You've had some conflicting advice here, Star. I do think you should get some good, sound, medical advice about ALL your options, before you make a decision. You're supposed to be fully informed and I don't think you have been. You are entitled to have EVERY question answered to your satisfaction before anyone so much as picks up a scalpel.
The reasons for leaving in various bits are generally based on sound medical reasons, although they need to be all given serious consideration depending on the patient's personal history and diagnosis. Leaving in the cervix, for example, means that sex is going to feel far more natural for both parties. And don't say you'll never have sex again - you never know who you'll fall in love with at the Twilight Home for the Terminally Confused...
The uterus and ovaries both secrete hormones. They all have a role to play in your endocrine balance. However, it all has to be weighed up according to what the problem is.
If/when you remove various bits, you're removing their place in the hormonal pathways. Menopause is not fun. Forced, fast menopause can be a walk in the park but more often is rough. Advantages - it's over and done with quickly. Disadvantages - the entire menopause experience gets telescoped into one solid punch.
Hormones are useful. Our bodies produce the optimum range as part of a feedback loop system, controlled and regulated by the pituitary and hypothalamus. If you remove part of that loop then you are having to rely on a synthetic (and often simplified) hormonal cocktail that relies on you remembering to take it. Your body will still try to regulate it, because your hormones have no intelligence, they don't 'know' that you've had bits removed.
As you can see, doctors don't like to interfere with that without a good reason. By leaving in various bits, they make it gentler on the endocrine systems and on you. However, it would be madness to leave in ovaries in someone whose family has lost every female over 50 with ovarian cancer... as an example. That would be a good reason.
And in your case, there may also be very good reasons to leave the ovaries. Again, it has to be your decision but you need to have all this explained to you, clearly, and specifically relevant to your own case.
And now my own experience - please take note, it sounds (at least in part) similar to you.
I've NEVER had PMT. Not a bit. My daughters have, sister in law does, but not me.
But I paid my dues. Big time. Period pain. BAD period pain. In an era where there was absolutely no sympathy, only scoldingfor being a wimp when I fainted. All through school, having a really bad period was absolutely no excuse for anything. No chance to get off school; no chance to get out of sport; absolutely no chance to get out of a swimming class. And when you go to an all-girls' school with male teachers and you get heavy, painful periods and your mother won't let you use tampons - swimming class takes on a whole new level of horror.
The one 'blessing' was that the period pain would ease slightly when the flow got heavy. The worst days were also a lot lighter. But climbing into a cold swimming pool in wintry weather - not recommended.
I remember believing I had heavy periods. I'd wear double pads, sometimes triple. And back in those days, they were mattresses. The period pain got even worse by the time I was a uni student. I remember getting carried in to the uni doctor and getting an injection of combined pethidine and muscle relaxant, so I could recover enough to walk home. If I hadn't wanted kids, I'd have begged for a hysterectomy back then.
I wanted to go on the Pill. I'd heard it could help. But back then it was considered immoral for a 17 year old girl living away from home (stupid). I finally found a Family Planning clinic and self-referred. But they were in the contraceptive market. Being a virgin and having to go for my first Pap smear and breast check was traumatic. Finding a doctor who abused his position of trust didn't help. For years after that, I would insist on a female doctor. Once husband was on the scene, I would arrange for him to be with me, so I could feel safe.
Being female can be dangerous to your health.
They say your period pain should settle after you have kids. Well, maybe it did a little. But nowhere near enough.
I had a D & after I had difficult child 3. That's when I discovered that period pain sometimes can be worse than ever before.
Then I hit 50 and hit menopause like a brick wall. To be more correct, it's peri-menopause. Good, I thought. Periods should ease back and stop soon.
Nope. Just the opposite. They got even heavier (I didn't think it was possible) and even more painful. And they lasted twice, three times as long and came back after a couple of days' break.
