To wait for natural shrinkage or TAH at 51 ? ?

Hello,
I will be 51 in June.
My uterus is 18-20 weeks size, with innumerable fibroids, 2 being rather large.

My doctor recommended a hysterectomy 8 years ago. After extensive research and consideration, I decided to wait for menopause for the uterus to shrink naturally.

Two months ago she again recommended a hysterectomy, stating I could keep my ovaries.
I went for a second opinion. This doctor stated that my uterus will only shrink a small percentage. At which point I immediately scheduled the the surgery my original doctor. ...I was originally under the impression that my uterus could shrink by 50%, so I was floored.

The little voice in my head, who I make a concerted effort to listen to, tells me that because I am so close to menopause, I should cancel the surgery and continue to wait.

I hate to lengthen this but feel I need to elaborate.
I have a general distrust of doctors. The first doctor said I would be fine to go on a cruise 9 days after my surgery. Some wonderful women on this site convinced me to reschedule.
So if the doctor is wrong about my recovery time, maybe the other doctor is mistaken about how much my uterus will shrink.
Furthermore...
The woman who does the scheduling set me up for a "total abdominal hysterectomy". Further leading to my mistrust, because doesn't that mean that the doctor unilaterally decided to take my ovaries??

My most pressing and burning question is should I cancel my surgery and continue to wait to see how much my uterus will shrink, thereby possibly avoiding a hysterectomy? Or is it likely to be minimal?

TIA!

I had the option to wait and see. But along with the large bulky fibroid uterus I had heavy bleeding and anemia. For me I just kept thinking what if my menopause is beyond 51 and my uterus continued to grow? I opted for the sure thing so that I could bring my life back into control.
I had a total hysterectomy- which meant uterus and cervix were removed. As well I had a bi-lateral salinpectomy(Fallopian tubes) my ovaries were healthy so I was able to keep them.
I was told by my Dr. that the fibroids feed off estrogen and once that supply is gone they shrink. Hysterectomy is a big decision and you have do what is right for your body and well-being. Hopefully some other sisters can share some experiences regarding their fibroid uterus after menopause. Good luck on your journey

The most important thing to me is to trust your doctor. You seem to have been given a difference of opinion which is so confusing. I had my uterus 6 1/2 months pregnant and riddled with fibroids. I had a ufe about 3 years ago which was supposed to shrink the fibroids. It didn't, and my symptoms only got worse. I'm not sure how much a uterus shrinks, I would not think it was 50% and having fibroids would make that worse.

Tia, you don't mention any pain or symptoms you are having. If it is strickly an large uterus with fibroids and no "side effects" then maybe it would be best to leave it alone. If you are having cramping, heaviness, bleeding, lower back pain, and and overall feeling like crap, then you may want to get another opinion. What is your menopause doesn't start for another 4-5 years? Are you okay with that? And just because you begin menopause I would imagine it can take years for anything to shrink.

I'm 48 and had everything taken out except the ovaries. My Doctor says that they help your heart and bones as you get older and if I have another 5 years of that before I hit menopause, that works for me. I can attest to the fact that the heaviness of having a full uterus is gone. While I am still in recovery at this time, I can sense that I will be feeling a lot better when I'm fully recovered.

It is a big decision, and a very personal one. I'm not sure I'd want to wait it out.

Good luck with whatever decision you make, and I'm sure you'll get a ton of different views on this amazing site.

Hey RunninFree,

I am in the same boat as you - as to whether or not go ahead with my surgery (it was scheduled for next Wed - but got postponed .... again ... this will be third time ... and I'm beginning to rethink the whole thing).

I don't know even know if my uterus is enlarged like many of you seem to know. My gyno just wants to remove the offending fibroids (largest is 10 cm - others are ranging in 3-5 sizes from ultrasound taken back in July).

All I know is for myself, which may help you RunninFree ... my periods stopped since August (they were horrible the last few years with loss of blood, anemia, pain, and reason for surgery). I haven't had a period since, and I'm going thru' major hot sweats and other fun mood swings associated with perimenopause but no pain from the fibroids ... so are they naturally shrinking and not necessitating surgery?

I just sent off a fax to both my gyno and GP asking them if I should cancel the surgery - since I'm no longer in discomfort - but then reading others here that their stomachs are distended due to uterus being enlarged ... it makes me wonder if mine is too. And perhaps this is reason gyno didn't just want to remove fibroids and leave uterus intact (ovaries are not being removed - she will only remove them after age of 60 - I'm 54).

My other fear factor is similar to yours ... hate doctors - hospitals. I'm a Type 1 diabetic of 50 years - and at pre-op I was told I had to go off my insulin pump due to no one knowing how to operate one if I'm not with it (I am having 4-6" lateral incision made in stomach). I think I'm more worried about diabetes health at this point in time, so it's an entirely diff scenario than yours.

FatCatAnna - I would be hesitant too about the insulin pump issue. My best friend was required to go off hers during child birth and she was in the hospital for several days. In her situation no one really understood how to manage her sugar levels. She would have to remind them to take her levels (they thought twice a day should be sufficient) and even direct them if she needed more insulin or less. Then everything had to go through the official approval process of contacting a doctor to get an order for more or less insulin. She was coherent and able to do this. I could only imagine what would happen after anesthesia and being on narcotic pain meds. All this was on the hospital she had gotten approval from her doctor to manage her sugar levels herself and even worked with the endocrinologist to set-up new insulin a levels in the pump for after she gave birth. Maybe you could compromise and go off the pump but see if they would let you manage your own levels. It is scary that nurses don't really understand diabetes and how to manage it but the hospitals make you rely on them.

