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Old 05-13-2009, 02:38 PM   #1
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Perimenopausal w/ fibroids: Do I really need a hysterectomy?

Hello, all--

All my adult life I was told that if I wait it out, my fibroid tumors would shrink up at menopause. So, here I am 52 years old, an the verge of menopause and I am being urged to have a hysterectomy. What are my options? I tried to get an appointment for a 2nd opinion, from an "expert" doctor who-- is booked up for the next 2 months.

I have had multiple, and huge (9cm) ASYMPTOMATIC fibroids most of my adult life. My periods were always "normal", until the past few years- peri menopause- I get that. But this past November, my period lasted 6 weeks-until I had a benign uterine polyp removed during an endometrial biopsy & D&C late December. It is now May and I have not had a period since.

However, I am now experiencing long bouts of very uncomfortable PMS like symptoms - bloating, pressure, cramping. My doctor (who is new to me) could not even cull material for a pap smear, it was that uncomfortable for me.

This doctor says the fibroids are now starving for blood, that's why I have symptoms. She is strongly suggesting a hysterectomy (abdominal) removal of cervix too.

When I was 26 I was told if I did not have a hysterectomy (the only option back then) ASAP, the fibroids would grow against my spine and I would be paralyzed from the waist down. I am still walking, and have always taken a wait and see approach, as I said up until now I have been a- symptomatic.

Since the fibroids are so big, can I consider the other options available today? Even if I'm past baby-making? (Freezing? Heat? etc)

Should I consider a hysterectomy so close to menopause? And at the urging of a doctor I have no history with? (Granted she has been very nice and answered all questions- an no doctor is perfect, still I have a small nagging doubt).

The 6 weeks down time post op scares me. The after effects (scar tissue, bladder issues etc) scare me too, as does surgery/hospital itself.

How many other women out there, in their early 50's have come up against this similar situation?

Thank you for reading through all this. I appreciate your responses.

Last edited by wordwench; 05-13-2009 at 02:44 PM.

 
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Old 05-13-2009, 04:52 PM   #2
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Re: Perimenopausal w/ fibroids: Do I really need a hysterectomy?

Hi Wordwench, you certainly have many options available to you.

Let me start by saying that I think you should get copies of your pathology reports to find out some information about your uterus, cervix, and fibroids. Information from your paps (for the last few years), ultrasounds, etc. I also would like to strongly suggest you seek another opinion. There are MANY options.

Do you know how many fibroids you have? Where they are located (type)? It can make a difference in your treatment options. I am confused as to why your doctor said the blood supply to your fibroid is being cut off. When that happens (see what I say later about UFE) it is very painful.

Fibroids are suppose to (and usually do) shrink after menopause, but they shrink at about the speed at which they grew - v-e-r-y slowly!

A few treatment options are:

UFE/UAE (uterine fibroid/artery embolization) -
myomectomy -
hysterectomy -


I had one, 12cm intramural fibroid (in the uterine wall) on the upper, back end of my uterus. When I was 44, I decided I was tired of my ever changing periods (more frequent, heavier, longer, yet erratic periods). I believed the fibroid, besides being the size of a large grapefruit, was causing bowel problems and perhaps adding to my back problems. My doctor and I talked about a few options and she suggested the UFE since I didn't want a hyst. I decided against a myomectomy because the recovery time was the same as a hyst. I figured if I was going to go through that pain, then take the entire thing. I didn't want to lose my uterus (not for any potential baby reasons - I was 44 and childfree/childless, I wasn't looking to start!), I was just emotionally attached to my body parts! I went to see an IR (interventional radiologist) and we discussed my fibroid and UFE. She said I was a "perfect" canidate because I only had one fibroid.

I had the UFE in December of 2007). I stayed in the hospital overnight with a good amount of pain. I love the pain med pump! Over the next week or two I stayed on my pain meds, then slowly got off of them. Over the next two months, I had a few times of cramping that were stronger than I normally had had, and I attributed them to the UFE. The cramping is caused because the blood supply to the fibroid is cut off. It makes the fibroids die. That process is painful.

My fibroid shrank from 12cm to (I think) 8.4 or 9.4cm. That's still pretty dern big, if you ask me . . . but the doctor said it was considered "successful" because it shrank at least 25%.

