Advice requested - women's stuff

Miscellaneous and Personal Stuff I Must Share
1

I’ll try to keep the gross down for you guys - if you want the gory details, I posted them in the Chick TMI thread. I don’t want to search for it now, 'cause it slows the system down.

Succinctly, I have had menstrual problems (sorry guys) for the last ten years, to the point that it is impacting my health, dancing, ability to exercise and ability to work. Just this last winter, I was diagnosed with fibroids - non-cancerous growths that can cause the problems I’ve been having, depending on where they are in the uterus. I have one large fibroid in the worst possible position, plus 4 others that aren’t as bad.

If I didn’t want to have children, this would be a simple decision - I would have a hysterectomy and be done with it.
But I do want to have children if possible.

The only drug therapy available is birth control pills and I’ve been on (IIRC) 7 or 8 different brands. This is just not working. Even if it did work, I would have to go off the pill to get pregnant.

That leaves two treatment options.

Myomectomy is a surgical procedure to remove the fibroids. This is a major surgery, with a six week recovery time and a distinct possibility of needing a transfusion. This can cause scarring in the uterus, especially where my bad fibroid is. If there is scarring, there is a possibility that the uterus will tear during pregnancy or labor and therefore I would probably have to have a C-Section with any children I had. Also, there is a possibility of the fibroids coming back or the procedure not fixing the base problem.

Uterine Fibroid Embolization is a procedure where pellets are injected into the blood supply of the fibroid, and this shrinks them down to the point where they are no longer a problem. This has a 90% success rate, and does not require major surgery. The main problem with this is that it is so new that no studies have been done to determine fertility rates after the procedure and there is a theoretical risk to fertility. Currently, most of the women having it done are past the age where they want to have children. However, there have been women who have gotten pregnant after having the procedure.

Here are some web pages with better info.

http://www.scvir.org/fibroid/
http://www.fibroidoptions.com/embol.htm

http://www.fibroidoptions.com/treat.htm
http://www.aafp.org/afp/20000615/3601.html

http://www.fibroid-choice.com/myomectomy.html
http://www.netreach.net/~hysterectomyedu/myomectoInf.htm

2

I’m a major wuss when it comes to surgery. I’ve had 2 surgeries on the female stuff - abdominal surgery is no fun - so my first reaction is to take the second option. The way you describe it, it sounds safe and not likely to affect fertility.

Anecdotally, I had a neighbor who had fibroids, and she and I were preg together. Then she went and had another kid.

Best of luck to you.

3

Zyada; I would have to agree with the second option, and if that failed, after an appropriate try, perhaps then opting for a try with the other alternatives. However, I myself, have been through a hysterectomy quite recently, and the difficulties you describe are pretty much what I was going through. The difference post op is fantastic. Obviously, not the first choice, when you want to have a child, so you should try every single option, before surgery. I wish you a lot of luck with any decision you make, I can relate to what you are going through now and you have my sympathy. It is just God awful, and does take over your entire life. Good thoughts heading your way, from one who has been there.

4

Try webmd.com they have plenty of info, here is some (no its not all of it, cause of copyright rules :-))
WebMD - Better information. Better health.

                    If you do notice any of the symptoms described earlier, you have
                    symptomatic fibroids. See your doctor and request a full pelvic exam that
                    includes a rectal exam. Unless a rectal exam is done, your doctor can
                    miss the fibroid. Large fibroids can usually be felt in a pelvic exam.
                    Depending on where they're located, smaller fibroids can also cause these
                    symptoms, particularly if you have numerous small fibroids. Generally, an
                    ultrasound test or a laparoscopy will confirm whether or not you have
                    smaller fibroids. If you have abnormal bleeding, then an endometrial biopsy
                    should be done to rule out a hormonal deficiency. Hysteroscopy (in which
                    a telescope is passed through the cervix) can determine whether there are
                    more fibroids on or under the uterine lining. Sometimes these fibroids can
                    be removed through the hysteroscope. Treatment for symptomatic fibroids
                    is discussed further on.

                    What if you suspect you have fibroids but have no symptoms? If this is the
                    case, you don't need to do anything until the fibroids start to bother you. If
                    the fibroids grow larger and you develop symptoms later on, then you can
                    see your doctor and confirm whether you have them.

                    Often, symptomless fibroids are discovered by your doctor accidentally
                    during a routine pelvic exam. If this happens, just ask him or her to keep
                    an eye on the fibroid(s). Then, see your doctor every six months instead of
                    annually for a thorough pelvic exam. The bottom line is that if the fibroid
                    isn't bothering you, you don't need to bother it.

                    The Symptomless Fibroid Controversy

                    In the past, if you had symptomless fibroids, once the uterus reached a
                    certain size your doctor would have recommended either a myomectomy
                    (surgical removal of the fibroids only) or, more likely, a hysterectomy. This
                    was done because an enlarged uterus would prevent the doctor from
                    feeling your ovaries and detecting potential problems. In addition, it was
                    difficult to be certain that what he or she was feeling was in fact a fibroid.
                    Back then, fibroid treatment was more radical because there really wasn't
                    any way of absolutely diagnosing fibroids; there was no easy, inexpensive
                    method of proving that the patient truly had only fibroids and not a more
                    serious condition. The philosophy was, "Don't take chances."

                    Today, ultrasound is an accurate and relatively inexpensive method of
                    confirming a fibroid diagnosis that can rule out ovarian abnormalities. In the
                    United States, many gynecologists have ultrasound available in their
                    offices. If there is still any doubt after the ultrasound, gynecologists today
                    will continue on with a laparoscopy. Now, when a fibroid is confirmed and
                    the patient doesn't have any symptoms, she has more options available to
                    her. If you're told you have fibroids but you don't have any symptoms, and
                    the diagnosis has been confirmed, seek a second opinion if any surgery,
                    such as a myomectomy or hysterectomy, is recommended. In this
                    situation, these procedures are very likely unnecessary.

                    Again, for fibroids of any size that are symptomless, leave them be.

Myth: If irregular or excessive bleeding is being caused by a fibroid, a
hysterectomy will take care of the problem.

                         Fact: Women with symptomless fibroids and irregular bleeding
                         need to have their doctors rule out other causes for the bleeding
                         first, before the fibroid is held responsible. When irregular bleeding
                         is the only symptom present in women with fibroids, there may be
                         another problem that's causing the bleeding, and it usually has
                         nothing to do with the fibroid. An endometrial biopsy can rule out a
                         hormonal cause, and for some patients, hysteroscopy might be
                         useful.
5

Wow, I don’t know what to say. If it were me, I would try the second option, as I am also hoping to have kids someday. Obviously you need to do what’s right for you and your body. I wish I could offer you a “right” choice. I’ll be thinking about you and saying little prayers that everything goes well with whatever you decide.

{{{{{Zyada}}}}}

6

Yeesh, fibroids. Something that is very common and greatly decreases the chance of hemorrhage during a myomectomy is to get injections of Lupron which induces a pseudo-menopause, THEN have the myomectomy. The most important thing is to have a very experienced surgeon, and have the surgery done at a hospital where this is not an uncommon procedure, such as a university teaching hospital. If you want children you actually do need to treat fibroids, symptomatic or not, due to increased risk of premature birth. Good luck! : )