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Should Depro Lupron shots be taken for bloating and difficult sex life?

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I am 54. I had an oblation about 4 yrs ago. Its been great ever since. Suddenly the last few weeks I have had major bloating, no bleeding. Sex has he point where I feel that pressure of the endo... Not pain. However when I had the biopsy 4 yrs ago, it showed no cancer. Just lots of endometriosis and its adhered itself to my small bowel. If I go straight to a hysterectomy they tell me I would have to also have a surgeon to unattach the part on the bowel. I have had 2 opinions, both have suggested wait it out, but now my sex life is a little more difficult , however Im not in pain. The common opinion is to do the 6 month Depro Lupron shots. Ive read about them and Im not sure I like all those side effects, weight gain, hair loss, etc. I would be out of work for awhile AND they said sometimes you have to wear a colposcopy bad outside your stomach , I REALLY don't want to do that. Very uncertain what to do. When I had the oblation she found the endo all over the overires and causing attachments. Uterus lining was at 12 when I had the oblation, it went down to 2.... 4 yrs later its now back up to 9. Almost where I was in the beginning. I already have IBS, been treating that for years, its having some effects that are a little different too but nothing I cant live with. We were hoping to wait it out since im already in the m idle of menopause, but with new things going on..... shots was the next step. Im scared of the surgery. And im not happy with what Ive read about those shots. What do you think. Im really anxious and stressing about this. My first grandchild will be born in November. I don't want to be in a condition that I cant hold the baby or help them. What would you do? What do you know about those shots. I have to be able to work also. Ive already had night sweats and emotiona, sad , crying , depressed days so I already deal with some of that, my understanding is that the shots will make it worse. Are they worth it? Do I go straight to the surgery, because its a major one if I do it. HELP
Posted Sun, 16 Mar 2014 in Women's Health
Answered by Dr. Saul Weinreb 25 minutes later
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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Follow-up: Should Depro Lupron shots be taken for bloating and difficult sex life? 19 hours later
I understand what you are saying.. but what about the lining of the uteris thickening, from 2 to 9.... does that mean that the endometriosis is still growing and will it continue to? Until Im through with menopause, Im being told it will. The oblation I had may also not be holding up anymore...I already have some cramps like I used to , when I was having a period. Is it XXXXXXX to let the lining continue to thicken? That's one concern I have and the dr. said its probably because the stuff has grown and/or maybe a polyp, but she couldn't see that part or worse case scenario... cancer. But she doesn't think it is. Tell me about the lining thickening.. is that normal during menopause to go up that much? If it gets back to a 12 before Im through with menopause what will happen? If you could please address the thickening of the lining for me, that would be great. I am about number 52 , (going from 1 to 100) per the dr. so Im halfway through menopause. Will the shots make me bleed again, get fat, etc. And the lining thickening during Menapause? Whats happening there? So far you have been terrific.. you did help but I need these points above addressed . Thanks so much, Jeni
Answered by Dr. Saul Weinreb 4 hours later
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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Follow-up: Should Depro Lupron shots be taken for bloating and difficult sex life? 7 hours later
What she said is that its probably endometriosis still growing more than likely, does that make the lining thicken? Ive tried to wait it out already and its still growing I guess... too much apparently for her liking. Her first suggestion was lets wait about 3 months and do another ultrasound and see if its still thickening and monitor it like you said and maybe another biopsy... the first one before the oblation came back as no cancer. The results after the oblation showed no signs of endometrial hyperplasia... I read the report. However, im wondering why its thickening, if its the endo growing than eventually it will keep thickening and then what will happen. I don't want to have to do an emergency surgery. I want to be available to help my son and his wife in November when their first baby comes. However, we can know the future like you said. The shots seem to be the popular opinion now, or waiting a little longer to see how the growing goes. If it was your wife.... what would you tell her.. or if it was your mother whats the advice you would give her. I don't like the thought of being a sitting duck while its growing and messing up my bowel either. I would have already had the hysterectomy, if it wasn't for the bowel being attached to the endo. I heard I might have to wear a colposcopy bad for awhile... NO WAY... if its cancer.. of course. take everything.... but why do surgery until we know for sure. Whats the worst that will happen if I wait it out another few months and it continues to grow and I feel more and more bloated and uncomfortable during sex.... that's what I see. We have no way of knowing how long it will take me to get through menopause naturally and its scary
Answered by Dr. Saul Weinreb 30 minutes later
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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