Diagnosed with fibroids and possible simple hyperplasia

I'm new and have been diagnosed with fibroids," possible simple hyperplasia and the pathology report states atypia can't be ruled out."
This seems very vague for a biopsy report. My doc gave me 2 options progesterone and repeat biopsy in 3 months or D&C to test cells. I am VERY frightened to have surgery and have GREAT anxiety about it- I started to bleed the day after the biopsy 3-11-09 and it was Extremely HEAVY for 10 days. I was going to have D&C on 3-23-09 but they cancelled by phone as my husband and I were walking out the door. I needed further clearance which I have now passed, but now it has given me too much time to worry- next date is 4-20-09 and I don't want to do it! He put me on Prometrium to stop the heavy bleeding -I'm not bleeding heavy but I still am after 1 week of Prometrium. Can anyone give me guidance??? Thanks, Petlover1

((petlover1))

We do have a Resource Database where you should find some helpful information regarding your diagnoses. The more you know, the better able you could be to make the best decision for you!

How long did your doctor say it should take before the bleeding stops with the Prometrium (progesterone)? Did he want you to call if you had not stopped bleeding in x amount of days?

Some doctors can do a D&C in their office. Is this an option for you? Would that help you with your anxiety? Possibly your doctor could prescribe some anxiety medications to help you right now until you and your doctors can find the best treatment plan for you!

I wish you all the best and hope you find support and answers here to help you! Sending gentle s your way!

Hi-
Thank you for getting back to me so quickly! My GYN put me on the prometrium to help stop the bleeding before the next attempt at D&C. My Hemoglobin was very low for awhile and I can't afford for it to go low again- I do take 3 slo Fe tabs daily.

I just read about the hysterscope biopsy that can be done in the office- I am going to call my doc monday and schedule another appointment. I just started with him- I had a very bad experience with my last GYN. I almost feel like I have to be my own doctor- your site has given me alot of answers, but also alot of questions.
As far as a med for anxiety- I am definitely anti medicine- I feel there are too many side effects- I don't like taking the prometrium but feel I have to do something to prevent the build up on the endometrium.
Has anyone else out there gone through this and not ended up with a hysterectomy? I always thought I didn't want menopause to get here and now I pray for it!
Petlover1

Hi Petlover1,

Your reply.."I always thought I didn't want menopause to get here and now I pray for it!" Boy...was that me when I was diagnosed with two large fibroids.

I was 46...and yikes..I was scared!! Before I was diagnosed..I started having very heavy and long periods, I had unexplainable pelvic pressure, bladder incontinence and I had no energy. I was just chalking it up to being 46. Boy...was I wrong.

In my case..I opted for surgery...I had never had a surgery before...so I was scared...since I had a window of opportunity for a less invasive hyst with my fibroid size. If I had waited..both my Drs who I got opinions from..felt my fibroids would have kept growing...and I wanted one surgery or procedure to handle my fibroids.

In the end...just do what is *right* for you. Drs give us options...and we make the final decision when it comes to our bodies.

Sending best wishes~

Mary

Hi petlover1,

Each of us has to make our own choices, and what is right for one, won't be right for another. But I wanted to tell you my experience with the D&C with hysteroscopy which I had yesterday.

It went very well. I'm most surprised that I haven't had any real pain. There was a little burning when I first woke up, and what can best be described as "twinges" in my sides today, but not the cramps I was told to expect. Actually, the worst part of the whole procedure was the sore throat from the air tube. There hasn't been much blood after the first day.

I really didn't want general anesthesia but I wanted pain less. I resisted getting a biopsy for two reasons. First, it is painful for many women, especially those of us who've never had kids and are older. Second, and most important, the biopsy only samples a few places in the endometrium. The D&C gets much more material to be examined. After reading a lot, I’d decided this was the test I wanted.

The D&C is a definitive test, the biopsy isn't. I'm guessing that's why your report said, "atypia can't be ruled out". They found something that may or may not be unusual, but the sample was too small to make a positive determination.

For the vast majority of people there are no complications from anesthesia. For my procedure there was no long recovery time. From start to back home, the whole process took six hours. So I'd say, try to relax about the D&C. My gyno said it is the best test out there to determine what is really inside the uterus. I can tell you the worst part was/is the waiting and worrying.

They won't do a hysteroscopy without anesthesia, though perhaps it can be done with a local in the doctor's office. I, for one, didn't want any chance of pain. I also didn’t want to be aware of what they were doing.

Dear Mary,
Thank you for your input! Did you have a transvaginal ultrasound to diagnose your fibroids and if so did it show any hyperplasia? Did they prescribe BC pills to control bleeding?
At this point I think I need to talk myself into the D&C- that was my initial "gut" reaction- I just have too much time to worry between now and the 20th.
Thanks again
Petlover1

Hi Petlover1,

Thanks for responding!!

