Endometrial ablation and hormone fluctuations

[Bluetit]

Confused! Saw a endo specialist today for the first time because my consultant is confused to why I’m bleeding still on zoledex. My treatment options are limited which I’m aware of but he’s suggested

a lap with treatment of endo

A lap with treatment of endo with endometrial ablation

A lap with as above plus sterilisation if I wish

Hysterectomy

I’m not sure what to do for the best, can anyone share any experiences good or bad? He’s sending me for a mri to get more information before my next appointment with him to discuss how I want it to forward. I’ve been diagnosed now for 9 years so I’ve been through every treatment I can without affecting fertility. I have 2 children which I’m very grateful for and had decided I’m done but lately having a wobble wondering if I want the option of more and if I’m ready to make that final decision. I have post natal depression which is why I’m doubting that decision as it maybe the depression talking.

The specialist also suggested that my bleeding is down to hormone fluctuations and not the endo. Has anyone had this and can they tell me if they had any treatments not mentioned above? Or what treatment they had which was successful?

[luthien]

I've not had a hysterectomy, so cannot comment on that part.

Sorry for all the questions, but based on experience of laps and posts on here:

Is the laparoscopy to remove endometriosis an excision? As that's the best form of removal of endometriosis to reduce symptoms and reduce regrowth.

Is the endometrial ablation to reduce your heavy periods - that's what it's usually for, however it can reduce the chance of implantation

Would sterilisation be cutting or removing ovaries? If they're suspecting things are driven by hormones then removing ovaries may help

Would the hysterectomy include endometriosis excision? Otherwise your endo (if present) would continue to grow - most women whom have a hysterectomy find that their endo does come back, so ideally both need to be done to reduce this chance as much as possible.

It may be an idea to read up a bit before you decide; pros and cons. I have a great book I found really helpful from Amazon:

Living Well with Endometriosis: What Your Doctor Doesn't Tell You...That You Need to Know by Kerry-Ann Morris

I have found it really helpful as it gives a breakdown of different treatments with case studies and stories including pros and cons of each, as well as any side effects / changes to expect. It may help with you learning more about what treatments do / help.

You could be bleeding because there's a lot of endo; it produces it's own oestrogen and so it doesn't matter what hormones you're on it can effectively overbalance it. I was on the combined pill and breakthrough bleeds when I hadn't taken a "break" was my first sign something wasn't right. I know it's slightly different to yours.

An MRI may not show up endo or a thicker uterine lining, it can however show up adhesions so perhaps that will help should you opt for surgery so they know what to expect, but really they won't know the state of stuff inside until they perform a lap.

Definately find out / read up as much as you can about different treatments, online if needed to gather all the facts and ask the above questions if you've not done so already.

xx

[Bluetit]

Thanks for the reply:

The laparoscopy hasn’t fully been discussed but it’s an endo specialist so should do excision.

Ablation is to try and stop the bleeding as contraceptions and zoledex have reduced but not stopped bleeding

Sterilisation would be cutting the ovaries but I may discuss removing them as it’s seen that I would need them removing if I had a hysterectomy

I would ask for excision of endo during a hysterectomy yes

Thanks for the recommendation on the book I will have a look. Currently trying to read the woman’s code to see if that might help