	Quote:
Originally Posted by Runninfree Hello, I will be 51 in June. My uterus is 18-20 weeks size, with innumerable fibroids, 2 being rather large. My doctor recommended a hysterectomy 8 years ago. After extensive research and consideration, I decided to wait for menopause for the uterus to shrink naturally. Two months ago she again recommended a hysterectomy, stating I could keep my ovaries. I went for a second opinion. This doctor stated that my uterus will only shrink a small percentage. At which point I immediately scheduled the the surgery my original doctor. ...I was originally under the impression that my uterus could shrink by 50%, so I was floored. The little voice in my head, who I make a concerted effort to listen to, tells me that because I am so close to menopause, I should cancel the surgery and continue to wait. I hate to lengthen this but feel I need to elaborate. I have a general distrust of doctors. The first doctor said I would be fine to go on a cruise 9 days after my surgery. Some wonderful women on this site convinced me to reschedule. So if the doctor is wrong about my recovery time, maybe the other doctor is mistaken about how much my uterus will shrink. Furthermore... The woman who does the scheduling set me up for a "total abdominal hysterectomy". Further leading to my mistrust, because doesn't that mean that the doctor unilaterally decided to take my ovaries?? My most pressing and burning question is should I cancel my surgery and continue to wait to see how much my uterus will shrink, thereby possibly avoiding a hysterectomy? Or is it likely to be minimal? TIA!

My situation was very similar to yours. I just turned 51, and have dealt with fibroids/heavy bleeding for several years. My OB/Gyn never pushed for a hysterectomy but always gave it as an option whenever I reported my ongoing symptoms.

I had the merina iud placed and that did help with most of the heavy bleeding, but still had some random heavy gushes. Fast forward a couple of years and I started gaining weight and a growing uterus.....ended up in the 18-20 week uterus size......YIKES.....Looked like and alien when I would lay flat.

I ended up getting 2 additional opinions, my OB/Gyn didn't do Da vinci procedures.....the surgeon she recommended said that in the past he wouldn't have hesitated to use the Da Vinci on me, but with everything that had come out recently, he would recommend TAH......working in healthcare I used a neighborhood connection and got a 3rd opinion from a very skilled Da Vinci surgeon (he and his wife operate together.....2 docs for the price of one)....

I went with the 3rd MD....and couldn't be happier. No, it wasn't perfect......a nicked bladder and foley cath for a week was not fun, BUT one of my fibroids was totally attached to the bladder and had stretched it up to near my belly button!
I opted to have everything out due to a family history of ovarian cancer......all 3 MDs encouraged their removal, but let me make the final call. On that note, I started on 1 mg of estradiol the first day post op and have not had any hot flashes or night sweats!!

All three MDs agreeded that any shrinkage of fibroid size would not be significant to relieve my "bulk" symptoms. In addition, the 2nd & 3rd surgeons felt strongly that the size of my uterus had the potential to cause kidney problems down the road (size/pressure).

As far as size goes, I could fit into all my pre-op jeans comfortably (even with some swelling) right after surgery! I am back to my initial weight (down the 10 pounds I gained in the past 15 months).

A part of me thinks I should have had the surgery 2 years ago......it would have been a much less complex surgery! However, I probably need the time to look at all the options and come to terms with it emotionally. It is not an easy decision for sure, but I definitely like fitting into my clothes again and not having to pee every time I turn around!!!

I do want to add that TRUST is huge! I didn't distrust any of the MDs I consulted with. BUT every conversation I had with the surgeon that did my surgery always left me feeling good about my choices and he always answered ALL of my questions. He even gave me his cell phone #!

Hi

Just wanted to reassure you that Total Abdominal Hysterectomy just means removal of all of uterus.

Only you can decide what surgery suits you best and when is the right time- not always an easy decision. My criteria for making my decision was based on the impact my uterus was having on my quality of life and the balance that it was definitely better out than in.

My TAH was the best thing ever - and despite a rocky initial recovery, I could have gone on a cruise at 9 days 😊

Good luck with whatever you decide x

I was scheduled for a LAH when the doctor went in thru my belly button with the camera, he found my uterus was to full of fybroids to remove and had to switch to a TAH (as an aside, when he went out to ask my DH if we shuld pospone my DH "oh no! take something out ! if she wakes up and you did nothing.heads will roll!) It true. I had been thru a Davinci surgery in Feb 14 to remove cysts and fybroids. This caused Ashermans syndrome where my entire uterus became a fybroid. We didnt find that ut till October when the doctor talked me into a Ablatin and then had to xl due to the fybroid blocking the entire inside of the uterus. Finally convinced the last doctor that at 51 I relly wasnt using it anymore and please end the pain and heavy bleeding. I am 13 days post op and althogh I could go on a cruise. there would be more sitting during my trip than dancing or touring. Pain is manageable with OTC advil. It is the crushing exaustion that hits every now and then.
They removed my ovaries but left the cervex.
If you have had children, I am questioning why they are not looking at going in thru your vagina insted if you have had chilren. Not an option for me as I have had none.

Good luck and feel better!

I'm astonished at your recovery time. Did you have open surgery? I hear recovery time of 6 weeks to 3 months for that.

Thanks

To the original poster,
Have you considered the foods you eat as possible sources of estrogen that encourage the growth of fibroids? I too suffered from painful fibroids. I also had experiences that led me to distrust the conventional medical wisdom. I did my research and uncovered a lot of information about diet and fibroids, as well as reproductive cancer. Based on what I learned I changed my diet and had positive and dramatic results. Look at my profile (about me) to learn more about it.