is hysterectomy my best option, really?

I have extreme cramping 2 days before and also the first day of my period- I take Ponstel for it because that is the only thing that makes it bearable.  I have somewhat heavy bleeding for the first few days- this ***** because due to slight pelvic prolapse, tampons don't stay put well.  I also have migraines that are related to my hormone cycle (both ovulation and menstruation)- about 8 of them a month.  Also, due to having 3 kids- I have very poor bladder control and need surgery to repair it.
Because of ALL the hormonal issues going on- does it make more sense to get a hysterectomy and have them repair my bladder also? Otherwise, I think I am looking at ALOT of other surgical procedures.  Someone suggested Mirena but I don't know how much that would help with cramping, and if I would still ovulate with that.  I am terrified of menopause that would be certainly brought on by the hysterectomy, but every month I end up in so much pain that I wonder if that would be better than this pain.  Also, I have tried birth control pills but the ones that are taken for 90 days at a time sent my migraines into overdrive, and I still had extreme cramping.  I am on monthly BC pills currently and it does help with ovulation but still have very bad cramps and periods.
I am 35, done having kids, and birth control isn't really a issue as my husband was snipped already.

[Elaine Brown, MD]

Hi!
If you were my patient, I would indeed be thinking along the lines of hysterectomy.  One important thing to know is that if the surgery is done vaginally (I would definitely suggest that approach), it is quite common to conserve the ovaries.  If ovaries are not removed, you would not be facing menopause for several more years.  It is hard to say how the migraines would respond.
One other thought, you could try a Mirena first, and then if it didn't work, you would still have the option of surgery.  
In my experience, women who have had bad cramping/pain for years are usually very happy after hysterectomy.  Everyone is different though.
Hope this helps!
Dr B

[damiana9]

Thank you.  What about ablation? I have been looking into that lately and it seems possible that it might be a good option but I haven't been able to find out if it would help cramping- especially since I have cramping before my period even starts.
I was finally going to a gyn surgical specialist but due to weather the appt was pushed back.  I am really looking forward to getting SOMETHING done about it.