Fibroids and Heavy Bleeding
Question
I am 54 years old and have used NFP for many years. In the last two years I developed fibroids, causing heavy bleeding in some cycles. I have seen a Gynecologist, who last year suggested ablation, which I was scared to do. This year he said the fibroids are large now, about 6cm, which means the only way is hysterectomy. I went to another Gynecologist outside my insurance group for a second opinion, he said it is not a bad idea, and if I don’t want that I should be on birth control pills to reduce the bleeding.
I know I will not take the pill- I have never taken them in my life. I know from the hormone test I took recently that I am perimenopausal, ie it could happen soon.
My question is if I wait till menopause and as they say the fibroids will shrink, will have no more bleeding so I live a normal life– is this a good idea? Or do I still have to consider hysterectomy, which they tell me has to be total, ie removing the uterus, ovaries and cervix. They tell me that fibroids are not cancerous, but yet they suggest the total hysterectomy.
I always wished I would age naturally, I know I will not take any hormones. I just want to see if it is a good idea to wait until menopause, will the problem be fixed once I stop bleeding?
Answer
Last Updated: June 26, 2013
One option is embolization of the fibroids. This is a much smaller procedure than a hysterectromy, and is done as an outpatient or possibly overnight stay in the hospital. A radiologist who is trained in this procedure puts a catheter in your femoral artery (in your groin) under sedation. He manipulates the catheter so that he can inject small beads into the arteries that are the blood supply to the fibroids. This cuts off the blood supply to the fibroids, causing them to shrink. 80% of women experience substantial improvement in bleeding.
Another option is using Lupron injections, which are given every one to three months, for a six month period. This drug will stop your pituitary gland from stimulating your ovaries, and you will go into an artificial menopause. After one month, most women have no bleeding whatsoever during the six month duration of the Lupron therapy. The fibroids should shrink considerably while you are on the Lupron due to lack of estrogen from the ovaries. After the six months of Lupron, the fibroids might slowly grow back, but there is a good possibility that at your age the menopause may be permanent.
If the Lupron or embolization fail to provide permanent relief, you can always get a hysterectomy at a later time. A hysterectomy is the only 100% cure for excessive uterine bleeding or fibroids.
Dr. Mary Davenport
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