Preparing my thoughts on paper for when I meet with the Gynecologist in less that two weeks. I have already had the hysterectomy. But suspect with the return of pain in my back/hips/buttocks that has been unresponsive to cortisone injections, that the return of my endometriosis of the uterosacral ligaments and cul-de-sac, or as you say in the UK the pouch of douglas has returned venomously for the 5th time. I read an interesting article last night that removing deep fibrotic endometriosis may be more difficult when there is no uterus between the anterior rectum and the bladder. And that after hysterectomy the endometriosis remaining in the anterior rectum and vaginal cuff frequently becomes densely adherent to, or invades into , the bladder or one or both ureters. So my 11 years of relief may have a price. Now the decision to at this time go ahead with the bilateral salpingo oopherectomy to avoid future development sites, (I'm 50 so nearing the age although not yet showing in blood test the staging of menopause) or going on synthetic hormones to stop estrogen development but meanwhile risk more bone loss (I have been diagnosed with osteopenia) and risk future arthritis thus still having a sore back. Then there is the dreaded menopausal symptoms to deal with, either choice and not having the luxury of choosing HRT's because they contain estrogens which is food for endometriosis' return ie more surgeries. HELP!!! Was I a bad man in a previous life? What can one take for getting through menopause without estrogen? Anyone have experiences with this issue, that found alternative relief? Any thoughts and suggestions, or opinions are appreciated, Thanks.