When a friend first mentioned that I should have a hysterectomy and go on HRT as the solution to my ongoing issues around my periods, I physically recoiled. There was absolutely no way I was going to have my uterus, and therefore opportunity to conceive, taken away from me. The fact that I already had an amazing little boy and three wonderful stepchildren (therefore child number 5 was out of the question!) didn't factor in my visceral reaction to this supremely rational suggestion.
Yet a few years down the line, having badgered my GP into submission via the medium of tears, depressive episodes and numerous appointments, I stepped into my consultant's office armed with a list of reasons why I absolutely SHOULD have a hysterectomy, only to have the wind taken completely out of my sails when he agreed to the surgery about 90 seconds later!!! So what changed my perception of hysterectomy to the point where I was prepared to beg and fight - I wasn't proud - to have major surgery which would result in hitting the menopause head on at just 45?
My earliest memories of my periods aren't defined by a feeling of elation when reached that milestone of teenage development - I definitely didn't do the 'coming of age' celebrations the Judy Blume books all seemed to pivot around, in fact, I think I cried. As a bit of a tomboy, I resented the changes to my body and strongly resisted my Mum's efforts to get me to wear training bras, whilst other friends were treating it all as a great adventure and something to be proud of. I do however remember period pains that made it hard to breathe, spending hours curled up around a hot water bottle in the foetal position if I was at home, and quite literally 'sweating it out' if I was at school. I remember one mortifying experience of being in a packed classroom and being unable to hold in a (mercifully quiet) fart which was, as the old saying goes, silent but deadly. I'm sure that many of you ladies are aware, the wind that accompanies period pains is quite possibly the most evil, malodorous stench out there, and it didn't take long for most of the class, the teacher included, to start complaining and pointing accusatory fingers. I - obviously - protested my innocence when those around me singled me out, but bearing in mind I'd gone bright red and was already shiny with sweat from dealing with the griping pains in my belly, I suspect no-one believed me. I feel exceptionally fortunate that the incident didn't follow me through the rest of my school career, and I didn't get tagged as the 'Farter of Death'...
Disgusting farts and tearing period pains aside, I also frequently experienced heavy bleeding which would soak through any protection I had on. On more than one occasion, I had to walk the mile back to town for the bus with a cardigan or coat tied round my waist to cover up the tell tale marks on my school skirt, extra toilet paper stuffed in my knickers to hopefully stop anymore escaping. I don't remember my periods stopping me doing things, but I'm sure that they must have interfered with my hobbies at the time, and bearing in mind I was an active, outdoorsy teenager who rode horses and lived in the country, I must have had times where I was affected. In my late teens, I went to college to study horses and business management (yes, it's actually a real course, and no, it probably hasn't helped me in life, but it was fun) and through the college nurse, went on the pill. For the next few years, I was untroubled by the bleeding, but in my early 20s realised - unfortunately only after I had the implant that lasted 6 months - that birth control hormones and me were not a good mix... Not only did I start to suffer from migraines every month just before my period - technically a withdrawal bleed - was due, I was finding that my emotional responses were definitely out control in the run up to it. A memorable event was responding to my then boyfriend's complaint about 'fucking courgettes again' one evening by picking up his freshly dished up plate and dumping the lot in the bin... At the end of a VERY volatile 6 months, I made the decision that I wouldn't ever use hormonal birth control ever again. And split up with said boyfriend.
For much of my late 20s and early 30s, I had the coil and for the most part, both my periods and any PMS actually unremarkable, although I did have times where I was definitely depressed and suffered anxiety. At the time, I put it down to circumstances - a difficult time at work, the breakdown of my first marriage, a friend moving away, a partner dying of cancer - but I wonder now that had I looked for a pattern, it would actually have tied in with my menstrual cycle. At 34 and in the throes of a new relationship, I (accidentally) fell pregnant following my first really heavy bleed in many years - I can only assume that the heavy period must have dislodged the coil I'd had in for the last 7 or 8 years, thus leaving my unprotected. It certainly didn't show up on the very early scan I had at around 8 weeks, although there were fibroids - the first I'd heard of them - so the assumption was that I had passed it without noticing.
