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Re: GENERAL: chronic cervicitis and hysterectomy
From: Liz (anonymous@obgyn.net)
Wed, 24 Sep 2008 11:33:14 -0500 (CDT)
Thanks. I've read about a lot of other, less invasive options, so it
was disconcerting to be told none of those are effective and that
hysterectomy or suffering are the only options. And I don't want to
minimize the symptoms -- it does interfere with daily life -- and it's
been going on since last March, so I'm getting a little fed up. But
trying the less invasive stuff first seems like a no-brainer. I've
asked my GP for another referral, and will go from there. Thanks again
for your response -- it helps put things in perspective!
At Mon, 22 Sep 2008, T. Lyons MD wrote:
>
>Message posted on Dr. Tom Lyons behalf by: Hope Waltman, Fibroid and
>Women’s Health Forum Moderator
>
>This all sounds a bit over the top - including recommending hysterectomy
>for chronic cervicitis. You can develop a microglandular hyperplasia
>secondary to pill usage that can look abit like ectropian but this is
>not usually symptomatic other than occasional bleeding after
>intercourse. I would think that your history would possibly make
>hysterectomy a consideration given the focal complex hyperplasia. I
>think I would get another opinion. A trial of antibiotics is a good
>consideration but I wouldn't go off the pill at this time.
>
>Dr. Tom Lyons, Atlanta, Georgia Sightline of Atlanta
>http://www.thomasllyons.com
>
>Note: Opinions expressed here are for educational purposes only and, as
>such, do not constitute a physician-patient relationship. This
>information is not intended to supplant the need for you to consult with
>your physician prior to choosing therapeutic options and/or
>interventions. ** Private emails cannot be entertained due to time
>constraints; consequently, they will receive no response.
>
>At Thu, 18 Sep 2008, Liz wrote:
>>
>>I am a 40-year old woman, done with childbearing. I have recently been
>>diagnosed with ectropion and told this is setting up the conditions for
>>symptomatic chronic cervicitis. Diagnosis was made based on a pelvic
>>exam w/speculum, and on symptoms (discharge, vulvar burning, urinary
>>tract symptoms), and by excluding other possibilities; that is, after
>>one bout of BV treated with metrogel (first time ever), all tests for
>>bacteria, viruses, yeast, STDs, other pathgens, etc. have been
>>repeatedly negative. The specialist (referral from my ob-gyn) who
>>diagnosed this said that cryosurgery doesn't work well, and that the
>>best option for me was a hysterectomy (he didn't mention laser). I did
>>have complex focal hyperplasia about 4 years ago due to extremely
>>irregular cycles (normal for me), but had a D&C and have been on BCPs
>>(lo-ovral) to keep the uterine lining from building up again. In short,
>>a hysterectomy seems a little extreme.
>>
>>So my questions are:
>>
>>1) Can ectropion by itself, or in conjunction with BV, cause chronic
>>cervicitis?
>>2) Should I have a colposcopy or other tests to confirm this diagnosis?
>>3) What is the current thinking on cryosurgery as an option? Laser?
>>Other options?
>>4) Would a course of antibiotics make sense to try, even if no tests
>>have been positive?
>>5) Would it make sense to stop using BCPs, or go to progesterone-only
>>pills, to see if that helps (I've read that ectropion is tied to BCP
>>use, but that is apparently in dispute).
>>6) I've also read that ectropion tends to recede with age - is it worth
>>waiting this out, with monitoring and better symptom control (e.g. I'm
>>on a very-low potency cortisone for vulvar inflammation and irritation
>>-- would a short course of higher potency make sense to break the
>>inflammatory cycle)?
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