Questions, questions, questions

I am a 38 yr old with a history of perfect periods...always 28 days apart and 6-7 days long. About a year ago I started bleeding randomly (close to every 2-3 weeks) and would bleed for about 10days. Hormone treatments work the opposite on me, making me bleed more. Finally went in for uterine ablation in late December and recovered great. (A polyp was found in the uterus and removed at that time.) At five weeks out I started bleeding, soaking a tampon and pad every hour. Dr got the bleeding to slow down but never stopped completely. I was scheduled for another ablation and laparoscopy March 23. When the dr went in he said that the uterus looked like the first ablation had never been done and the polyp was larger than the first time he removed it. He did not do the second ablation. He was afraid of burning through the uterine wall. The polyp was removed and laparosccopy revealed no problems outside of the uterus, tubes and ovaries. I'm waiting a couple of cycles to see what happens but the dr feels a hysterectomy is definitely down the road. I asked about a TVH and he said I'm not "roomy" enough. What in the world does that mean? I've had two 8 1/2 lb babies and can't imagine why a TVH can't be done. I also am having issues with losing my uterus. I'm afraid I won't feel like a real woman anymore (which is why the dr has put off the hysterectomy so far). I know this seems stupid but is a real fear for me. Can anyone shed some light? Thanks.

Hi ((js864)) & welcome to HysterSisters!!
I'm sorry to hear you are suffering with abnormal bleeding yet no diagnosis
The Polyp you mentioned can result in extended bleeding and since it grew back, perhaps it is the part of the cause? Did it improve after this last Lap?? These Polyps can occur from taking Hormones that contain Estrogen alone w/o the benefit of Progesterone to even it out...that too sounds like a possibility as it did grow back & how you experienced an increase in the bleeding when you took them...Just some thots.

I had Adenomyosis that went undiscovered until the Pathology that was performed after my Hyst. It can often go undetected sigh> Even with certain tests...a D&C w/or w/o biopsy can be difficult to give this dx as it is usually not spread thru out the uterus but only in certain parts. If the area that doesn't contain this disease is taken as a sample, it will not show up. Same goes for any other intrauterine testing. I have seen where some were given a DX thru the use of an MRI..it can show a thickening. Most women with Adenomyosis are noted as having large, boggy Uteruses. That can also be helpful in leading the discovery of this disease...unfortunately, the only treatment guaranteed at removing this condition is a Hyst.

I found this article that was similar to your current situation that I thot might be of some help to you:

	Quote:
Why am I bleeding so much? Inaccurate diagnosis can lead to inappropriate treatment. How can I still bleed after an endometrial ablation? A common cause of continued bleeding is regrowth of the endometrium from adenomyosis. Deep adeno is one of the most common causes of failure of the procedure. If this is suspected, an ablation may not be the best procedure. In worst cases it can even grow all they way through the wall. Adenomyosis can cause heavy bleeding and may also cause severe cramping. http://www.heavybleeding.com/adenomyosis.htm.

Here is another excellent site, that I found in our Resources Directory
Causes of abnormal bleeding & treatment options

Our Resources Directory contains many informative articles concerning the many conditions, aspects, possible risks & possible aftermath of this surgery along with concerns leading up to making the decision to have it.

IMO, I personally would be concerned over making the choice to undergo a Hyst when I didn't know what was causing it. Of course without the Uterus, there will be no bleeding but if it is due to another cause such as a Thyroid condition or Hormonal imbalance even after a Hyst those problems will still be there. Unfortunately, they can be worsened after this surgery that is the last thing you need to deal with, more problems.
Your concern of not feeling like a women is a very real concern for many, many women Pre-Op it is also a large issue for several gals who are Post-Op. They experiencing severe depression & feelings of not being worthy anymore, weeks, months & years after their own surgery. To read & learn more about what they are dealing with, exp. since you have some of these feelings to...many post in our Aching Hearts forum.

