I am 41 and have advanced endometriosis and my ovaries are now adhered to my uterus - ouch in addition I have a large fibroid growing on the outside of the uterus to the inside and is pushing on my intestines because the uterus is retroverted - more ouch. My doctor has recommended a hysterectomy if I don't want children; haven't had any yet and my chances of getting pregnant now and maintaining a pregnancy are low. But my biggest concern is that if I choose to have the hysterectomy I might not be able to tolerate estrogen replacement therapy. I say this because I have had terrible problems with birth control pills - and I have tried almost all of them.

I will not be considering hrt because that has progesterone and will just cause the endometriosis to come back. But I am worried that if I can't take the estrogen (ert) that the other side effects may outweigh the benefits. As it is now, every time I ovulate, I have really bad pms with mood swings and my allergies are worse but I don't know if that is minimal compared with what I could go through with no hormones at all. In that case I will be having a laparoscopic surgery to remove the fibroids and as much of the endometrial tissue as possible to make me comfortable until the hysterectomy is mandatory.

Any advice is greatly appreciated.