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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is Hysterectomy Recommended For Endometriosis?

Hi.. I have had weight gain, of about 25pds in a two month span with major lower abdomen pain. A constant pain and ache that increases majorly during periods but never goes away. I have high estrogen levels and have been placed on progesterone for the last six months they also put me on amitriptyline and have had laproscopic surgery to eliminate endometriosis. Adeymiosis runs in my family and I believe this is what is causing my pain as well. I am 28years old two kids and have my tubes tied. The doctor I see keeps pushing out saying I won t qualify for a hysterectomy yet and keeps having me jump through hoops and have lived on so many pain killers a day for the last seven months. She told me after I took the hormones and the prescriptions and did laparoscopic I would qualify for a hysterectomy and now that I have done these steps she s saying I have to go in for a bladder laproscopic where they will cut into it to examine as well as a colonoscopy before she will ask for pre authorization for a hysterectomy. This seems to be minotulas things for the ending result being the same and makes no sense to me. Why would I have three minor surgeries before being approved for a hysterectomy? I have never heard someone going through all of this and now am pushed out another two months and she said she will just order more percocets for me to get through it. I am tired of living in pain meds to get through my day. Are these steps and hoops I am jumping through to get this pain from my uterus to go away really what I have to go through or is she just procrastinating and giving me the run around?
Wed, 8 Apr 2020
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General & Family Physician 's  Response
Hello,
It is important that you understand the health condition you have in order to comprehend the treatment plan. The presence of endometrial tissue( the innermost layer/lining of uterus) outside the uterus is termed as endometriosis. What that means is, few women have patches of uterine tissue outside uterus in and around various abdominal organs. During each menstrual cycle the endometrial tissue inside the uterus sheds off under the influence of hormones which causes the monthly menstrual bleeding. In endometriosis the tissue that is present in various other parts apart from the uterus gets activated under the influence of hormones during each period cycle.

This tissue behaves just like uterine tissue during periods, and may even bleed ,which in turn can cause local inflammation of that part (hence severe pain and spasms even when you are not in your periods). As in your case the treating doctor appears to suspect the extra-uterine endometrial tissue to be around the bladder (hence laproscopy of the bladder)and around the intestine (explains why colonoscopy is suggest). I completely understand, you must thinking hysterectomy is the right choice for you. However, it is not done in women of reproductive age group unless there is no other possible treatment. In my view, it is worth trying treatment plan suggested by your treating doctor.

Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Ayesha Shareef, General & Family Physician
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Is Hysterectomy Recommended For Endometriosis?

Hello, It is important that you understand the health condition you have in order to comprehend the treatment plan. The presence of endometrial tissue( the innermost layer/lining of uterus) outside the uterus is termed as endometriosis. What that means is, few women have patches of uterine tissue outside uterus in and around various abdominal organs. During each menstrual cycle the endometrial tissue inside the uterus sheds off under the influence of hormones which causes the monthly menstrual bleeding. In endometriosis the tissue that is present in various other parts apart from the uterus gets activated under the influence of hormones during each period cycle. This tissue behaves just like uterine tissue during periods, and may even bleed ,which in turn can cause local inflammation of that part (hence severe pain and spasms even when you are not in your periods). As in your case the treating doctor appears to suspect the extra-uterine endometrial tissue to be around the bladder (hence laproscopy of the bladder)and around the intestine (explains why colonoscopy is suggest). I completely understand, you must thinking hysterectomy is the right choice for you. However, it is not done in women of reproductive age group unless there is no other possible treatment. In my view, it is worth trying treatment plan suggested by your treating doctor. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ayesha Shareef, General & Family Physician