Why TAH/BSO if there is nothing really wrong?

A little bit of background, I am 42, and had three miscarriages in the last three years. In between I had a little heavier and unpredictable periods, but nothing really too bad. My doc performed a hysteroscopy about two years ago, and found no evidence of cancer, but some pre-cancerous cells. He has also seen white spots during paps, did a colposcopy and biopsie back in May 2004, again no cancer cells. He did another one just last week, again, no cancer, but the pap had come back abnormal.
My periods started getting heavier, and start a week early, lasting about two weeks, but not every month. This started in November, before that that were predictable and light, lasting about 5 days. I don't have pain, but the heavy bleeding does scare me, and it makes life miserable of course. Plus, it makes me think something must be wrong.
My doc suggested a TAH/BSO, kind of as a preemptive strike, since he keeps suspecting uterine and/or cervical cancer, even though nothing is ever really showing up in biopsies, and because of the periods being irregular and heavy at times. I am not sure that is good enough justification, on the other hand, I hate sitting on a timebomb. I suppose I could habe an ablation and keep getting biopsies instead...I just don't know what to do....I don't have the periods as bad as some here, so is this premature? Should I let it get that bad? Or have the TAH/BSO now and be done with it?

Hi there:

Have you looked into a 2nd or 3rd opinion? I'm a bit concerned that your doctor wants to do so much and that's your only option.

An ablation is a good option as long as you do not have fibroids. It won't work if you do (I know from experience) I saw 3 other doctors besides my regular gyno. I'm glad I had a few others looking at me and my file before I made my final decision. I'm happy with the outcome.

Good luck. Let us know how it goes.

I think that having a hysterectomy as a "pre-emptive strike" against cancer that hasn't yet been diagnosed sounds pretty radical.

And unless he's suspicious of ovarian cancer (which it sounds like he's not) there's no need to remove the ovaries -- unless of course there is other disease present.

I'd agree that a second opinion would be a good idea. Good luck to you!

I agree with the other ladies, a second or third opinion may be a good idea.

It's great that your doctor is so conscientious about keeping on top of your condition, so I can understand your desire to stick with him.

I think oophorectomy is drastic for something that is only pre-cancerous - since your ovaries will protect you from so many other things that are more likely.

It must be terribly stressful to you to always be in this watchful state - you owe it to yourself to try to seek other options. You might want to find another doctor to review your biopsies and/or find another doctor to get another opinion.

Take care.

Greyt-sister, You need a second and perhaps a third opinion. Fear of cancer is very psychologically cohersive. Where is the science? I think you have cancer in spite of no evidence. Watchful is good! You can tell I don't recommend getting it over with and being done with it.

The American College of Surgeons does have a position on prophylactic hysterectomies: The benefits do not not outweigh the risks! I am cynical, but my feeling is that if the American College of Obstetricians and Gynecologists doesn't share this statement, it is only because these surgeries bring in so much money!

Your ovaries need to be considered separately. At 42 you are approx 9-10 away from your last period on average. This article is a summary of the main points regarding removal of ovaries:Rational for Ovarian Conservation by Donna Shoupe MD

For many doctors the bar to encourage removal of the ovaries has been raised from 40 to 50. This is because of the benefit of leaving premenopausal ovaries in place. Donna Shoupe is encouraging raising the bar even to age 55 and beyond. For a doctor who is encouraging removal at age 42, I'm sure this sounds very radical. Reading these boards you will see that the doctors are not uniform whatsoever in their recommendations. You are the one who will have to live with the results, there is no such thing as too much information!

If you read the board topics, sexual dysfunction, post op, bladder matters the oftentimes real problems will be further illustrated.

P.S. Although a real nuisance, heavy periods are considered pretty normal when we get into our 40's.

Greyt,
Now you will hear a opposite opinion. I lost my mom to cancer, so I on the other hand would be concern that you have had " abnormal" paps, and white spots.
It sounds like you want children and a TAH will end that.
And that is tough also because you know its final and there is no way to reverse it.
However I like you started out with excess bleeding, and ended up bleeding for about 6 weeks and off for a day or 2..it really got to be a pain..lol.
Had an ultra sound found nothing, but when they did the surgery they found a cyst behind my ovarie (sp) blonde moment...the size of a walnut.
But as I was saying, its a tough decission but I sure wouldnt want to risk cancer just to save my parts..but as I said I have strong reasons to my decission..
big hugs and God bless
sheryl
my

Hi ((greyt_sister)),
I'm sorry your experiencing these issues and understand your fear and concern over them
Before my TAH I had to have PAP's done either every 6 months or every 3 months due to the amount of abnormal test results I'd always get on them I had my surgery because of Fibroids, suspected Adenomyosis < which was confirmed after surgery>, heavy, prolonged bleeding < my last period lasted for 3 months, I was still on it as I was wheeled into the OR> I would also suffer severe pelvic pain that went through my back & down my legs. I had researched this surgery for almost a yr..I went back & forth on whether to go through with it. I had underwent many other procedures and testing along with multiple Hormone therapies all to no avail I finally decided I couldn't live like I was anymore and went through with surgery. My pathology revealed Pre-cancer cells along with a condition known as Chronic cervicitis. My Dr said that was probably the cause of my many abnormal PAP's...

I have to agree with the others on undergoing such a major surgery to reduce the risk. A Hyst itself can bring on other issues and bigger problems, one being Surgical Menopause. Some women have a very rough time on finding balance...when you get time please read the other forums where women who are dealing with further issues. Please keep in mind though that the women here need support because of further complications and the women who had successful surgery usually don't stick around as they aren't in need of a Hysterectomy Support forum..things can seem skewed at times but there are many, many women who have gotten relief from all the pain & problems, some who have never felt better.

Here are some links to some articles that can perhaps provide you with some further insight and info into this surgery along with the function of our Ovaries and why its important to retain them if they are healthy:

Hysterectomy: Making Choices and Knowing What to Expect: https://www.hystersisters.com/vb2/lin...=jump&lid=1577

Should my ovaries be removed at hysterectomy?: https://www.hystersisters.com/vb2/lin...=jump&lid=1128

DrN4u.com : Hysterectomy : Keep Your Ovaries Or Not: https://www.hystersisters.com/vb2/lin...on=jump&lid=37

Alternatives in Gynecology - hysterectomy alternatives, abnormal uterine bleed: https://www.hystersisters.com/vb2/lin...n=jump&lid=432

Good Luck in your research and decision I do hope in whatever option you decide upon it will bring you some much needed relief

Please keep us posted on your progress and most of all continue to ask those questions along with seeking out answers to any/all concerns you may have...((hugs))

Thanks for all your supportive responses! I will definitely seek a second opinion, and will seek out a female OB/GYN, not sure if it matters, but I want someone who can better understand my concerns (maybe).
I am not in any pain, and the bleeding is more annoying than really debilitating, and I would like to try other options, Novasure sounds pretty promising actually, and there is a doctor in Raleigh who does that.