Ask Dr Kelly: I'm 30 years old and want a hysterectomy | HerCanberra

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Ask Dr Kelly: I’m 30 years old and want a hysterectomy

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If you could ask a doctor anything anonymously, what would you ask? 

In the third instalment of a new HerCanberra series, Dr Kelly Teagle, GP and Women’s Health Specialist, answers your anonymous questions.

Dear Dr Kelly, I’m 30 and have PCOS and suspected endometriosis.

I know that I don’t want children and would like to have a hysterectomy, but know it can be difficult for people my age to get one.

What is the best way to go about this/is there someone in Canberra who will take me seriously regarding this, and what kind of costs are involved?

You have quite the gynaecological grab-bag of issues there! You don’t mention how these conditions are affecting your daily life, but the fact that you’re seeking a hysterectomy tells me it can’t be good.

If you are seeking hysterectomy due to the pelvic pain of endometriosis then hopefully you’ve seen some good doctors already, been properly diagnosed and tried a few things.

One of the problems with endometriosis is that the pain is largely caused by deposits of endo outside the uterus.

These deposits are similar to the tissue which lines the uterus but are scattered elsewhere throughout the pelvis. We can only find out for sure where your endo is with laparoscopic surgery or a very expert ultrasound scan. The deposits grow, change and secrete under hormonal control during your cycle similarly to the lining of the uterus.

These secretions can inflame the pelvis and cause damage to the pelvic organs, leading to further problems like infertility and pain with urination, defecation or intercourse. Read my earlier post for more information about endometriosis.

If you are a young woman with reasonably high estrogen levels and regular ovulations, removal of the uterus may not solve your endometriosis pain. A specialist may still recommend other treatments to suppress ovulation and help control the endo deposits elsewhere.

There are always risks involved with surgeries too, and hysterectomy is a big procedure. Things can go wrong during anaesthetics and surgeries, so there is a risk you will actually be worse off afterwards.

I’ve certainly seen young women with severe endometriosis have hysterectomies, but only after a long process of trialling other options.

I don’t think you’d be refused one simply because of concerns that you’d change your mind about wanting kids.

I do think your surgeon will want to be sure that you’d probably be better off afterwards, to justify the surgical risks. And it won’t come cheap.

PCOS is a disorder of hormones and metabolism, causing irregular or absent periods, acne, excess body hair, and an increased risk of diabetes (see my earlier article on PCOS for more details).

None of these things will be solved by a hysterectomy if you still have functioning ovaries and receive no other treatment. Ovaries are not normally removed from 30-year olds because it would send you into menopause 20 years too soon. This could result in severe menopausal symptoms, osteoporosis and premature heart disease.

We are blessed with many excellent gynaecologists in Canberra and many more nearby in Sydney.

As a start point, I suggest you seek advice from the Canberra Endometriosis Network about who to see or visit the Canberra Endometriosis Centre at the Canberra Hospital.

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