I met with the new Gynecologist yesterday. If you follow me on Twitter you would know I’ve been experiencing some endometriosis pain. I know I have a cyst on my ovary. This is just a feeling I have. I’ve had so many endometriomas on that ovary that I’ve become accustomed to the feeling by now. The new doctor didn’t fight me on this, she understood and agreed that I probably did then have a cyst. But… let’s get to the meat of the visit shall we.
She asked me why my former doctor had prescribed Mirena for the endometriosis. I told her it was because my periods had been 2 days of excruciating pain and very heavy flow. Then after the birth of my son, this went to 5 days. Clots the size of ping pong balls were not uncommon. It was exhausting! And to add to it, I have irregular periods so I never knew when the cursed thing was coming. It could spring up a week early, or fool me by being a week late (many pregnancy tests were wasted this way when I was trying for a baby). The, to add insult to injury, the endometriosis pain began coming all month not just right before my period. I needed relief, and quick! I had been anemic my entire life and my monthly “situation” only made me beholden to injections and pills and all sorts of iron laden nightmares. I was told by a doctor that I had to start eating the dreaded cow again, and I did for a long while. I smothered the beast in steak sauce to get through the unpleasant experience, but still it didn’t help. Finally came Mirena and with no periods came an even iron level. All was good, or so I thought.
But this new doctor is now telling me that the Mirena only works to stop the period, it does nothing to inhibit the endometriosis from growing back. I’ve read this, but I’ve also read that some women with endometriosis, that don’t have periods (like myself) find adequate pain relief with the device. But I’m no longer having “adaquate pain relief” am I? So, these symptoms I’m having now – the discomfort with intercourse again, the gnawing pain into my thighs and groin, etc., all signs that it’s back. And I think it was back when I had that laparoscopy last October because these implants can be deep. My doctor, at the time, did a very quick look over after she released those adhesions. She was just looking for obvious endometriosis because she wasn’t originally going in to look for endometrial implants but a chocolate cyst. It wouldn’t be a stretch to assume 1) that it’s been there a while or, 2) it’s a recent development of endometriosis. But it feels deeper, like it’s in the ligaments, in the muscle.
How are we going to tackle this? Well, that’s where it gets rough. Because of my Basilar Artery Migraines, I can’t have estrogen. For now, she wants me to take Zoloft 25 mg. at night for 6 weeks. I am very skeptical and have mixed feelings about this. She says she has some patients it’s helps and some that it doesn’t work for. But she wants me to try it. My other options are Lupron for 6 months or a hysterectomy. I told her my views on hysterectomy, especially at a young age, and she agreed with me. You have to abstain from hormone replacement therapy for at least 6 months for the endometrial implants that remain in your body post-hysterectomy to die off. For young women, this is extremely difficult because the side effects of surgical menopause are often times more severe than for older women who are closer to a natural occurring menopause.
As your body ages your hormones naturally begin to decline on their own. So, take a woman in their late 40’s who’s estrogen levels are already dipping low (let’s call this a 4 out of 10). Where as a woman in her late 20’s would have an estrogen that’s still high (let’s say 9 out of 10) – these numbers are not technical, OK, just to show you the difference in ages. There is less shock going from 4 to 0 than going from 9 to 0. Imagine driving in your car at 65 MPH and slamming on your breaks – that’s a young woman getting a hysterectomy. It’s an abrupt change. Some women don’t have as much problem, and they adjust smoothly. And others have a terrible time. And you can even still have a higher estrogen count well into your late 40’s. There really is no magic age, it just depends on when your body begins going into peri-menopause, which is roughly in your 40’s. Again though, there is no magical number.
For me, a hysterectomy is always a last, last, last resort option. It’s one of those options I have to take because the bleeding can’t be stopped, or because of cancer, or something out of my control. I decided to give the Zoloft a chance for 6 weeks. I’ll go back to her and discuss if it’s helping or not, and where we go from there. I will look into taking the Lupron jump if this doesn’t work since that’s the only real option I have left at this point.
I took the Zoloft last night and it pretty much knocked me out. I still feel out of it and drugged up. I really don’t like the feeling this med gives me – just in a fog, like I could sleep all day. I have no appetite and I’m nauseous. I feel hung over. And I’m only on 25 mg! This stuff is vial. It’s doing nothing for my pain, but she said it can take time to work. I know there is research backing up that SSRI’s help endometrial pain, especially when it may be in the muscle and whatnot, but I don’t like how this is making me feel. I was on Zoloft once a long time ago and I don’t remember it making me feel like this! I wonder if it’s because of my other meds that the side effects are heightened? I just feel awful AND I have endometriosis pain!!! I want to crawl in bed and cry 😦