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Feel bloated and have pain. On Medroxyprogesterone. Had endometrial ablation. Have fibroids. Suggested total hysterectomy. Guide?

Mar 2013
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I am 54. My gynecologist thinks I should get a total hysterectomy. I need more information to decide. I felt pretty good until the nurse practitioner put me on Medroxyprogesterone. It made me feel very bloated and I had some pain. I had an endometrial ablation 3 yrs. ago and would get occasional light periods every 7-8 mos. I think they were concerned about the endometrium getting too thick and that's why I was started on the new medication. I told my doctor I could not take that medication. I just had a US and biopsy of of the endometrium. Don't have the results yet. If everything is ok I wonder if I should have the procedure. I'm concerned about side effects including sex. I do have fibroids also. I don't know how well the ovaries are functioning and if I should keep those. My Dr. see's no reason to keep them as there is a 1 in 72 chance of ovarian cancer. I do have some atrophy of the uterus and vagina. He wants to keep me on estrogen due to dryness and to prevent atrophy which makes sense.
Posted Sat, 6 Jul 2013 in Women's Health
Answered by Dr. Aarti Abraham 2 hours later
Thanks for your query.
If the biopsy results are fine, I do not see any indication for a hysterectomy if the occasional spotting does not bother you.
If you DO need a hysterectomy ( decision based on the pending biopsy results ) , it makes sense to remove the ovaries, and to use estrogen if the dryness and atrophy are bothersome.
Regarding the side effects of a total hysterectomy, yes, they do exist, but are treatable, and you would adapt to them, instead of putting yourself at risk for complications which would result if the biopsy is suspicious.
Even naturally post menopause ( since you are 54, it is just around the corner ), you would have similar problems of dryness, atrophy, estrogen deficit, which would be treatable the same way as the symptoms and side effects induced by a surgical menopause ( total hysterectomy ).
Hope this clarifies things.
Take care, and feel free to discuss further.
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