The Period Blog: Epilogue

Just when you thought the period posts were finished, here I come with another one. Since there's nothing following an epilogue other than a sequel, I guess we're at the end of the road. I just wanted to check in with some updates, as several of you gals and even a few of you guys were somewhat curious about all this period stuff and what some of us women go through on a monthly basis. Is it time for menopause yet? Sheesh...

Okay, so I last left you after having deciding that I was going to get a uterine ablation, which, to recap, is the procedure in which the uterine lining is permanently damaged causing scar tissue to form, thereby making it nearly impossible for a fertilized egg to attach, and resulting in decreased or non-existent periods. I found a doctor here in town who came highly recommended not just by women who had had procedures done by him, but by nurses who worked in the operating room alongside him. There is no better recommendation of a doctor, in my opinion, than by the nurses who work for him or her.

I had it in my head prior to meeting this doctor that I was set on ablation. What I appreciated the very most about him, is that he took the time to sit with me and to talk to me about all the options out there. Birth control medications, IUD, Ablation, Hysterectomy...all those options were on the table and we sat and discussed all of them in depth. Oddly enough, it turns out, all four of those options carry significant risks, and the odds of the risks really don't change from method to method, but the risks are very different depending on which method you choose. I hadn't thought much about that prior to making my appointment, and I was really glad that he took the time to go over all of that with me. So we made an appointment for me to get an ultrasound, as anatomical variances will outright eliminate certain options. More specifically, the IUD or the ablation.

So I got the ultrasound. Not going to go too in depth about that whole procedure, but I'll just tell you, the wand they use looks like a big white dildo. Turns out, I have a heart shaped uterus, known as a bicornuate uterus to those of you in the medical field. Cute right? A uterus shaped like a heart? Not so much. Basically what that means is, I have almost (but not quite) two uteruses...uterii...whatever the heck you call more than one uterus. So the uterus is normal at the bottom, and rather than opening up into one larger reservoir, it branches off into two separate reservoirs. I still only have 2 ovaries though. In humans, this is considered a malformation. However, if I were a rodent or a pig, this would be completely normal. Unfortunately, I am neither a rodent nor a pig...although sometimes I feel as though I take on their behaviors depending on my current mood (lying in my own filth, hoarding...things of that nature). So what does this mean for me? A few things, actually.  It's very likely a significant cause of my very heavy, somewhat irregular, devastatingly crampy periods...so I'm not just being a whiny wimp. ;)

Having a bicornuate uterus is actually quite rare, occurring in 0.1-0.5% of women. A bicornuate uterus could very well be the reason I've never had a pregnancy scare, as women with this type of malformation tend to have a lot of trouble getting pregnant, depending on the severity of the malformation, of course. Women with bicornuate uteruses (uterii) also tend to also have a higher incidence of recurrent pregnancy loss, spontaneous abortion within the first 3 months, birth defects, preterm labor, and breech births...all of which are undesirable in regards to pregnancy...breech birth being the least undesirable in that list, as most of the time, breech babies are just healthy babies who happen to be oriented in the wrong direction for vaginal birth. Most if not all pregnancies in women with a bicornuate uterus are considered high-risk. There are procedures that can be done to correct a bicornuate uterus to make it a more hospitable environment for a developing fetus, and from what I've read, those procedures have been very successful. But that's not of interest to me. At all.

It could almost be assumed that I was never intended to have children in the first place. There's a weird sort of peace that comes along with this diagnosis. If having children was something that I had really wanted, it would have most likely been a very long, very difficult, very stressful process for me to conceive and to deliver a full-term healthy baby. Honestly, knowing this about my body makes me feel better about the choice I've made to not have children. All this time I've felt that I was throwing my lack of desire to conceive into the faces of those women who simply couldn't...turns out I'm most likely one of those women who can't easily conceive, and all that feeling bad was most likely for nothing. Not that there was any reason to feel bad in the first place, but it was hard for me to watch my friends and family struggle with getting pregnant while I sat there all viable and with no desire to have children at all. Turns out I'm not as viable as I thought. Sigh of relief, actually.

So what does that mean for my birth control and period options? Well, the bicornuate uterus causes a lot of problems in that area as well. An IUD is basically out, as it won't sit properly in my uterus and would most likely be pushed out. The uterus in general is pretty sensitive, and doesn't take well to having things in there that don't belong, particularly if that thing is ill-fitting. My doctor said that we could give it a shot just for curiosity's sake, but he's not confident that it would be successful. If he's not confident, I'm not confident, and given that I'm the one paying for this service, I'm not about to embark on something just for curiosity's sake. Hysterectomy is out, and truth be told, wasn't ever really in, as that's kind of a last-ditch effort when all other methods have failed. Birth control medication is out...not having anything to do with the shape of the uterus and everything to do with the fact that I didn't tolerate the hormones when I was on them in my 20's; there seems no reason to think I'll tolerate them any better now. The ablation procedure is still on the table, although my anatomy would pose difficulties with that as well. During the ablation procedure, a little device is inserted into the uterus that heats up and basically scalds (cauterizes) the lining of the uterus. Typically, the device does all the work...in a normal shaped uterus. My doctor explained to me that this device likely wouldn't be successful for me, and that he would have to go in manually and scrape away the lining of my uterus with one tool, and cauterize with another. Sounds a bit like peeling and then burning a carrot. It also sounds complicated and rather miserable, and carries with it a little higher risks than the aforementioned ablation device. Also, given that I'm under the age of 40, there's a 20% chance that my uterus will just heal itself, and my only option after that would be the hysterectomy. He was completely confident and has done this particular ablation procedure before on women with malformations just like mine, so I trust his judgement and his abilities. But...I'm hesitating.

I hesitate because I'm a nurse and I know that a procedure, any procedure, carries with it some significant risks. I would have to be put under general anesthesia for this procedure, meaning that I would be completely knocked out, breathing tube in, the whole 9 yards. I know that surgery in healthy people has less risks associated with it than less healthy people, but the risks are still there. Over the years I've kind of adopted the idea that if you don't need surgery to save your life, then maybe it's best not to do it at all. It's silly, I know, but there's a part of me that's terrified of having significant negative outcomes in the interest of an elective procedure. Are my periods really that bad to outweigh the risks of an elective surgical procedure?

So here I sit. Doing nothing about my periods other than what I was doing before. It wasn't a total loss though...I found some great natural period products and I learned a lot about my own body. It's weird to feel so good about knowing that the process of having a child would be difficult for me. I don't know why that makes me feel better, but it's almost as if now I have a physical reason to back up my choice to not have children. As if choosing to not have children was never a good enough excuse to those who don't understand or can't empathize. So now I can say, "My uterus is weird! That's why I'm not having children!" That's as good a reason as any, right?

So there it is...the final chapter (for real!) on this whole period thing. Can't wait for the menopause blogs, right?? Thanks so much to all who have supported me along the way and have asked questions and given advice. It was all very welcome and very helpful. :)