advice

Ok first this is my hx, 42 y.o. 4 pregnancies, 3 births, 1 csect, r ovary removied due to lg 8x6 tumor during pregnancy, hx of endometriosis, uterine and cervical polyps, tubal ligation, 2 d&c anemia due to heavy menstural cycle.  My periods before 40 were regular every 30-31 days but heavy and cramping plus passing clots, after 40 they became irregular such as every 26-38 days. I have for the past year been about every 21-26 days they have always been heavy. My periods used to start off as brown spotting first day and end on 7-8th day with brown spotting with day 2-4 heavy. Now they start with mucus and bright red spotting to within and hour or so as if i turned on a faucet i can go thru up to 16 tampons that first day, will stop and stop for about 7-8 days never know when i will bleed thru my clothing.  have left work and plan activities around my periond.  went to my primary on monday, she ordered blood work and ultr sound and refereral to gyn, had ultra sound monday and tuesday came back with enlrged uteris say 14 weeks, a 3 cm fibroid, thickening lining, cyst on cervix, all hormones in check but anemic. saw gyn yesterday, will have biopsy on 2/24, pap 2/16, blood work done to check ovary functions. I am opting for a hysterectomy. i know am cramping and spotting bright red with mucus cramps are lower back, she mentioned a few things that could be oh and the ultra sound questioned endometriosis again. Looking for another opinon on this and wether to do the hyst or an ablasion

[Elaine Brown, MD]

Hi!
If you were my patient, I would quite likely counsel you for the hysterectomy with conservation of the remaining ovary.  When fibroids are present, ablations are less successful.  Also, the ablation doesn't address the endometriosis.  Finally there is the possibility of the "post ablation" syndrome because you have had a tubal ligation.
Of course, the ablation could be done, and then if unsuccessful, you still have the option of the hysterectomy later.  It just seems to me that you will have a high likelihood of needing the hysterectomy ultimately.
Hope this helps!
Dr B