Lupron "failure" -- Keep ovaries?

I had the 3-month course of once-a-month shots of Depo-Lupron this summer, starting in June. My June period was horrific, but then I didn't have another one until October 13. And I am right back to square one, start, then stop, then start, stop. My doctor did okay another 3-month round of the Lupron to get me to the first of the year, and I see him in January to discuss hysterectomy. I did tell the nurse today that this summer was the most happy and care-free I have had in years (except my bad knee started acting up; thought I would have to have THAT replaced but saw a new doctor who prescribed new arthritis meds and a wedge in my shoe and after only two weeks it is FABULOUS. At least I got through all of golf league before it started acting up!).

I'm 47, never had kids, always had bad periods, LOTS of pain, and was diagnosed with adeno this past spring with a uiterus the size of a 9-week pregnancy. MAIN question is, since all my hormone levels were normal before I started the Lupron, should I keep my ovaries and wait to go through "natural" menopause? The side effects of the Lupron were really not that bad (sometimes the hot flashes in the heat of summer were annoying, but not ANYTHING like bleeding for days and weeks at a stretch could have been). I do know natural estrogen fights a lot of bad things like osteoporosis and high cholesterol (mine has always been low-normal but I have a family history of high cholesterol and heart disease).

Should I keep my cervix? For that matter, could I even keep my Fallopian tubes (they were tied off back in 1997)? Also, I would like to do laprascopic if POSSIBLE but after last spring's MRI and ultrasound my doctor was pretty sure he would have to cut me open.

WOW, before I thought this was a done deal, then I thought it would be the knee, now it really looks like it could be happening! I can't wait, actually...doctor thought since my job is pretty sedentary I could go back to work in 3 weeks, even if he had to do an abdominal...if I had it done the last half of February could I be swinging a golf club by the first of April?

The knee doctor did prescribe Tramadol for break-through pain and actually I have only taken one in the last two weeks and THAT was for cramps. It's obviously not a drug I can function on at work, so more Lupron it is.

Any advice or websites I could research would be helpful!

I am glad that overall you had a great summer!

Regarding whether or not you should keep your ovaries based on how things went with Lupron...I have heard about women who found surgical menopause similar to Lupron, worse than Lupron, and better than Lupron! So, it is hard to say what your experience would be! If we could be sure it would be at least similar in your case then your decision would be easier! I would suggest discussing this over carefully with your doctor before making your final decision!

It is also a good idea to have at least a second opinion before scheduling a surgery to be sure the surgery is the best option for you! Getting a second opinion about whether or not to have an oophorectomy could also be helpful for you!

When deciding what to do about your ovaries you should consider your options regarding HRT.

With regard to your tubes, talk to your doctor. If your ovaries are removed, likely your tubes will be as well. If not, they may be left.

The cervix is not a separate organ but rather the neck of the uterus. In some cases retaining the cervix is possible, however since you have adenomyosis it might not be the best option as there can be endometrial lining on the cervix that could then cause issues in the future. Ask your doctor about the pros and cons for your specifically.

The type of surgery can depend on the skill of your surgeon as well as your specific circumstances.

I wish you all the best and hope this answers some of your questions! S

THANK you for the info. I thought I would keep my cervix too, but if there is the remotest possibility of further complications from adeno, forget it.

I don't feel I need a second opinion at this point. My current OB/GYN is very experienced and advanced in his field; I found him after my GYN of the past 17 years retired and I almost immediately "liked" him better....a lot of what he has told me over the past two years have led me to believe my last GYN was either not up to date on things, or was just going through the motions. This even after the very first time I saw this new doctor, he had to do an endometrial biopsy in the office...NOT a great way to ingratiate yourself to a new patient, and he even said so.

I would prefer to keep my ovaries simply because natural estrogen helps protect you from high cholesterol (which runs in my family, although mine has been low-normal almost always) and osteoporosis. I have no intention of ever using HRT (too many risks). I did tell my mother my main concern is that in extremely rare instances, women with active ovaries who have had their uterus removed could actually have a fertilized egg implant in their stomach cavity. As an RN she dismissed this, but trust me, my family has a habit of having the weirdest or most obscure medical conditions and with my luck, it would happen to me!

I start the second 3-month course of Depo-Lupron on Monday, and I see my GYN mid-January. We will definitely be discussing the removal of the uterus (sorry, at this point I don't know the abbreviation for it)...he originally thought it would have to be taken abdominally, based on the MRI and ultrasound, but if we can shrink it with the second course of Lupron it MIGHT be able to be done vaginally. I definitely will discuss leaving the ovaries with him.

Thanks again, this has been most helpful!