I'm a scientist by training and mind-set. That meant I could sit in my bathroom and dispassionately analyse what my body was doing. I graphed it. I charted things. I kept meticulous records. And because my GP (then) was an old mate from uni who knew me when I worked in the labs, he understood and didn't treat me like a nut case.
What I found -
1) periods were lasting up to two weeks, then taking a week's break at most.
2) periods were heavy. Dangerously heavy, now. If I'd been a bloke, it would have been called haemorrhage.
I actually weighed my tampons and pads to see how much I was losing. I was wearing both and having to change every half hour sometimes. I was beginning to write jokes for menopausal women along the lines of "You know you're in peri-menopause when...". I would tare my kitchen scales with a fresh tampon in a plastic bag, then put my used tampon in the plastic bag to find how much it had absorbed. Same with pads. I calculated I was losing 40-50 mls each change. It worked out to 200 mls a day. For two weeks! Five days at that rate is a litre. We only have five litres of blood in our bodies, so no wonder I was getting anaemic! OK, the flow wasn't so heavy in the second week, but it was still adding to the problem.
The GP monitored my iron levels. He knew I can't take iron in any form except a small amount only, in my diet. Just before I had difficult child 3 doctors hospitalised me and poured 3 grams of iron into my body IV. I suspect that damaged my liver back then and I'm still paying for it. But it did mean I had abnormally high levels of iron for a long time.
Not any more. My haemoglobin was dropping observably every month. It's measured in g/dL and normal levels for a woman are 12-15 g/dL. Each month my level would drop by 1 - 1.5 g/dL. By the time it had dropped to 10 g/dL the doctor was panicking. No longer possible to give iron by IV, I would need a blood transfusion. So I got referred to the gynaecologist and was preparing myself to be told I had to have a hysterectomy.
What happened - the doctor put me on HRT. It was like turning off a tap - within hours, the heavy flow had stopped totally.
Then I started spotting, so they tried a lower dose. Wonderful!
I stayed on the tablets for two years, during which tie I probably had about four periods in all, most of them very light and with little pain.
Then my blood pressure went up. It was getting dangerous so I was weaned off the HRT. What would happen? A return to "Bloodbath at the House of Death"?
Nope. Two years had been enough, for me, for things to have moved a bit further along the menopause path. I've had a couple of heavy, long periods but none as bad as they had been. And nothing now for almost a year.
If the HRT hadn't worked at all, or if things had returned as bad as ever when I had to stop it, I would have been a candidate for hysterectomy. I'm glad I didn't have to do that because I'd rather my body get the use of the last dregs produced by my atrophying organs. They still have an important role to play.
I've since had hormone pessaries recommended, to keep things pre-menopausal, at least locally. The vaginal wall tissue gets more fragile and more vulnerable to infection post-menopause and the doctors are trying to help me in those areas now. The pessaries can also raise blood pressure, which at the moment I must keep low. Again, I have to make my own decisions based on my own body needs and advice I'm given. The decisions change depending on the circumstances I'm dealing with.
But that's me. As I said, we are all different.
Star, I'd be asking more questions of your doctors. What more conservative options are available? What are the pros and cons of those? A hysterectomy is major surgery. It is an assault on the body, no matter how desperately you need it. You need time to care for yourself emotionally and physically, more time than you might think.
Getting your appendix out is as major as some people consider surgery to be.
A hysterectomy is much bigger.
I had kidney surgery back in my late teens. It was rough on me. Very rough. And yet, because I was young and otherwise healthy. I made a faster recovery than most. But it was still 8 weeks lazing about with exercise within my limitations (and no heavy lifting) and a good six months before I had much chance of getting back to full-time work. And with hindsight, I was still fragile for the next two years.
OK, I was beach fishing and body surfing within four weeks of surgery, but only if I spent a lot of my days sleeping to recover from it all!
So Star, ask questions. And if you go ahead with this, make a careful decision and plan in at least the opportunity to take life easy for several months.
You've worked hard to look after your family. It's time to be selfish for a while and get them to look after you.
Marg
