapy, and radiation - the chemotherapy put me into menopause, which was an utter disaster for me, both physically and emotionally.

I started ERT this past spring (Vivelle Dot .1), which works well for me. As I currently have an intact uterus, however, I cannot have unopposed estrogen. Oral progesterone was not tenable - for one thing, it had severe 'side' effects; for another, my endrometrial tissue is still very healthy and responsive to estrogen - I'd need to be cycling oral progesterone every month. As progesterone has been shown to increase the risk of breast cancer recurrence, that's not a good idea.

Three weeks ago, I had a Mirena IUD inserted - with all hopes that this would be my bionic buddy for the next five years. So far, the adjustment period has been a lot rougher than I hoped, and I'm experiencing hormonal 'side' effects, including mood disturbances - I've not given up on it yet, but I want to understand my options in case it doesn't work out.

So, all else being equal - hysterectomy.

I would think (aside from the major surgery aspect of it, which is fairly major) it might be a good option. I'd expect I could have one or another form of MIP; I'd want to keep my cervix and ovaries (useless though they be, they're *mine*), there shouldn't be anything to complicate the surgery - I'm thin, in relatively good shape, minor fibroids but no other known uterine disorders to complicate things.

Am I being naive? Jumping out of the frying pan into the fire? Missing something huge?

It's not that I'm much into the concept of surgery, or ripping out bits of me, but it would seem to solve the major problem of progesterone.

Hi Framboise - I just wanted to ask which type of progesterone you had tried in the past. Were you actually taking a progesterone or were you taking a progestin? For me, progestin (Aygestin, for example) made me want to shoot myself. It was awful. I had a Mirena (which contains a different type of progestin) for about 6 months and that was an awful experience as well. Mood swings, headaches, cystic acne, sleeplessness and cramping that didn't stop. It just didn't work for me. Progesterone (Prometrium) has worked very well. My understanding is that progestins can cause an increase in breast cancer risk but that progesterone does not. Best of luck to you.

You know, I'm not absolutely sure but I'm believe I was taking Prometrium. The side effects I experienced were extreme fatigue, acne, weeping - it took me a bit over a month to recover from a ten day cyclic dose.

Not a good thing. Before I started the progesterone, I had already started bleeding and an ultrasound showed that my uterine lining was abnormally thickened (the recommendation was for an immediate D&C, but I went for the progesterone instead).

I'm not sure the research is in on the different risks of different types of progesterone/progestins - what I've seen is that (according to the studies) unopposed estrogen does not increase the risks of recurrence; opposed does.