Question 89
Dear Doctor N,
I am 44 years old and believe I am in the early stages of premenopause. I have three children, all born to a normal delivery, no abortions nor miscarriages, and have had a tubal ligation after the birth of my last child in 1984. I lost my mother last year and was deeply traumatized and began noticing changes since, such as loss of sexual desire, hot flashes at nights, mood swings, etc. Just recently, I had my yearly pap smear (8-2000). The doctor mentioned no abnormal hormonal or estrogen activity, which would suggest to her that I was not in premenopause, however, one month after having the pap smear, I began bleeding profusely for over 30 days. There were spells of light bleeding which followed by a 15 day period of heavy bleeding. This concerned me and I visited a Gynecologist who prescribed Prempro Oral for 7 days. The bleeding has since stopped with the exception of a very light discharge. An ultrasound was performed two days ago and the technician mentioned small fibroids and one small cyst on my left ovary. The doctor had a small glimpse of the technician's report and immediately suggested a hysterectomy. I was advised that a complete report is due within a week and am very concerned that the doctor was able to come to the conclusion of removing my uterus without looking at the report. I am not keen on having my uterus removed at all, unless it is life-threatening. Should I have another opinion and a second pap smear and/or ultrasound performed? Please advise. I would appreciate it very dearly.
Reply:
Unless your doctor can define some reason for immediate surgery and from what you say this isn't likely, this is good opportunity to familiarize yourself about the relevant issues. There is no reason to not get another opinion as well, but you still need to understand what is going on and your options. This will enable you to make choices that are appropriate for you.
If you have not already, read as much of the web site as you can as this is what it addresses. I would start with the sections under the hysterectomy, sex and HRT headings and any of the Ask Dr N questions that seem to apply. You can access them from the main menu of the home page. www.drn4u.com
Dr N