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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18192
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have a large fibroid in the wall of my uterus, my gyneacologist

Resolved Question:

I have a large fibroid in the wall of my uterus, my gyneacologist recommends having it removed and possibly having a hysterectomy as I am 48 years old but not menopausal yet. I have a lot of anxiety and fear about having surgery particularly as my father recently died shortly after having surgery. I don't think I can overcome my fears. Can you recommend any other treatment or advice I can get.
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.
It will help if you cold provide some further information:
How heavy are the periods?
Do you have any problems with anaemia from the heavy periods?

Customer: replied 3 years ago.

Yes periods are heavy - I take mefenamic acid and tranexamic acid tablets during a period. I also take iron tablets as last year I was anaemic due to heavy periods. I also suffer with irregular bleeds.

Expert:  Dr. D. Love replied 3 years ago.
Has the iron tablets been able to correct the anaemia?

Customer: replied 3 years ago.

I am presuming so as I feel better - not as breathless and not as much fatigue. I have not had a blood test to confirm that though. I am now most worried about the fibroid growing in size and what I can do about that. I understand the anemia is a concern. Last year I also had pneumonia and suffered costachondritis at the same time as being admitted to hospital with a pelvic bleed due to the fact the uterus/fibroid pushed out the coil. Sorry if this all sounds confusing.. i am trying to work out the best thing to do about this large fibroid other health issues have improved although I do have chest pains as a result of the chest infection and inflammation.

Expert:  Dr. D. Love replied 3 years ago.
Thank you for the additional information.

There are several issues to discuss in this situation.

First, there is no need to do anything for a fibroid simply because it is present. It is a benign tumour and does not require removal. It is only if it is causing symptoms that we would consider removal.

When assessing symptoms, there is a difference between those symptoms that are bothersome and those that are dangerous. Having pain is bothersome and heavy periods may only be bothersome if anaemia can be controlled with other interventions. On the other hand, severe anaemia, particularly if causing shortness of breath, is potentially dangerous.

If only having bothersome symptoms, then it still may be OK to do nothing, if the concerns about the risks of surgery outweighs the benefit of clearing symptoms.

If the bothersome symptoms are greater or there are potentially dangerous symptoms, then surgery is usually recommended. However, another option would be to perform embolization treatment, in which a small clot of your own blood is used to block the blood flow to the fibroid. This is done under x-ray guidance so that only the fibroid is affected.

Therefore, it is reasonable to do nothing and tolerate the symptoms, if not at a dangerous level, but if intervention is necessary and you want to avoid surgery, then you discuss embolization with your doctor.

If you need any clarification, please let me know.

Customer: replied 3 years ago.

I have been advised all other treatment is not possible only options are either hysterectomy, mymectomy or do nothing. I have been told doing nothing is not a good solution as symptoms are likely to deteriate due to size and position of fibroid and my age. Do I allow the fibroid to grow in size and wait to see how I fair? Is that a good approach? I do have a lot of anxiety about surgery so maybe that is best thank you for your advice.

Expert:  Dr. D. Love replied 3 years ago.
Only you can say whether each option is a good approach. Surgery is very well tolerated. Yes, there are some risks, but the risks are actually quite small. If you are asking me what I would recommend to a family member, it would be to have surgery, as the risks are so small that surgery would be appropriate. But only you are able to say whether it is worth the potential risks for you to undergo surgery.

Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18192
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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