I was very lucky that after the debilitating tiredness of the first 12 weeks, I actually had a very easy pregnancy, despite being referred to as a 'geriatric mother'; I had no morning sickness, and although I didn't LOVE being pregnant, compared to many, the 9 months were uncomplicated. My son's entry into the world after 39 weeks and 1 day, was anything but! After about 40 hours from the point my hind waters broke, my wonderful boy arrived via emergency C section with the cord round his neck, but miraculously without any complications.
Around the time my son was 2, my periods were noticeably heavier again. I was also finding it hard to control my temper, but equally when I did 'lose it' I would then be remorseful and beat myself up - both mentally and physically - for being unable to curb my moods. Over the years, both the bleeding and the moods got much worse. I had large clots and flooding for at least 24 hours of each period, leaving me exhausted and turning my life upside down. Simple trips to the local supermarket had to be planned with military precision as I would need to change protection before leaving the house, on arrival at the supermarket, potentially again before the journey home, and then absolutely when I got home. I had ruined holidays, wrecked nights sleep as I had to change several times each night, missed family weddings, being unable to take my son swimming or on some outings, a bag full of the biggest nighttime pads available and a whole lot of washing of clothes and sheets. On one holiday, we had checked out of our rooms and were waiting at the resort for the taxi to the airport - I remember being perched on a sun bed on a towel and changing every 20 minutes, dreading the ride to the airport and the thought of a flight home where I would have to be fighting for use of the onboard toilet. Any visit to the GP would involve the usual 'oh yes, I remember flooding like that, you just have to live with it' (female GP) or 'well try tranexmic acid if it's that bad, but I can't imagine it is' (male GP). It wasn't unusual to be changing protection every 30 minutes, and the clots I passed were so big that I would have a stabbing pain in my cervix as they passed through, and I would feel them as the moved down the vagina. One day, I actually made myself catch and photograph a clot to show the GP. It was the size of my hand.
In conjunction with the bleeding, my body was doubly punishing me with the extreme mood swings, fatigue and other symptoms in the 7 - 14 days before I even started my period. Thinking I was actually going mad, I felt so relieved the day I read a blog by someone who was describing EXACTLY what I was feeling, and gave it a name; PMDD, or Premenstrual Dysphoric Disorder. In fact, the blog resonated with me so much, I emailed it to my partner saying 'this, this is how I feel. For all those times when I'm a total bitch and then cry hysterically saying I'm sorry and what an awful person I am, this is why'. Following reading the blog, I started to try and exercise more, drink less caffeine, eat healthily (although I have always cooked from scratch) and sleep better, but the ebbing tide of oestrogen during those weeks was never going to allow good lifestyle choices to completely turn the situation around.
By 2018, 7 years after the birth of my son and what felt like a million GPs appointments, I finally had a referral to a gynaecologist who offered me an endometrial ablation. I was told it might not work, but I was ready to grasp the opportunity with both hands. This was despite being told that following the procedure, I could become pregnant, but it would be life threatening for both me and the foetus, so therefore it must not happen. I had the treatment in December 2018, and for a while, it did make a difference to my periods, but over time, the volume of my monthly bleed began to increase to the old levels again. And of course it had no effect on the PMDD. In the Autumn of 2020, I had what can only be described as a work related breakdown, putting my mental health back to the forefront of everyone's concerns about me, and then in the lockdown of 2021, I yet again ended up on the phone to the GP in floods of tears begging them for help with the PMDD and bleeding. This time, I got the help I'd been looking for, and in the spring of 2021, I was able to walk out of the consultant's office and call my partner in tears (of joy) to tell him that they'd agreed to me having a full hysterectomy, including my ovaries.
I am writing this 358 days after my operation, and although there have been some adjustments and tweaks with my HRT, I can honestly say that having the operation was the best decision I have made. I no longer have 10 - 14 days out of 28 of feeling like total shit, whether that's because I was bleeding heavily and exhausted, or on an emotional rollercoaster to rival Alton Towers! Physically, I might have lost a large piece of myself, but I have gained energy, emotional balance, and more importantly, a considerable chunk of my life back.
Useful links;
Macmillan - https://www.macmillan.org.uk/cancer-information-and-support/treatments-and-drugs/hysterectomy
Mayo Clinic - https://www.mayoclinic.org/diseases-conditions/menorrhagia/symptoms-causes/syc-20352829
Comments