questions re:fibroids and treatment options

Hi all
I just found out I have a uterine fibroid. According to the US report, it is described as "a large, markedly inhomogeneous fibroid replaces most of the myometrium in the upper two thirds of the uterus, measuring 8.1x6.7x6.7 cm"
I originally went to my gyn for heavy bleeding with large clots and gushing. Cramping has been getting worse over th past couple of years, but nothing debilatating. 3 Advil or 2 Aleve usually take care of the cramps. This happened two months in a row. this month period was completely normal though. I am 38 years old and already have three children so we are done having any more kids.

My Dr told me the treatment was up to me. Options inlcuded hysterectomy, UFE, birth cotrol pills, progesterone, Lupron or do nothing and wait to see what happens. Novasure was originally mentioned as a treatment option until the ultrasound report came back then she said Novasure was out.

I thought Novasure could be done for treatment of fibroids? Does this depend on the type of fibroid, placement or size?

Also, since the heavy bleeding has only occured during two periods now, am I jumping into things by treating the fibroid now? My thought is it will only get worse if I wait but I can't help feeling like my symptoms are so mild compared to others I have read about here. My heart goes out to all of you that suffer far more than I!

Hysterectomy would be my last choice...if I need to choose a treatment I am leaning towards UFE as I feel taking BCP will not do anything to reduce the fibroid...just lessen the bleeding, Lupron doesn't sound like a good choice and progesterone side effects turn me off.

I guess I'm just so confused with the options out there to treat this...the dr didn't seem to push me in any particular direction with this or seem to concerned with doing anything at all unless I wanted to.

Any advice is appreciated. Thanks

I have been suffering with intracavity fibroid tumors for four years now. I have tried all of these options, and then some.

Have you asked your GYN about Depo-Provera? It's a shot you get periodically (every three months, in most cases) that, in many women, stops your period entirely. I am one of the tiny percentage of women who can't tolerate it, and there are side effects, but it could be an option to stop your heavy bleeds and bad cramps.

A Mirena IUD may also stop periods, but you'd have to ask your GYN if it would work for you. I couldn't use one, as all of my fibroids are inside the cavity - there isn't any room!

BC pills may not make it smaller but may stop the growth for awhile. I had many fibroids, had a myomectomy and when they started to grow back, was given the BC pill. It kept them the same size for 8 years and I then had a hysterectomy.

thanks for the replies.
I have not asked about Depo Provera...wasn't aware that it was a treatment option. My gyn did not mention it to me. It is worth thinking about...thanks

Mirena was also mentioned initally, but then when she read the us report, she thought Mirena woudl not work because of the size/placement of the fibroid...she didn't think it would stay in or would fit (??) Can't remember exactly what she said other than she didn't think it would be a great option.

I did not realize that bcp would stop the growth...thank you for that info. That is worth considering also, although I hated being on bcp years ago, I guess I could deal if it meant the heavy periods would go away.

another question...for the past few years my periods have been getting increasingly heavier, more cramping, more breast soreness in the two weeks following ovulation. Is this related to the fibroid or normal changes given my age? Now that I know the fibroid is there, I am starting to wonder if all these gradual changes are related to the firboid being there. I don't know of anyone that has dealt with this before...it's all so foreign to me. Thanks again for the replies

I also hated the BC pill and to tell you the truth, feel so much better now that I am not on it. I had a total hysterectomy and had everything taken and I feel great.

Most people do not mind it. I hated it and it looks like you do too!

The cramping and bleeding is from the fibroid.

I would not think the breast soreness is from the fibroid.

My situation was kind of like yours though my fibroids weren't diagnosed until I was in my mid-40's. Mine were actually discovered before I had any other symptoms so I started researching what I would do if I had problems. Then I had the first occurrence of the horrible gushing bleeding and clots but did not have this happen with every period. It didn't take long though to become quite anemic even under those circumstances.

After a couple situations of having the gushing, uncontrollable bleeding occur while I was away from home I quickly realized I couldn't function like this. I work outside the home, travel for work, etc. and couldn't be in situations where I had to be in the bathroom every fifteen minutes for 6-8 hours. Some nights I just sat on the toilet and tried to sleep because I had to get up every fifteen minutes. It got to the point I had to schedule everything around two weeks a month that I thought would be "safe". It was awful.

Anyway, you need to consider how the fibroid symptoms are impacting your quality of life in your decision to do something about them. In my case I decided on UFE because of the relatively short recovery time (about a week) and the fact it is not major surgery so does not have the level of risk inherent in that. You need to be evaluated by an interventional radiologist to determine if you are a good candidate for UFE - your gynecologist cannot make that call.

I would highly recommend you investigate all your options now so you are prepared when you decide fibroids are impacting your quailty of life to the point you need to take action.

connie111...thanks. I guess I was wondering if the fibroid was causing some weird hormonal changes that would cause the increased breast soreness...it's like clockwork. It starts right after ovulation (like a day or two) and continues until whenever my period starts (lately on the 23rd of each month, but previously very erratic like sometimes 40 days and other times 28 days)

Ambrosia...thanka also for your input. This is all very helpful to hear what others have to say. I guess I'm at the point right now where I don't know if I should wait and see if it gets worse or if I can deal with it how it is. Am I fooling myself in thinking it won't get worse? Right now it's not too bad (as compared to others) I was freaked out at first not knowing why this was happening, but now that I know what the cause is I can deal with it better, if this is as bad as it will get. From what I have read it seems this usually progresses as time goes on though.

I am torn about taking care of it now even though my symptoms are not debilatating and thinking it's silly and jumping the gun to take care of it now because my symptoms are not debilatating, ya know? I sort of think it's smart to take care of it now before it gets worse....but I'm not fully convinced yet.

I had to call out of work last weekend anticipating the worst and wouldn't you know, I had no problems at all. I work retail and can not be dealing with flooding and heavy bleeding when I'm on my feet for hours and not having immediate access to the ladies room, so what do I do, call out sick every month expecting the worst? Ughhh

lindsay - like ambroaia, i feel it comes down to what you decide your quality of life is like. After 1 1/2 years of GUSHING and clots i could not stand it anymore. I just wanted them gone and personlly did not want to go through multiple procedures to take care of the problem. I did try the pill for 6 months, and it did not really work for me. Everyone is different, and you certainly should consider starting with something less invasive and see if it works for you. Everyone is different. I think you will absolutely know when your symptoms are bad enough to go all the way. For me it was all mentally debilitating to be out in public and look down at a puddle of blood on the floor!
There is a good website that lays out the options....
www.gynsecondopinion.com
check it out.....
one fact I thought was interesting was that I always read that fibroids shrink as women near menopause, which might warrant just braving it out. Then, after my surgery, i had read that they only shrink about 1%. Yikes! That is nothing.
Good luck in your "quest" for answers. You have all of us here!

Welcome, lindsayjen!

Regarding ablation, my understanding is that it has some success with when abnormal bleeding has other causes, but it is not as successful for fibroids that are actually in the uterine cavity.

I have a submucosal fibroid (smaller than yours) and I had an endometrial ablation in July 2005. Bought me about six months of very light periods, then the trouble started again. In addition to the positive, I had a negative side effect, which was scarring on my cervix (created as my body healed from the ablation). I had to have a D&C to correct that.

I encourage you to look into UFE and other alternatives to hysterectomy if you are looking to keep your uterus. It's worth exploring since your symptoms are not debilitating. Good luck!