Hysterectomy or D&C ? ( I have disordered proliferative endometrium without a-typia + on/off hpv not 16 or 18)

Hello HysterSisters,
In advance, I am extremely appreciative of responses from anyone with similar conditions/experiences: Many many thanks ! – Vita Forte.

Overview:
I have had on and off conditions of uterus for 6-7 years and on and off of cervix (hpv – not 16 or 18) for 10 + years. I am 50 years old , 5'-5", 145lbs (+/- a few over years) and have been in menopause for 2.5 years with one spotting 10 mons into menopause which led to a series of endo biopsies. I did genetic testing and no genes with pre-disposition for hereditary cancer.

Doctor’s recommendations:

• Two doctors are pushing me towards a hysterectomy without removal of ovaries, so I don’t have to worry in future and keep watching these conditions.

• Two other doctors feel I can proceed more conservatively with a D&C only for now, since I have no bleeding and all findings are benign.

My Questions/perspective:
I know if I would EVER need a hysterectomy, I would want to do that now. I just don’t know if hysterectomy is overkill for these conditions, nor know if these are conditions will turn malignant in future. Therefore, do I want to cut major organs out for no real reason? I don’t know how long I will have to stay on progesterone if I don’t do a hysterectomy. Progesterone makes me a bit crazy after several months of use. I have no pain, aside some with intercourse, nor any bleeding any more.

MEDICATIONS:
I started taking progesterone (Medroxyprogesterone 10mg-10 days ea. month) again in March 2021. I had stopped it for 1-1/2 years, and took it for a continuous year prior to that.

CURRENT & PAST Diagnosis:

UTERUS/OVARIES :
( I have had 5 endometrium biopsies over past 4 years and one D&C 6 years ago)

• 01-2021 Endo Biopsy Diagnosis: Pre-hyperplasia, Disordered proliferative endometrium without atypia. No evidence of endometrium or malignancy.

• 01-2021 Vaginal Ultrasound: Showed 3 fibroids, endometrium lining 8.72 mm w/ polyp. Ovaries: RT (3.35x2.33x2.01) w/ cyst 1.6x1.36x1.48. LF: 2.5x1.54x1.29 (no cyst).

• 03-2020 Endo Biopsy Diagnosis: A-tropic endometrium, no evidence of endometrium, polyp or malignancy.

• 12-2019 Endo Biopsy Diagnosis: Focal simple hyperplasia w/o atypia, backgroud pattern weakly endometrium. No evidence endometrium, polyp or malinancy.

• 08-2019 Vaginal Ultrasound: Endometrium lining 9mm, uterine fibrosis end thickness 8mm. Ovaries: RT (1.9x1.4x2) w/dominant focal on right side (1.6x1.4x1.6), could not see left ovary.

• 08-2019 Endo Biopsy Diagnosis: Disordered proliferative patterned endometrium w/ simple hyperplasia w/o atypia. No malignancy found.

• 2017 Endo Biopsy Diagnosis: Proliferative pattern w/ end breakdown unremarkable tissue, negative for hyperplasia & malignancy.

• 09-2015 D&C test results: Benign endo polyp found, negative for hyperplasia and endometriosis.


CERVIX:
(Pap & Colpo results last 9 years)

• 2021 Pap results: No virus detected.
• 2020 Pap results: HPV virus found, (not 16 or 18) and no malignancy found.
• 2019 (Jan) Pap results: Abnormal cells ascus, surface layers
• 2019 (Aug) Pap results: Cells normal but HPV still detected (not 16 or 18)
• 2019 (Feb) Colpo results: HPV detected, but within normal limits
• 2018 Pap results: Pap normal, no HPV found
• 2017 (June) Colpo results: negative for HPV and no hyperplasia
• 2017 Pap results: normal, no HPV found
• 2016 Pap results: HPV virus found, (not 16 or 18)
• 2016 (April) Colpo results: Mildly abnormal cells of CIN-1 cells
• 2014 Pap results: HPV virus found, (not 16 or 18)
• 2012 Pap results: No virus found


Thankyou , thank you for any thoughts/ideas/experiences/recommendations Hystersisterst!___ from the bottom of my heart! VitaForte

We can’t tell you whether or not to proceed with a hysterectomy, but we recommend you seek other opinions.

A hysterectomy is a major surgery and you should be the last resort.

A hysterectomy is a major surgery and it can result in side effects that are worse than your current condition

thank you ! vitaforte