weighing my options

Hello everyone, I hope I am posting this right and in the correct spot...

I find myself faced with a decision that I always thought would be easy for me to make, considering how much I have always hated my periods. However, now that I am faced with it, I have having a really hard time.

Ablation vs Hysterectomy.....

For five years now my periods have been getting progressively worse and worse. More and more heavy, irregular and more painful. I have always been the kind of person that if you just ignore something it goes away....I know, I know.

May 6th I started bleeding and it just didn't stop. The thing is, is that it didn't hurt...there was no cramping, no twinges, no sharp pains...nothing. That in and of itself was weird, considering the amount of pain I had been having with my periods previously. When I was finally able to get an appointment with a doctor, I had been bleeding for 77 days. He did a biopsy right away, scheduled labs and an ultrasound. Remarkably, I wasn't anemic which was surprising to us both, but I do take massive amounts of B vitamins, so that probably helps.

The biopsy came back negative for cancer or pre-cancer. However, when I went in for my follow up visit, he said that if he had gotten the ultrasound report back before the biopsy he would have thought it was cancer, because the ultrasound was "possibly" indicative of endometrial cancer. But the biopsy was negative. And there was a golf ball sized cyst on my left ovary, which he said was no big deal "every lady has them"

He put me on birth control pills, 3 a day to stop the bleeding. Long story not so short, I am now 4 months into this...and about 1.5 months into the pills and still bleeding. I stopped the bleeding for about a week, but then it started again. The only change is that after the biopsy, the pain started. I now have cramps that are about as painful as I remember early labor to be. Also, I know I am not supposed to get really graphic, but I am passing clots the size of my feet about every 4 days...usually about 3-5 at a time...no kidding.

OH! and in the first 2 months of bleeding I gained 50lbs...how does that happen?!

I spoke to the doctor on the phone the other day because I had to cancel an appointment. He has to redo my PAP smear because it came back unsatisfactory because of all the blood, but I had to cancel the redo because I am still bleeding! So he called to give me more options...most of them included more hormones..if it is not working now...why is increasing it by shots or implants going to make it work??? plus its making me feel terrible! Then he the option of ablation or hysterectomy. We had discussed those in office before, but they are not any more appealing now. They seem like the only viable options, but I just don't know what to do.

From researching it seems that ablation only works about 1/4 of the time and I am scared to death of the possible after effects of a hysterectomy. Plus, surgeries just scare me.

I want my life back. I pretty much just lay on the couch like a big lump of goo. Tired, worn out and no energy. But I just can't seem to figure out which course of action to take.

I think part of the problem is that they wont tell me what is wrong with me. Why have I been bleeding for 4 months? My "guts" keep telling me the biopsy was wrong, wrong, wrong...I have 2 aunts who died from uterine/endometrial cancer. So I'm probably just being a worry wart. But I just can't shake it.


I hope that by joining this site I can get some good information and hear other stories that can help me clear my head and come to some sort of a decision.

Sorry to hear that you are going through the same thing I went through, I had all that crazy stuff for two years. Went through a LSH last week, with an an amazingly acredited doctor. I kept going back and forth between, myomectomy and hysterectomy, I choose the hysterectomy, not a wise choice for me. I found out after the surgery that my surgeon didn't take advantage of all the ligament support that she could have, and I am now facing possible prolapse in my future. Study everything you can about prolapse, and any and all alternitives to hysterectomy. The is relief, but you must be very careful, there is no going back.

Have they mentioned a D&C? That was the first thing my doctor recommended when I was constantly bleeding and ultrasound found thick lining. That way they can do a much better sample for testing as well. Have done lots of both D&Cs and biopsies and feel that the D&Cs are way more detailed and don't leave as much room for mistakes. I have also had to have one when the biopsy came back inconclusive so know they are more definite. They can also get some of the lining out and sometimes depending on what is wrong can cure/help the problem. Just a suggestion to talk with your doctor about. It might not be a viable option for you depending on your situation, but might be something to discuss. I ultimately felt that I needed to have a hysterectomy as my issues were not resolving and I was just tired of fighting, but I was able to put it off with combinations of the D&Cs and BCPs for 7 years. Good luck on your journey!!

I don't see mention of a 2nd opinion, Could you get one? Also I wonder about the biopsy. Have they considered maybe a d and c for a better sample? I think you're wise to try to avoid surgery, since you can't go back. There may be other options, I'm no expert. But if you try other options first to no avail, at least you'll know you tried everything. Good luck with your decision.

I second greyown's recommendation of a second opinion. If no one can explain to you what is going on, but just recommending procedures to "cure" it, I think you need to dig a bit deeper.

It would be to your advantage and the doctor's to have more information so you can equip yourself to make the best decision.

Good luck.

Thank you so much for the replies. Prolapse is the the thing that scares me the most about a hysterectomy. I knew my bladder could prolapse I expect it too at some point even without a hysterectomy after four vaginal deliveries...but I NO idea that both my vagina and my rectum could prolapse after a hysterectomy and the thought of this absolutely terrifies me.

My doctor never mentioned a D&C, but I have actually thought of asking for one. After reading that it would give a bigger, better biopsy sample. I am just not sure how open to the idea he will be.

I would love a second opinion! Sadly, I belong to a fully contained, self funded HMO and if I ask for a second opinion will just be sent to one of the other 16 doctors in the building that are part of the plan's coverage "area". They have a set care protocol for how to treat that they don't deviate from. So it would be the same song and dance. I could request an outside referral based on a violation of my patient rights as my husband works for the company and I constantly feel like my confidentiality is being violated, but it will take about 3 months to get it approved.

I was awake all night trying to work all this out. I definitely need some time to clear my head and come up with a game plane of sorts. Seeing so many of you suggest a D&C just solidifies with me that that is a viable course. So I am definitely going to pursue that path next I think. I just need to decide now if I do it with my current doctor or if I push for an outside referral.

Thank you all again!

I am going through the same thing and have been for over a year now. I have just started my 3rd week of Seasonique pills and have been bleeding HEAVY for 3 1/2 weeks now. I have my appt tomorrow to talk about ablation w/ tubal litigation and partial hysterectomy. The cramps since my biopsy 1 week ago are unbearable. I have now missed 2 days work b/c of the cramping and clotting. Nothing is showing up abnormal. The culprit for me seems to be that I was getting the Depo Provera shot for years. The periods and cramps have now become so bad that I am going through 1 box of tampons a day. It is not just annoying but it is making me sick, the cramps are out of this world and I am bleeding through before I can even get from home to work. I need help really deciding which route to go too.

Get your pain under control first and formost. Then research, research, research. Do not make up your mind while you are in pain or exhausted from pain. The emergency room doctor told me to take 600 mg of advil every 4 hours. Ask your doctor if you are healthy enough to do this. If you are, then get some rest, and hit the internet, including Youtube.

I belong to an HMO like that, too. I think it would still be worth it to get a 2nd opinion from within, to see if there is actually more even within the system. Not all Drs actually use all the options available. Also, I think there are some options for "if all the usual options have failed", and I know that although at first I was denied an outside opinion, later I got one, somehow, without much problem. I realize we probably aren't in the same HMO so your outcomes may be different, but I'd try another Dr anyway, even in-house. If you can figure who might sub-specialize in your issues, all the better. I've found differences even though supposedly they have the game plan. You might be surprised. I wouldn't give up on the idea yet. Good luck.