Brief Answer: Thank you for using HCM, I would love to help Detailed Answer: I am so sorry for what you are going through, I can only imagine how difficult it must be to make such a decision. I can completely understand your problem, and the most difficult part is not knowing what exactly the side effects and discomfort will be like, both from the surgery, or from the shots. essentially, you have three options, the shots, the surgery, and doing nothing while waiting for natural menopause. although I am a surgeon and I often advise surgical fixes, I still recommend that you first consider the consequences of doing nothing at all. the bottom line is that you do know what you feel like now, and how bad the discomfort is. you also know that there is nothing XXXXXXX about waiting for menopause, it only means that you will be uncomfortable like you are now until then. most likely, the symptoms will resolve after menopause, because endometriosis generally does resolve with menopause. in addition, if you choose to do nothing, and the symptoms do get worse, you still have the surgery and medication option available to you. based on what you told me, te surgery will most probably go well, but it is significantly more risky then an average hysterectomy. this also means more likelihood of complications such as bowel damage, infection, longer recovery, and adhesion development. this doesn't mean that it will happen, but it is more likely. and you will also have to deal with the pain of recovery. the shots do have the side effects that you are afraid of, but most women generally do well with the shots, and in general, even if they are bad, the side effects can be managed with progesterone pills (usually called "add-back" therapy). so in your case, I think your best option is either the shots or wait it out and do nothing. if things get much worse, you can always do the surgery later if you have to. this does not mean that you would be wenv to choose the surgery, but you should weigh the pros and bins and decide what is best for you. of course, there may be some things about your history that I don't know, which might change my assessment, and this you need to talk to your doctor about. but based on what you told me, this seems the most reasonable to me. I hope this was helpful, feel free to ask if you have any more questions.

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Brief Answer: Non problem, it is my privilege to help Detailed Answer: regarding the thickening, your doctor is probably right that it is nothing or maybe a polyp which is benign. however, the concern is that you may develop something called endometrial hyperplasia, and some types of hyperplasia can lead to uterine cancer. assuming that you choose not to get a hysterectomy, most likely your doctor would recommend following you by ultrasound, and if the thickness increases, your doctor will want to get at least a biopsy from your uterus. alternatively, she may recommend a D and C with a hysteroscopy so she can look inside as well as sample tissue. the problem is that after an ablation, it is not clear how effective a biopsy or D and C will be in getting a diagnosis . so at that time your choice would be to continue following by ultrasound and getting a d and c versus getting a hysterectomy. if the lining continues to thicken after menopause, that would be unusual but highly suspicious for cancer. I doubt it will happen, but if it did you may need surgery for sure. though you need to remember that it probably won't happen, but there is no way to predict the future. as far as the shots go, it will cause menopausal symptoms, and side effects like weight gain are possible, but usually that doesn't happen. the majority of women do just fine with the shots. but again, there is no way to know for sure what will happen. please feel free to let me know if you have any more questions. it is my privilege to help you.

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Brief Answer: You are asking all the right questions Detailed Answer: I really have sympathy for your situation, you seem to be very well informed and your doctor is taking good care of you. I also want to wish you congratulations on your grandchild that will be born soon. it is so difficult to answer that question when you ask what I would recommend to my wife. that is because wvery person is different and every person has different values and priorities. however, I would probably tell them to think about 1) how uncomfortable they are 2) how nervous they are about cancer 3) how nervous they are about the symptoms getting worse. just based on our conversation so far, it seems to me that this issue is really bothering you. so even if the symptoms aren't so bad, the anxiety is really getting to you. frankly, the only way to absolutely solve the problem and be done with it is to get the hysterectomy. the chances of a colostomy is extremely small, and if you got the surgery by early September you will be fully recovered by November for the baby, even if the surgery was traditional open surgery. and if you had the surgery, you would be done, period, no more worries. the only carat would be f your doctor told you that your pelvis inside was a total mess, with everything all stuck together. this is very rare, even if your endometriosis involved some bowel it is usually only a small attachment. ask your doctor how high she thinks the risk is of a bowel perforation during the surgery. if the risk is small, you should be safe wetting the surgery, but if she says that you have a "frozen pelvis" with multiple adhesions and that there is a significant chane of a bowel injury, then maybe go won't the shots. remember though, that even with a bowel injury, it is extremely rare to new a colostomy and a bag. most bowel perforations are simply sown back together and heal with no consequence. even if they remove a small piece of bowel tent ca. usually just put it back together. I hope this puts it into perspective for you. please feel free to ask me if you still have more questions, it truly is my privilege to help. whatever you decide, I wish you the best.

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