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Considering a hysterectomy? Consider these 6 alternatives first

FEATURE Hysterectomies are the most common major procedure performed in the United States. As a gynecological surgeon, I am one of those doctors that performs them.

But I am also one that believes in trying all reasonable options first. Along those lines, here are some alternatives to consider before making the decision to get a hysterectomy.

1. Endometrial ablation

For heavy bleeding, and endometrial ablation can stop or very much slow down the flow.  It is an in-and-out procedure and you can go out to dinner the same night.

2. Hormone therapy

Medications like DepoProvera can be used indefinitely to suppress ovulation and cycles in women with heavy and painful cycles, and it is tolerated by the vast majority of women.

3. Progesterone IUD

A lot of women with heavy regular cycles can cut bleeding down to next to nothing with a progesterone IUD (like the Mirena IUD).

Stock image, St. George News

4. Extended cycle oral contraceptives

These pills are set up to allow cycles only every three months.  That means instead of 12 heavy painful cycles a year, there are usually only four much more manageable ones.  And sometimes, you can even skip over some of those four to have even fewer.

5. Laparoscopic or endoscopic removal of fibroids and polyps

If fibroids and polyps are the cause of the problem, they can often be removed in a noninvasive fashion.

6. Minimally invasive hysterectomy

I know this is an article on how to avoid surgery, but I add this last because sometimes nothing else works. But the uterus can be removed by a surgeon experienced in minimally-invasive technique, vaginally or with laparoscopic assistance, and the downtime is surprisingly low. You are home the same day, and if done on a Wednesday or Thursday, you can be back to work by Monday.

Hopefully, for those of you dealing with these menstrual issues, you can now bounce around and think about these options before being seen. The more you know, the more you can make the choices that are best for you.

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