?Total Hysterectomy needed at menopause

[Ladydi55]

I am scheduled for a total hysterectomy at the end of Dec. 2013.  I was told by my family Dr. 2yrs ago I was in post-Menopause, by blood test. I was also told by my Gyn. Dr. that I have a tennis ball size fibroid in the uterus. I do not have any Bleeding. I have not had a period in 2 yrs. I have painful intercourse  from severe dryness and vaginal atrophy. I tried Premarin years ago, but stopped it due to Heart disease and stroke in my family history. No family Hx. of cancer. This past summer I tried Estrogen patch and oral Progesterone 100mg for six months, I felt like I gained a lot of weight around the middle. I'm only 5'4" and weigh 150lbs, so I don't need any additional weight on me. I have a Hx. of Bilateral Knee osteoarthritis and D.D.D. of the spine, due to old athletic injuries. MY Gyn. told me to stop the hormones, because I developed two small raised lesions on my biceps, which turned out to be Ok. I was mostly dissatisfied with the extra weight gain. I would  like to have a healthy libido again, without pain. I feel like the 3 OB-GYNS I have seen in the past year, (same group) want to do nothing but surgery. But I am still not sure what to do. The last Dr. told me I also need to have my Rt. ovary removed due to a cyst now on a sonogram last week. I have past the mild hot flashes yrs. ago and really do not have any severe symptoms, but joint pain,  bladder pressure Dx. with  I.C.( Interstitial Cystitis) and some forgetfulness occasionally . If anyone out there can give me some insight or advice before I make a drastic mistake, I would greatly appreciate it.

[Ladydi55]

Thank you for your  suggestions, I will see if My GYN. Will order the CA125 blood test. I don't' believe she will order another  U.S.  since I had one on Nov. 22, 2013 . They even WOULDN'T order an FSH and LH level , that I requested.
You would think that if I was having a total  Hyst./DaVinci procedure and would probably go hormones after surgery, the Dr. Would want an updated hormone levels, as a baseline. She didn't  want to talk about that. Said " We will talk about it after surgery."
Can you tell me what blood test would be useful, if I go on HRT.?
What about an Estrogen and testosterone levels?

[Ladydi55]

.Thank you for your  advice .  I guess I  should have added that I  had a Biopsy of the fibroid last year, and thankfully it turned out begin. Would that make any difference,  being in the middle range of post-menopausal?

[Bhupinder Kaur, MD]

Hello,
You are basically having the symptoms of fibroid and ovarian cysts. Any cysts in a postmenopausal woman should be taken seriously and ovarian cancer should be ruled out. You should get a repeat ultrasound and CT scan done. A CA125 blood test should also be performed. Simple cysts (those which only contain liquid) are generally benign and may be followed through serial ultrasounds for a period of time. Cysts should be considered for removal if they are associated with pain or an elevated CA125.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.