After the UFE, I had 3 periods between January and June. The UFE isn't suppose to stop periods, but I think it messed with my body just enough (along with another gynecological problem I had going on) that I just didn't have many. In June of 2008 I ended up having to have a hysterectomy anyway (for stage Ia1 cervical cancer which was detected 2 weeks after my UFE - but that's another VERY long story).

Anyway, you have a number of options before you. The myomectomy and the UFE preserve the uterus and cervix. If you choose to have a hysterectomy, it doesn't necessarily have to be abdominally. Mine was LAVH (lap assisted vaginal). Perhaps because of the size and number of your fibroids the LAVH, Robotic, or vaginal hysts are out of the quesiton. But I suggest you ask your doctor (and then the second opinion doctor) about all of your options.

While the cancer diagnosis turned my life on its ear and was very difficult, I am glad I had my hyst. It was my only needed treatment. Being period free is pretty nice! I did keep my ovaries. I figured I'd rather have my body-made hormones for as long as I possibly can. I'll consider hormone replacement, later, if I need them.

This post is getting really long, so I'll sign off for now. I see that you have several options before you.

Let me know if you have any other questions. I'll do my best to answer them.

 
Old 05-13-2009, 05:04 PM   #3
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wordwench HB User
Re: Perimenopausal w/ fibroids: Do I really need a hysterectomy?

Hello, Pickles-- Thanks for your story... My doctor theorized that since I'd had a D&C and had not had any menstrual bleeding for 5 months that the blood supply the fibroids need to grow was cut off and the cramping I was experiencing were the death-throes of my fibroids..

I know I have multiple fibroids, and one very large one on my left side. I've been told my uterus is the size of a 4-month pregnancy.

I know there are many options- and I've been told time and again I was too old (post baby making) and the fibroids were too big... I want to keep asking until I get a right answer...

I guess I'll have to snuff out a second opinion doctor as I can't see the "expert" on fibroids doctor until July.

Thanks again...

 
Old 03-21-2010, 09:09 AM   #4
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Re: Perimenopausal w/ fibroids: Do I really need a hysterectomy?

Quote:
Originally Posted by wordwench View Post
Hello, Pickles-- Thanks for your story... My doctor theorized that since I'd had a D&C and had not had any menstrual bleeding for 5 months that the blood supply the fibroids need to grow was cut off and the cramping I was experiencing were the death-throes of my fibroids..

I know I have multiple fibroids, and one very large one on my left side. I've been told my uterus is the size of a 4-month pregnancy.

I know there are many options- and I've been told time and again I was too old (post baby making) and the fibroids were too big... I want to keep asking until I get a right answer...

I guess I'll have to snuff out a second opinion doctor as I can't see the "expert" on fibroids doctor until July.

Thanks again...
First-- ((((hugs))))

Been there. Began CT scans for them in 2001. In 2004 I began having bleeding issues bad enough to see a dr regularly who basically always replied "hysterectomy". In 05/06 she began treating my really bad anemia while always saying "hysterectomy, hysterectomy, hysterectomy". I was 50 in 2006. And I would always say "no, no, no".
Found four or was it five? other docs who would only say the H-word.

I did find one doc in PA that would surgically remove the fibroids leaving the rest of my body in tact. And one in CA, but PA was closer to me.
Because of finances, I could not arrange to fly to PA to have the surgery so I soldiered on. Left many a yoga/pilates class with my mat around me due to heavy bleeding, (I looked like I was hemorrhaging when my period came). I also looked into some ultrasound thing Mayo Clinic was offering and even had the forms ready to go. But again for dh to take off a couple weeks of work meant two weeks of NO pay. So it didn't happen.
I was put on Neferex for anemia and just accepted it.
My heavy periods are now a memory. Painful, awful but a memory, none the less. They became manageable around 08 and in May 09 just stopped all together. *Had one a couple weeks ago and it was light. No cramping. Guess this is menopause?

Good luck to you in your decision. I know what a pain they are. I know what you are going thru.
I wish you well.

Last edited by starryGal09; 04-11-2010 at 11:55 AM.

 
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