Question: I am 52 & female. For years have suffered from heavy, prolonged bleeding & am frequently anemic although I can almost manage it with tranexamic acid (lysteda) & iron supplementation. Had d&c in dec, did not help except to confirm no cancer. Doc said had one cantaloupe sized fibroid. He expected to find many. I opted for UAE but MRI showed adenomyosis with large adenomyoma and I was told not a candidate anymore for UAE. Tried combination bc, lo loestrin fe, with very poor results. Had extreme bloating and swelling in feet and ankles ( never had swelling before) and then chest pressure and elevated d dimer & doc said my heart murmer sounded louder. In checking for clots found out I had severe venous insuffiency in one leg & cardiologist said never try bc again. Now doc says we can try Mirena or ablation. Since bc attempt in August (stopped tranexamic acid & bc on 8-29) am exhausted, SOB, no appetite, discouraged. I don't believe I want Mirena bc of hormones involved, feeling cautious there, and last time I tried one hurt bad and then after four days popped out. What about ablation? I don't know how deep my adenomyosis is but doc seems confident it will help bleeding. I have pain but can manage that with OTC ibuprofen most of time. He says helps most women and might get me to menopause.

I want to trust my doctor but he seems unconcerned about the impact bc had on me and it almost seems as if I am getting this standard speech from him every time and new info doesnt seem to change his opinion. I brought him a copy of Mri but he said he didnt need to see it and seemed dismissive of it. Said he knew what it was going to say.

I have missed a lot of work, due to fatigue. I really need advice.

Thank you. I know I'm not a candidate for UAE and that hysterectomy is always an option though not what my doc recommends; but my question is about ablation, which is what my doc wants to do. He thinks it will help me get to menopause. With adenomyosis, am I a candidate for that? I am not convinced it's a good option for me.