As for the TVH, I also was hoping to have one as well. I ended up with a TAH. I had Fibroids <what my Surgeon felt was causing my own nonstop, heavy bleeding> my Uterus was enlarged, some due to the Adeno also. I have 3 children, each born naturally but my Gyn commented that my Uterus was to tightly secured < I also had a Tipped* uterus > so he would be unable to perform it vaginally. I wonder if he felt your ligaments were tightly secured as well...
This is not an easy choice by no means...it can stir up many emotions for some...some not easily dealt with afterwards. Grief from the loss of being able to bear children or any additional children can be a loss unlike any other. Pls be sure that you consider this also and that you are ok with this as is your DH or any other significant other that may be a part of your life. That you don't define your organs as your *womanhood* that it's all based on your ability to reproduce. I'm sharing these from all I have seen & read from others suffering the emotional aspects of this surgery. Some had no choice in this decision, either
due to Cancer or done because they were in a life or death situation, most were done for *Quality of life issues* in fact 85% or so of them are. To have these emotions occur due to an option you choose but were unsure of it at the time may cause even more pain with regrets and what-if's.
They are always 2 sides to everything, this holds true for this surgery also! While there are risks & complications that can be bought on by this surgery, there are women that have praised the outcome they had. How they finally found relief to all the pain, issues they were previously experiencing, how they felt younger more vital ect...most often it appears in those who were unable to retain their Ovaries...Surgical Menopause is a whole other issues <sigh> One that is not so easily *fixed* by taking HRT <Hormone Replacement Therapy, one that many gals are still battling months & years later in an attempt to achieve some balance

The best thing I've found to do when faced with decisions concerning my current health and that could possibly affect my future health < exp. for one that is this major > is to educate myself on all my symptoms, conditions, any possible ones that match what I am experiencing then the treatment options that are available for each! The options, I seek out any and all possible outcomes and/or risks of them..include a Hyst along with *no-treatment*. The more you learn the more confident you can be with your decision & knowing if it is the right one for you...only you have to live with the outcome of this surgery be it good or bad, and only you can make that decision if it is right for you.

By weighing your options & the risks of each, you can weigh which ones are worth taking compared to what you are currently suffering. Also, for you, pls obtain a 2nd or even 3rd opinion. By doing this it can help confirm a treatment you may have been considering or mark one out...either way, it is always a good idea with this type of choice to be made.

Here are a couple more links that have helped me inform myself on issues/complications I've had...they detail the possible risks of this surgery and what to expect along with questions & concerns that need to be asked & clarified before consenting to or even considering this surgery:

Answers to FAQs and Articles about Hysterectomy and other surgery from Woman's]


Understanding Hysterectomy

I'm sure others will stop by to share their own experiences also. I hope you will continue to research, post, read posts from others & how their outcomes are. Good Luck with everything, I do hope you are able to find some answers & relief to all you suffer soon. Pls keep us posted on ** things are coming along & know that we will be here for support no matter what decision you make. All that matters is that you are well-informed and that the treatment you choose is the one you know is the best one for you

(((((((((((((((((hugs))))))))))))))))

Sheri has given you great advice. I can only add that I would seek out a second opinion from an infertility endocrinologist since these are the kind of gynecologist that deal with women's hormones; and hormones are chiefly responsible for abnormal bleeding either directly or indirectly.

Has your gynecologist done a complete hormonal workup on you? Did he test you via saliva testing? (This has been proven to be the most accurate form of testing.) If the answers to these are "no" then I strongly urge you to get another opinion.

Best wishes,

Thanks ladies...I think I'll be doing some reading. As for the hormore and thyroid imbalance, all has been checked (although not saliva) and found to be normal. You have helped immensely and I'll let you know how things are coming!

Hi js864

I'm posting a link below that someone put into a thread in "options & alternatives"--I asked about progesterone-releasing IUD for bleeding from fibroids. It looks like they have potential in treatment of bleeding for other reasons too, including adenomyosis. I was just hoping that endo & adeno sufferers would read that post even though it says fibroids in the title, because it seems like such a ray of hope. Maybe it would be worth asking your doctor if this would benefit you.

http://www.biomedcentral.com/1534-5874/2/417

I am only guessing on this, but it makes sense to me that a woman could be "roomy enough" to give birth to an 8 lb+ baby, but not for vaginal hyst, because #1, the baby is being "pushed" out from behind by labor, but the doctor is "pulling" the uterus from in front (I am having visions here of block & tackle in the OR & doctor, nurse & everyone hauling away at the end of the rope ), and #2 the baby holds the sides of the vagina apart as it is born, which doesn't happen during surgery. But take this with a great many grains of salt...I have never had a baby *or* a hysterectomy!!

I don't know what to say about "not feeling like a real woman" if you have a hysterectomy. You *are* a woman--nothing can change that. Whether you still have all your original factory equipment is really irrelevant to whether you are a real woman, IMO. I hope permanent loss of body parts doesn't make me un-real, because I have 8 fewer teeth than the full complement (removed for orthodonture). I'd hate to think that I've been "not a real person" ever since then! Seriously, some people think that being a woman is defined by the ability to have babies. I hope you won't lay that trip on yourself or let anyone else lay it on you.

Best wishes and a big

cookie1956 (finally found out how to make smilies!!!)