Either Mirena or hysterectomy, which is better for irregular periods?

Question

Hi doctor,

I am 29 years old. I have tilted bicornuate uterus. My history includes two cesarean sections, PCOS, adenomyosis, dysmenorrhea and amenorrhea. Now, I am suffering from irregular and very painful periods. I am getting heavy clots for three days and bleeding for the next four days. My cycle varies between 23 and 45 days. The pain has been increasing and the cycle becomes more irregular for the past 12 months now. Other symptoms are irritability, night sweats, sore breasts, feverish days leading up to the period. My current medications are Pristiq, Lithium and Dothep. The plan of treatment was to insert Mirena. However, the attempt failed due to closed cervix. I was booked in for Misoprostol (vagina) and attempt Mirenas again. If this does not work, then open hysterectomy will be considered as laparoscopy cannot be done due to scarring. Both, my mother and maternal grandmother had hysterectomy before 40 years of age. Should I seek a second opinion or further testing?

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I went through your query.

At your age, instead of hysterectomy, Mirena is a better option. Misoprostol is very effective in opening the uterine cervix and most likely the procedure will be successful. Whereas hysterectomy is concerned, you can go for both laparoscopic as well as open. Previous surgeries and adenomyosis is not a problem if your surgeon is competent enough to do such surgeries. Though I would recommend you try with Mirenas (Levonorgestrel-releasing intrauterine system) as much as possible, as it would be a wonderful option for you.

Thank you.