endometrial ablation or Hysterectomy

Posted by sireesha36 @sireesha36, Feb 20, 2019

I am 36. I had two kids in my twenties. I had paraguard iud for 6+ years. After 5 years of paraguard iud, i had symptoms such as yeast infections, and poking feeling etc at which point i asked my gynecologist to remove it. Someone said Mirena would reduce periods and period related problems such as cramps. I had Mirena for few years but my period and period symptoms lasted the same, there wasn't any change. I experienced similar symptoms with Mirena as well (I could feel the strings etc) and hence got the mirena removed.
I haven't used shots or bc pills. I am not inclined with birth control pills as i am on medication for Thyroid.
Now i am in mid thirties and i feel like i don't want any kids and i don't want to deal with menustration, PMS every month. I really like the idea of getting Hysterectomy but wondering if it is the right choice in 30's. I looked in to endometrial ablation but wondering if it would entirely take away my periods or not.
What are the pros and cons of getting either a hysterectomy vs endometrial ablation?

Thanks.

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Hi, @sireesha36 - welcome to Mayo Clinic Connect. Determining what you want to do with birth control, especially with having a hysterectomy, is a very personal decision, and one you'd definitely want to make with your doctor to weigh the pros and cons in current medical literature.

I had a hysterectomy myself, at age 41, due to needing prolapse repairs and hysterectomy being a necessary part of that procedure. Other than the surgical recovery, physically it's been very nice not to have to deal with the monthly menstruation or birth control. I will say that though my husband and I had decided not to pursue having any more children over a year before I decided to have this surgery, I did have some emotional reaction just a few days before my surgery - just feeling worried and a little weepy about that choice to ever have a baby again going away, though cognitively I knew we would not plan to have any more children, regardless. My surgeon told me that emotions are often part of the process with hysterectomy either before it or afterward, regardless of the logic of the decision.

I'd like to invite @airey2 @granny55 @khauff @carolhope @patsydanley @baxtersmom to join in this discussion. Though none of us can provide medical advice as we are not medical professionals, @sireesha36, I'm hoping they can provide perspective on the pros and cons of making the decision to have a hysterectomy from their own experiences, or the option to have endometrial ablation. @jenniferhunter may also have some input for you.

What is your doctor recommending you pursue at this point, @sireesha36?

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First of all I am sorry you are having such a difficult time with your cycles. I got my first cycle when I was 13 and only got it maybe 1 or twice maybe 3 times a year due to having PCOS. After getting married and trying to have kids I ended up having to go through fertility treatments. I my kids are 12 years apart 1 with fertility 1 without (the later without) but I had to be on birth control when we were not trying to get pregnant in order to regulate my cycles. At age 42 I was severe abdominal pain and a CT scan showed I had 3 fibroids in my uterus so I had a hysterectomy. I wanted the doctor to take my ovaries also but he said because I was to young to be put into menopause already.

You will have to schedule an appointment with your doctor and talk about your options. I am a nurse and I don’t know of any doctor that will do a hysterectomy just because someone wants one. You usually have to be having issues/problems.

Side not exactly 1 year after my hysterectomy the doctor ended up having to take my ovaries out also due to the ADH diagnosis and a large complex cyst on left ovary.

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@lisalucier

Hi, @sireesha36 - welcome to Mayo Clinic Connect. Determining what you want to do with birth control, especially with having a hysterectomy, is a very personal decision, and one you'd definitely want to make with your doctor to weigh the pros and cons in current medical literature.

I had a hysterectomy myself, at age 41, due to needing prolapse repairs and hysterectomy being a necessary part of that procedure. Other than the surgical recovery, physically it's been very nice not to have to deal with the monthly menstruation or birth control. I will say that though my husband and I had decided not to pursue having any more children over a year before I decided to have this surgery, I did have some emotional reaction just a few days before my surgery - just feeling worried and a little weepy about that choice to ever have a baby again going away, though cognitively I knew we would not plan to have any more children, regardless. My surgeon told me that emotions are often part of the process with hysterectomy either before it or afterward, regardless of the logic of the decision.

I'd like to invite @airey2 @granny55 @khauff @carolhope @patsydanley @baxtersmom to join in this discussion. Though none of us can provide medical advice as we are not medical professionals, @sireesha36, I'm hoping they can provide perspective on the pros and cons of making the decision to have a hysterectomy from their own experiences, or the option to have endometrial ablation. @jenniferhunter may also have some input for you.

What is your doctor recommending you pursue at this point, @sireesha36?

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Thanks Lisa. Based on online research and info i can get on this topic, i will decide and talk to my doctor.

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@khauff

First of all I am sorry you are having such a difficult time with your cycles. I got my first cycle when I was 13 and only got it maybe 1 or twice maybe 3 times a year due to having PCOS. After getting married and trying to have kids I ended up having to go through fertility treatments. I my kids are 12 years apart 1 with fertility 1 without (the later without) but I had to be on birth control when we were not trying to get pregnant in order to regulate my cycles. At age 42 I was severe abdominal pain and a CT scan showed I had 3 fibroids in my uterus so I had a hysterectomy. I wanted the doctor to take my ovaries also but he said because I was to young to be put into menopause already.

