Should I Have a Hysterectomy?
I had some spotting once that led to the OBGYN to do an ultrasound test. The test showed that the endometrial lining was thicker than normal. I am on hormone replacement therapy (HRT) and have been on it for 5 years. Prior to that, I was on birth control pills for 10 years. So from the ages of 40-50 years, I used birth control pills and then from 50-55 years, I used HRT, first a cream form of bioidentical hormones and then I switched to a patch (estradiol-combination of estrogen and progesterone). Both at the very lowest dosage.
The OBGYN said that if by ablation he could remove the extra lining then I would be safe for the next 10 years from getting endometrial cancer. But because he was not able to perform it, he said that the uterus should be removed to prevent this from happening. I do trust his opinion. He has been my gynecologist for 15 years, but I really do not want to do this surgery. I am fully aware of the consequences. On the other hand, the possibility of the lining developing cancer is also scary. Also, I am not sure if he was able to get the endometrial tissue for pathology since the cervix was too tight for ablation. If it’s not possible to get the tissues from the lining for testing, then I do have a big problem?
I do not have any other symptoms. I am overweight, but I have been like that for the past 20 years with no major changes up or down. My fasting sugar is at 110-120 most of the time, which is considered pre-diabetes, so I do take Metformin 500 once a day at night. Other than that, my blood tests are perfect. There are no other issues.
I do not have any family history of any female organ cancers that I know off. None of the females in my family, including grandmothers, aunts, cousins, had any type of cancer. My family history is full of heart disease (heart failure on both sides of the family and heart attacks) and there is some diabetes in the distant family (great-aunts) but NO cancers of any female organs (that includes breast cancer also).
The only reason my doctor suggests the hysterectomy is because he could not do an ablation and my endometrial lining was thicker than normal for my age (55) and menopausal stage. He could not perform the ablation since I have cervical stenosis and the cervix could not be opened wide enough even with dilation.
He says that in order to keep me safe from possible endometrial cancer I must get the hysterectomy. I do not want to do that, but I have no idea how to check the endometrial lining tissue for pathological changes if the tight cervix will not allow to get samples of the tissue. There were tissues taken for pathology at the procedure, which came back negative (no cancer of pre-cancer cells). I am just not completely sure if the tissue was also taken from the endometrial lining or not. He is being evasive and not specific.
What should I do? Any suggestions would be greatly appreciated.
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