In answer to your question...yes...I had an ultraround and that is how my two large fibroids were diagnosed. I was also tested for anemia...which I did not have. As I remember, it did not show hyperplasia.

After I was diagnosed with my two fibroids, my 2nd Dr. recommended a laparoscopic hyst (LSH)...and he wanted me to do (3) months of lupron shots to shrink my fibroids some for the less invasive hyst. Lupron is not for everyone and it was a success for me. Lupron causes temporary chemical menopause. I had hot flashes and night sweats for awhile...but the good news was that lupron stopped my periods, it helped to bring up my blood count and it helped to relieve my pelvic pressure since my fibroids went down in size. So...I did not do bc pills.

Hope that helps.

Sending best wishes again~

Mary

Hi Mary,
You have been very helpful! This site is great, there are so many people that have walked in the same shoes. I had been a guest to the site for a month prior to joining, just trying to gather up information from other womens experience.
I still can't decide for sure- but everyone in my family says get the procedure done so I have a definitive diagnosis.
I like your end quote"Trust your inner voice" My problem is I have 2!
Thanks again,
Petlover1

Hi Nopainnow,
Wow- you just went through what I am contemplating! And you are right , waiting for results is scary- I nervously awaited my biopsy result and then the diagnosis was so vague!
When my doc called me with results -he said I know you don't like surgery- so here are your 2 options, which I stated before,." I immediately said "I'm going for the D&C so I know for sure". The D&C was scheduled for 1 week later it didn't give me so much time to worry.

I haven't decided yet what I'll do but I do appreciate your insight>
You didn't mention if the D&C was done because of abnormal bleeding before or after menopause.( I'm 52 but no menopause in sight.) I'm really unclear if the fibroids are causing my heavy bleeding or is it the estrogen dominance- which I read causes fibroids to enlarge. This all goes in a circle.

Please let me know your results from the D&C pathology and what road you choose to follow with the new information.
Wishing you a speedy recovery,

Petlover1

Hi Petlover1,

I can’t agree more with what your family is telling you, i.e. have the D&C so you get a definitive diagnosis. While the D&C with hysteroscopy is a surgical procedure, it is a very minor one. You have mentioned that you are frightened of surgery. Analyze why that is so. Take the fear apart one piece at a time. Is it the unknown? Is it the lack of control? Is it possible complications? If complications exactly what? Is it pain? Is it dependency on others for help? Is it ???? Only you can make peace with your feelings.

During my pre-op visit with the gyno, one of my primary questions was, “Will this test answer for sure, YES or NO, cancer is present?” When he told me it will, I knew I’d made the right choice. I was fortunate that the time between first seeing the gyno and having the procedure was just ten days. But I had to wait six weeks to get the appointment with the gyno, after waiting three and a half months of on-again, off-again biopsy appointments with my GP. I was going completely crazy but the time did allow me to read and research and come to terms with the need for some type of test. I learned I have almost all of the risk factors for endometrial cancer. Everything I read pointed to the D&C with hysteroscopy as what I wanted.

You asked about why the test was done. Before my physical on October 20 2008, I thought everything was normal. I felt fine. I had no pain. My periods were more irregular, but similar in flow to what I’d had for the last 9 years. I hadn’t had bleeding in several months. I rarely had hot flashes, and when I did, they were mild. In short, I didn’t think there was anything wrong with me except maybe finally menopause. Then I was hit with, “You have bleeding. That is the symptom of endometrial cancer. You need a biopsy as soon as possible.” I’d told my doctor about my one and only episode of flooding in December 2007. That combined with what the nurse told me, “Any bleeding at your age is abnormal”, started this process.

On the day I was to have the biopsy the second time, it was cancelled again when they sent me for both a pelvic and transvaginal ultrasound. That showed two golf-ball sized fibroids, a 1.8cm thick endometrium, and the uterine muscle as “inhomogeneous”. It is my understanding that hyperplasia cannot be diagnosed with the ultrasound and a thick endometrium does not automatically mean hyperplasia. Polyps can only be identified with saline infusion during the ultrasound.

I’m glad that my waiting is about over. I should know the results of the D&C by Monday or Tuesday. If it is cancer, obviously I’ve had it since before my big bleed in December 2007. The doctor came into recovery after the procedure and gave me pictures of polyps he’d removed. Perhaps that is the reason I’ve had bleeding when everyone is telling me I’m too old to still have periods.

In every interview I’ve had recently one of the questions is “Have you reached menopause?” I laugh and say to them, “That is the question”. I don’t think I have even though statistically according to the medical profession, I should have. All I know for sure is that I’ve not gone a full twelve months without a bleed.

Well, Petlover1, I’ve babbled on quite a while. I hope some of what I’ve said is helpful. I had no qualms about the D&C. I know you have two more weeks to wait, but I think you’ll be glad to have this test too. BTW, two days after the procedure, I mowed the lawn.