You will have to schedule an appointment with your doctor and talk about your options. I am a nurse and I don’t know of any doctor that will do a hysterectomy just because someone wants one. You usually have to be having issues/problems.

Side not exactly 1 year after my hysterectomy the doctor ended up having to take my ovaries out also due to the ADH diagnosis and a large complex cyst on left ovary.

Jump to this post

Thanks for the information Khauff

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@lisalucier

Hi, @sireesha36 - welcome to Mayo Clinic Connect. Determining what you want to do with birth control, especially with having a hysterectomy, is a very personal decision, and one you'd definitely want to make with your doctor to weigh the pros and cons in current medical literature.

I had a hysterectomy myself, at age 41, due to needing prolapse repairs and hysterectomy being a necessary part of that procedure. Other than the surgical recovery, physically it's been very nice not to have to deal with the monthly menstruation or birth control. I will say that though my husband and I had decided not to pursue having any more children over a year before I decided to have this surgery, I did have some emotional reaction just a few days before my surgery - just feeling worried and a little weepy about that choice to ever have a baby again going away, though cognitively I knew we would not plan to have any more children, regardless. My surgeon told me that emotions are often part of the process with hysterectomy either before it or afterward, regardless of the logic of the decision.

I'd like to invite @airey2 @granny55 @khauff @carolhope @patsydanley @baxtersmom to join in this discussion. Though none of us can provide medical advice as we are not medical professionals, @sireesha36, I'm hoping they can provide perspective on the pros and cons of making the decision to have a hysterectomy from their own experiences, or the option to have endometrial ablation. @jenniferhunter may also have some input for you.

What is your doctor recommending you pursue at this point, @sireesha36?

Jump to this post

Hello @sireesha36. My situation was somewhat different. I started menustrating when I was 11 years old. I always had heavy bleeding and cramping and was not able to get pregnant until I was 35. The decision for a complete hysterectomy (ovaries, tubes and uterus) was a result of many factors. My grandmother died of ovarian cancer many years ago. The medical field had come a long way over the years. At 60 years old, i was diagnosed with triple negative breast cancer and ER+ breast cancer. I also tested positive for BRCA1&2 and had already been through menopause, so the decision to “remove it all” was pretty straightforward. I am sorry you are having problems with your cycles and wish you the best.

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@patsy2910 I didn’t realize you could test positive both BRCA 1&2 I thought is was one or the other. My husbands side of the family are all BRCA 1 positive. I had ADH a year ago and have a 19 year old daughter who has been told since she is BRCA 1 positive and now with a mother having a diagnosis she needs to start doing mammograms at age 25. She was not impressed.

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@khauff

@patsy2910 I didn’t realize you could test positive both BRCA 1&2 I thought is was one or the other. My husbands side of the family are all BRCA 1 positive. I had ADH a year ago and have a 19 year old daughter who has been told since she is BRCA 1 positive and now with a mother having a diagnosis she needs to start doing mammograms at age 25. She was not impressed.

Jump to this post

My sister had breast cancer (ER+) years ago when she was pregnant (before genetic testing was available). After my diagnosis, she tested positive for BRCA 1 & 2 as well. My brother never tested, but had prostrate cancer years ago. He passed last summer of pancreatic cancer. My daughter decided to be tested following my results. She tested positive for BRCA 1, but not 2. As a result, her doctor recommended MRI on the breasts every 6 months for the first couple of years (age 26). She then had ultrasounds every 6 months and had her first mammogram (age 30). I know it is scary for young women to go through the exams/tests so early, but am grateful the exams/test are available. It means they will be closely watched! Because one is my cancers was ER+, I have been taking Anastrazole (4 years so far). That is another story 😊. I am 65 years old and will be celebrating 5 years cancer-free in October! I pray your daughter will be encouraged and come to realize the mammograms are for her benefit. Just realized this is a LONG post! Blessings to you and your daughter.

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I am so sorry about your brother. There is just way to much of this nasty cancer out there.

I was on Anastrozole for 1month following my ADH diagnoses I had such pretty much every side affect you can possibly have so I had to stop taking it. They don’t want me taking tomaxafin (spelled that wrong) as after my lumpectomy I ended up with a blood clot. So I am trying to get healthy, I have cut all sugar out of my diet and have lost 40lbs and am exercising in the hopes of keeping it away that way. Blessing to you and everyone on here.

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I have not had an ablation, but know a friend who did. She said that it made her have a mini period (spotting) whenever she was around someone who was on their cycle. Some of the side effects of an ablation are POSSIBLE damage/burns to nearby organs. An ablation is considered surgery and so the normal risks that come with any surgery will apply
I had endometriosis and I asked about an ablation, but was told that because of the endometriosis, I could not have one. They did eventually do a total hysterectomy (everything gone). I have read that hysterectomies are not performed just because of heavy bleeding, unless the heavy bleeding is caused by something else, like endometriosis or fibroids. But because of being tired of cycles, I'm not sure that would be a reason to have an hysterectomy. But each doctor is different, so I would ask your ob/gyn. But remember that hysterectomy is major surgery, and recovery time is longer, the risk of complications is greater also. But it is up to you. Ask your doctor. He may even have another idea to help you.
You may also be suffering from fatigue caused by cycles going awry. He may have a solution for that too.

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