Question 20 - Endometriosis And Undecided About Hysterectomy (Posted March 15, 2000)

Dr N

I am thirty-seven years old and scheduled to have a hysterectomy in a few days. I am feeling pretty good right now, so it is easy to try and talk myself out of doing it. However, there are days when I would gladly do it. I have had endometriosis (two operations) in the past. The pain I sometimes experience puts me in bed with a heating pad. Often when I'm on my feet too long or sit for too long, I feel great discomfort. My greatest concern is hormone replacement therapy. My Mom had a hysterectomy many years ago and seems to have done well with HRT. My sister had a hysterectomy in her late twenty's. Her ovaries were left and at the age of 39 is now having symptoms of menopause. I hear so many positive things about how much better I will feel after having the hysterectomy, but I'm still concerned about the pros and cons of HRT. Any advice?:

Hi,

This is not an easy decision. The problem with endometriosis, at least so far is that the only thing that is curative in most instances is a surgical removal of the uterus and ovaries and endometrial implants. If you find that the endometriosis does not negatively affect your life and your Dr's tell you that it proposes no serious threat to your health, there is no hurry to have surgery. If it is ruining your quality of life and threatening your health, then surgery is obviously the way to go.

In your case it seems that you are somewhere in the middle and you will have to decide what to do. If you do have the surgery and are able to access someone who has special skills in HRT and a wide array of HRT options, then you will probably do well. The women who have real difficulty most of the time are those who have the surgery, receive HRT which does not relieve their symptoms, are told that nothing can be done, and either believe it, or do not have the ability or wherewithal, to pursue appropriate therapy.

At your young age the prospect of not having ovaries and being without replacement therapy is not reasonable in terms of your future health and quality of life.

Let me know what and how you do.

Dr N