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[Tuppenceworth]

Hello everyone. I'm hoping there is someone out there who may understand or have some experience of what I am about to go through.
I'm just coming up to 52 and have no menopausal symptoms (I feel very lucky).
I have a large fibroid and my gynaecologist has given me the option of having injections to induce my menopause with immediate effect, or have a hysterectomy, leaving my ovaries (which he suggests I should have removed too but I would want to keep them).
I am finding the decision really hard to make.

Obviously at my age I will go through the menopause at some point soon-ish, but I'm not sure of how hard it is to go through an induced menopause at my age; will the symptoms be worse?

Having looked through forums on a couple of sites there are a lot of women who have had a bad experience from an induced menopause, mainly (I guess) because it's so sudden, without any natural slower changes. But there must be some women who have an ok time with it?

I'm completely confused as to which route might be better.  I know whatever I choose will change my life. Do any of you have experience that may help me?

[Dancinggirl]

Hi and welcome to MM

You do have a dilemma  - stuck between a rock and hard place.   I personally would not want drugs to put me straight into menopause, because if you still have your uterus and ovaries it is unlikely that HRT would be an option for you because of the fibroid.   A full hysterectomy is not without it's problems but at least you would be able to have oestrogen to reduce menopause symptoms, IF menopause symptoms became an issue. The other plus to having a hysterectomy is that you wouldn't have any more bleeds or need progesterone - the progesterone part of HRT tends to be the hormone that can give nasty side effects.

Have they offered you a Mirena - this can sometimes shrink fibroids?

If you do go for a hysterectomy (I would research this very carefully as well) - then I'd have the ovaries out as well.  The ovaries may well be coming to the end of their life anyway. I have to say that there was a stage when I would have given anything to have a hysterectomy, so I only needed oestrogen and not combined HRT( I had awful cramps with combined HRT), - if I'd had the money I would have gone privately as the NHS wouldn't do this for me. 

Would it be possible to try the drugs that put you into menopause and, if things are not good, could you then go for the hysterectomy ? It seems harsh to only offer you one of two options!

There are many ladies on this forum who have had hysterectomies and they may be better placed to give you advice about your options.  Keep us posted.  DG x

[Hurdity]

Hi Tuppenceworth

  from me too.

Just to add to what Dancinggirl has said - that in your position, if you decide to have a hysterectomy I would most definitely and emphatically KEEP your ovaries and I would be surprised if their removal would be recommended if you have not reached menopause. They continue to produce hormones at a low level even post-menopause. If you haven't gone through menopause yet, all the more reason to keep them - vital I would say, as you would experience sudden (surgical) menopause just as you would through a chemically induced one. Reading the stories of women on here who have had surgical menopause - it is far more difficult to get the right balance of HRT (oestrogen doses and possibly testosterone) than those going through a natural menopause, even without the problems caused by progestogens.

Hurdity x

[CLKD]

Difficult as my Gynae still insists that removal of ovaries should be done at the same time to avoid a) cancer risk and b) a 2nd anaesthetic.  Maybe ask the Consultant if you can take to patients that have decided on both and see what pitfalls you might encounter.

Do make sure that you know which HRT will be offered and by home B4 you go for intervention  then let us know.

[helenmelon]

Hi Tuppenceworth,

I had a large fibroid 9cms plus other small ones. I was told a hysterectomy was the best route but after a lot of research I found UFE Uterine Fibroid Embolisation.

It's carried out by a interventional radiologist and they make a nick in your femoral artery, feed a wire through whilst viewing your insides via a scanner and they fire tiny beads in to block the blood supply to the Fibroid. It's done whilst awake with some morphine. Mine took about 2 1/2 hours to complete.

My original gynaecologist said it wouldn't work because my big Fibroid was too big but it did. Best decision I ever made. It wasn't with out pain, infact it was like labour pains for about 24 hours after but no long lasting problems and a fairly quick recovery period.

In my mind hysterectomy is a big op for fibroids when they can do a minimally invasive procedure like UFE

Good luck with your decision, any questions please ask x

[NorthArm]

Hi

I'm looking at having a hysterectomy in the future if I'm unable to have a Mirena fitted, due to constant bleeding. I'll be opting to keep my ovaries though, as even though they've stopped working, they still produce some hormones throughout life which helps to protect bones and heart. Good luck with your decision, that's a tough one. If it was me I wouldn't opt for drug induced, too many side effects xx

[Annika]

Hi Tuppence yes you do have a dilemma but hopefully the ladies have some great advice as always. My question would be how much is the fibroid affecting your life at the moment? Is it painful or pressing on something? In other words could you live with it for another few years if need be to put off menopause?  My fibroids caused a lot of pain and the uncomfortable feeling of needing to go all the time and then too a great deal of bleeding. So eventually I went in for a complete hysterectomy, my doctor advised to let the ovaries go because later on they can become cancerous. I should say I was around your age at the time and after the surgery I felt better than I have felt in years. No pain down below, no worrying about bleeding or other issues so for me it was without doubt the best thing I could have done. I hope this helps its a difficult choice to make I know.

[jaypo]

Everyone has their own story & this might complicate things more for you.
I had fibroids & horrendous periods & clots,had an endometrial ablation done to not much effect,after months of useless treatments I had a hysterectomy,it was done vaginally & I was home next day,ovaries left but I wish they'd taken them too,wasn't given that option though
Good luck

[Tuppenceworth]

Thank you so much for your replies, it's been lovely to hear from others. I have felt quite alone in this decision (even though hubby is 100% supportive, he can't make the decision for me) so this forum has helped think about my options lots.

I'm still unsure what I will do. Sadly all other options of treatment have been ruled out due to the size of the fibriod and how it is attached. In theory I could live with it and see what happens with menopause, but I have been bleeding almost the whole time (6 days without bleeding in the last 6 weeks) and am fed up with it!
But the idea of either a sudden, induced menopause or major surgery doesn't really grab me (no surprise really  )
So today I'm thinking I might sit it out and see if my body can sort itself out.
Thank you all again x

[donnacrichton]

Hi I've had a chemical induced menopause for 4 years and it has not been an easy journey. I have just stopped the medication to see if I have any life left in my ovaries. I have had the support from an amazing consultant. Not an easy decision just ask as many questions if you could try that but If it fails then have surgery. I now after 4 long years have been offered ovary removal. Good luck x

[walkingthedog]

Hi tuppenceworth
Different circumstances to you as I was 7 years into perimenopause but it will be 2 years march coming up since I had a total hysterectomy ovaries everything due to womb overgrowth and constant periods.
Its the best thing I ever did no regrets at all I 8nsisted my ovaries went as I had terrible pms also. I was already having hot flushes night sweats etc so wasn't thrown into surgical menopause quite as much as you may be.
I use 0.5 mg sandrena gel daily I get a flyshescstill but they seem to come in batches so may get them for a day then nothing weeks or for a few weeks but compared to before my hysterectomy it's easily livable with.
Goid luck with your decision I just wanted to say a total hysterectomy isn't without its problems but for me it's been brilliant