Chapter 61: An Announcement:

About a year ago, I made the decision to stop taking my birth control pills. I’ve been on them pretty consistently since I was 15 (which was somehow almost 20 years ago), and I wanted to see what my cycles were like without hormonal intervention. I had a laparoscopic endo excision surgery 3 years ago in October, so I was curious to see if my symptoms had improved at all. All things considered, they are mostly unchanged. The good news: My periods were more spread apart (every 4 weeks instead of every 3) and I don’t get ovulation pain as frequently or as severely. The bad news: my periods are still heavy and accompanied by cramps, back pain, nausea and headaches.

My primary care doctor and my OBGYN both suggested that I go back on birth control, but I was hesitant for a few reasons. I want to preface this conversation with the fact that I love that birth control exists and it gives women the ability to choose when and if they want to become pregnant. With that being said, I didn’t realize the side effects I was getting from being on the pill, probably because I had been on since puberty. I didn’t realize the emotional toll the pill was taking on me- my depression and anxiety were consistently much worse while on the pill. It also surpressed my sex drive. And I was on a pretty low dose pill. Going off of it felt like I was becoming myself again for the first time in years. But then the physical pain that the pill shielded me from came back with it.

Around this time, the Supreme Court released the decision in Dobbs v. Jackson’s Women’s Health Organization, which reversed the federal abortion protections granted under Roe v. Wade. As someone who is militantly pro choice and would not hesitate to get an abortion if I ever became pregnant, this was a scary and terrifying moment. I’m lucky that I live in New York, a state where my right to make decisions about my body is protected, and will be as long as we remain a blue state with a Democratic governor (Thanks, Gov Hochul!). But as a uterus owner, it was scary to me that my rights now varied depending on arbitrary borders within the same country. I decided that it was time for a hysterectomy.

The only problem is I’m 33, unmarried, and I do not want kids. I have never wanted kids. I barely liked kids when I was a kid. This has never changed. I have struggled finding a doctor who is willing to believe that my educated, self aware, 33 year old self is able to make a decision about my body without a husband to guide me. I had never met my OBGYN MD before (I usually see his PA), but coincidentally, I had plans to interview him for a magazine article around this time. He told me that there was no situation in which he’d sterilize an unmarried woman. So I decided to look elsewhere for a doctor that would.

It’s important to note here that a hysterectomy is not a cure for endometriosis. By removing my uterus, fallopian tubes and cervix, I will no longer have periods or be able to have an ectopic pregnancy (which is a scary prospect in this post Roe hellscape that we are living in). My periods are still so debilitating, so this will hopefully improve my quality of life. Additionally, my new doctor (more on him in a bit), thinks that retrograde menstruation could be a cause of endometriosis, and by ending my periods, it should slow down the endo recurrence rate a bit. Lastly, adenomyosis, which is a painful condition often associated with endo, is only tested for and cured by a hysterectomy. Adenomyosis is when tissue from the lining of the uterus grows into the uterine wall, enlarging the uterus. Symptoms include heavy periods, cramping, painful sex and infertility. Hormonal therapies can ease symptoms. A hysterectomy offers permanent relief.

So, I was pretty set in my decision, but I just needed a doctor on board who valued my quality of life more than my breeding prospects for a potential husband that I don’t have and am not even sure that I want. Unfortunately, as a woman with an invisible disease, I am used to advocating for myself. As a white woman I have it much easier than women of color, who are often the victims of racism and sexism in the exam room.

Luckily, I had already been diagnosed with endometriosis, and had the documentation to prove it. As I’ve previously mentioned, my former endo specialist moved 8 hours away, and there’s only one other true specialist of minimally invasive endo surgery in my midsized city and the surrounding suburbs. That is the first place I started. Ironically enough, he works out of an IVF clinic, so I was incredibly nervous to ask him about the prospect of a hysterectomy. His job is to help build families, and I wanted to permanently remove my ability to do just that.

I brainstormed a list of my arguments for a hysterectomy before my consultation with him. I researched and prepared for this consult law school style. It was shockingly easy to talk him into a hysterectomy, which I will forever be thankful for. He did ask that I see a therapist before the surgery to make sure that I won’t regret it. But he didn’t require that either. He listened to me and was receptive to my concerns about my quality of life. Either way, I needed another endo excision surgery, but he is hoping that the hysterectomy makes my endometriosis come back more slowly.

My surgery is January 17th and I could not be more excited! I just need to get through the pain for the next 67 days. I can do this! I already spoke to a therapist about this, per my surgeon’s request. I didn’t even take a whole session for her to be confident in my decision, which made me feel vindicated and listened to. Finally.