I am scheduled for hysteroctomy in November. Besides my already diagnosed endometriosis of 13 years, I was recently diagnosed with hyperplasia through a D&C and a tumor in my uterus not to mention I have a cyst the size of a golf ball growing on one of my ovaries. I am terrified of the after effects of the surgery. My main problem with this disease is the lack of sleep due to backache and fatigue. I’ve been done the Lupron treatment already and have on numerous occasions tried different types of birth control only to not be able to tolerate them. I get seeeeveeere migraine headaches. At twentytwo when I was first diagnosed with this disease after having undergone my first laparoscopy only to be followed by a laparotomy I was told that I had the body of an old woman inside the body of a young woman. Very consoling as you can imagine and subsequently have been told by five different doctors that my alternative is a hysteroctomy. Since I really don’t understand the long term consequences of hyperplasia, tumors in the uterus and the fear of ovarian cancer I find myself cornered with having to make this decision. I am very confused and scared of the unknown.

Dear Anonymous-
Hyerplasia is always a concerning diagnosis. Primarily, because of the uncertainty of associated malignancy.In most cases, endometrial biopsies should be done to confirm the diagnosis after a D&C. I personally would not act upon the simple results of a D&C. Symptoms of back pain, fatigue and headaches could be a combination of hormonal imbalance, as well as associated uterine disease. Do not be so hasty in making a decision for a hysterectomy.

DOCTOR,
I’M 26 YEARS OLD AND JUST HAD A OVARIAN CYST REMOVED BY LAPAROSCOPY. WHILE THEY WERE REMOVING THE CYST THEY NOTICED THAT I HAD ENDOMETRIOSIS AND THEY REMOVED WHAT THEY CAN AT THE TIME OF SURGERY. I’VE BEEN ON THE HORMONAL THERAPY FOR 3 WEEKS AND IT IS NOT HELPING ANY. MY QUESTION IS WHAT IS NEXT?

Dear Sharkey-
The success of surgery for endometriosis depends on how much of the disease they were able to discover and how it was treated. In my experience, we find it is best to use the laser to ablate the disease and surrounding seedlings-it is imperative to have a follow-up scope within 3-5 months for a repeat treatment. It is very possible that you gyn did not find all the sites and this is why you are having continued pain. Ask your doctor if he/she would consider a second procedure to determine your current status. Good Luck

Dr. del Junco,
I have a pmhx of 5+ yrs of infertility, dx with endometriosis and autoimmune issues. Currently I’m being treated by a Reproductive Immunologist and a different Reproductive Endocrinologist. I finally seem to have all my immune issues under control but my baseline US on cycle day 1 and 5 showed a cyst, so I will not be able to do this FSH/IUI cycle. After reading your descriptions of the types of cysts I’m wondering what mine may be and what could be done to make sure it dissolves quickly (hopefully by the start of my next cycle.) It is 32mm x 32mm and appears completely black with smooth edges on ultrasound. I have had intermittant pain on that side since cd 6 of my LMP, with the pain increasing midcycle and during intercourse. If this is a follicular cyst will it dissolve without treatment? Is it possible this is an endometrioma even though the appearance is consistent throughout?
Thank you for your time.
Missy

Dear Missy
There is no way to specifically determine the type of cyst you have unless you get a CT scan done to evaluate the density of the fluid in the cysts. Even then it may not be possible to diagnose with certainty your cyst type. Get a CA 125 done-this will give you more information to go on.
Good Luck

Dear Dr.Junco Jr.,
My wife’s OB is suggesting the she has her uterus removed and leave her ovaries, so to not put her into menopause. Is there still side affects from this surgery that we should be aware of like hormones imbalances, sexual dysfunction, and or long recovery time. my wife is only 29 yr. old and has had numerous ovarian cycsts removed, heavy vaginal bleeding, very tender breast, and pain during intercourse.
Your comment would be much appreciated!!

Dear Steven-
Thank you for this email…
You hit the nail on the head with the post hysterectomy complications….women can experience sexual dysfunction, hormone imbalances, depression, early onset of osteoporsis and heart disease, as well as prolapse of bowel and bladder.
Your wife is far too young to even consider this option….especially as a first line of defense.
Her symptoms may be related to forms of endometriosis(please read the website sections on endo and adenomyosis) which can be successfully treated without removing the uterus. Please do your research carefully and get several opinions before having a hysterectomy…that is irreversible surgery and you and your wife may not like the final outcome.
Please let me know if we can assist your further.

Hello Dr. del Junco.

I’m 24 years old and have had severe pain durring my periods for as long as I can remember.

3 years ago I had my first visit to the gyn. I told her about the pain and she told me it was all in my head, and that it was quite normal.

My symptoms are horrid pain, for 2 – 4 days which disables me. It even hurts just to sit. Horrible pain durring urination when on my period, and even worse pain with a bowel movement or even passing gas. I also get diareah, headaches and lower back pain.

My periods are very heavy and clotted, lasting about 4 days, stoping for one and then continuing for about 1 – 2 days.

The pain has been getting worse and worse with each period, and it has gotten to the point now where I have pain throughout the entire month.

I reciently found out from my mother that both she and my grandmother have endo. I know that puts me at high risk.

I have been reading about endo on the internet, and have read that many women do not get properly diagnosed for years. I don’t know if I do have endo, but I can not stand this any longer! I can’t wait for years to find out what is going on.

I have scheduled an apointment with my GP next week. I was hoping if I go to him, he could refer me to a specialist and hopefully we can find out what’s going on a lot quicker.

After my last GYN told me it was “all in my head”, I am afraid that they won’t believe me. I don’t know how to tell them just how bad this is.

If you can offer any advice, It would be aprecieated.

thank you,
Mercy

Dear Mercy-
We get emails like yours quite frequently…the pain you are experiencing is NOT all in your head. You probably have endometriosis and possible adenomyosis, which is uterine endometriosis. Please read our website section on this disease. Either way..you need treatment asap.
If your doctor will not listen to you…find another one. I would recommend a laparoscopy to diagnose the condition definitively, and the sooner the better.
Dr. DJ

I know exactly how Mercy feels I am 23 years old and have suffered with painful heavy periods, large clots, flooding, always having to spend at least 2 days in bed and bleeding for 7 days, since the age of 11. I underwent a Laparoscopy in December afer fnally finding a doctor who didnt tell me I was being stupid, but nothing was found from doing this. In January I went back to the hospitl and the gyn told me nothing to be found basically all in my head and just carry on as normal! I was not happy with this answer and was referred by my GP for a scan which also came back negative. In May I went back to hospital and saw another gyn after making a complaint and was told that I probably had adenomyosis but the only way it could be diagnosed is by giving me a hysterectomy and therefore the only form of medication they have given me is to take the contraceptive pill for 6 months constantly and then have a 1 week break proceeding to take the pill for another 6 months. This is fine but when my 6 months is up my period will be horrendous. But still I have no exact confirmation that this is what I have, I am glad I have found somebody who has the same problem as me.

Dear Sara-
Your symptoms are classic for adenomyosis….traditional gynecological treatment is often palliative, like birth control pills, and D&Cs, with patients eventually having a hysterectomy.Waiting 6months to a year only allows the disease to spread.
We do not recommend that avenue…we have been very successful at treating the disease with a laser debulking procedure. The healthy part of the uterus is saved to give the woman normal hormone regulation and normal sexual functioning.
I would recommend doing more research as a hysterectomy is an irreversible and final procedure.