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At this point my hysterectomy has not been scheduled and I'm waiting to hear when it needs to be done. I turned 40 in April and had a tubal when my daughter was born in Feb 06. At the time the Dr never mentioned that Pre-menopause could happen earlier. (My mom had hers early, at 45 and waited too long to have it done. She was anemic and needed a blood transfusion, she waited so long.) I do not want to be as sick as I remember her to be. I just want to get it over with and feel better.
Right now, I am having periods that last 13-18 days per month, passing large clots and spotting through the remainder of the month. I constantly feel exhausted and have no interest in sex or being touched. I have a fibroid that is currently 1 1/4 inch in diameter when not on my cycle (I'm told probably doubles in size when menstruating.) Since the tubal I have a lot of pain during my periods. Pain I thought was due to having ovarian cysts. It never occurred to me that it was the fibroid. My fibroid grew to the size of a grapefruit when I was pregnant with my boys and to the size of a plum when pregnant with my daughter. The dr said my fibroid likes testosterone. When not pregnant it is the size of a pea. Well, it use to be...
Now the questions...
Will Hormone therapy be necessary after my hysterectomy if my ovaries are left in place? How soon after will I feel better? That is, aside from the pain of surgery. What questions should I ask my Dr before surgery? Any reason to wait?
You don't always need HRT with or without your ovaries for menopause. Somtimes your ovaries will go into shock a bit with the trauma of surgery then wake up and function as normal for you, but sometimes they will fail due to compromised blood supply. It's really hard to say what any one persons experience will be, you may have to take a wait and see approach to see how you will do. Your recovery will depend on your own body and the type of surgery you have, there are other treatments available for fibroids and bleeding I recommend learing as much as you can to decide what option is best for you.
what kind of hysterectomy are you having? you most likely wont need hormone replacement if you keep your ovaries. if you choose to have them removed, you will go into surgical menopause and then you would need it. are you keeping your cervix? how you feel after, really depends on what type of surgery youre having.
One good treatment you may want to look into is Uterine fibroid artery embolization (UAE). What they do is a radiologist threads a catheter through the groin and into blood vessels going to the uterus. Tiny plugs block the blood supply, shriveling the fibroids.
The procedure reduces heavy bleeding, pain, and pressure about 90% of the time,women who get UAE have less pain on average a day after the procedure than those who undergo hysterectomy or myomectomy (a laparoscopic procedure), average a shorter stay in the hosp, and return to work quicker.
Turf wars between medical specialists and uneven insurance coverage are two big reasons it's not often mentioned by some doctors. Gynecological surgeons feel they're giving their business away to radiologists if they suggest UAE over hysterectomy.
I had a laproscopically assisted vaginal hyst 4.5 months ago and can say that it is the best thing that I have ever done. I am 43 and pretty much the same issues as you are having and all caused by a pesky fibroid. I kept my ovaries and have had no problems, but I also read that they can go into a shock sometimes after the surgery and may need temporary hormones to get the going again. Other than the pain of the surgery, I can't complain. But I did do a lot of research ahead of time. I also had 6 weeks fully paid disability and my insurance company would cover it even if it was elective so that all played a huge part of my decison. Plus I knew that fibroids can grow back or others grow so I wanted the permanent fix for it. Everyone is different, but the surgery gave me my life back. I no longer have to worry about what color of clothes I wear, staying close to a bathroom, and planning weekend activities with friends depending on what time of the month it was. Now I can go whenever I want and it is great. My advice is to do a lot of research, talk to your doctor about some of the negatives of a hyst, research this website and the internet, and talk to friends who have had it done...that is where I got a lot of info. Good luck on your decision.