Got my diagnosis and treatment options today... now it's decision time.

I'm 36, and I have 5 children. About 3 years ago my periods became very heavy and extremely painful, and very disruptive to my life.

Two weeks ago I had an endometrial biopsy and a series of ultrasounds done. They found one small fibroid, but normal endometrial lining, ovaries, etc. They have offered me three options: provera, an IUD, or a hysterectomy. They're pushing me pretty hard towards an IUD, but my research makes me more uncomfortable than comfortable with the idea. One obstacle is that I have to have the surgery between May and August, due to my school schedule. I know sometimes it take up to 6 months to get the body adjusted to an IUD, and that would put me out of my window. Also, I have zero desire to preserve my fertility, as I have been done having children for 10+ years.

Having surgery seems like the best option for me, but I fear sexual side effects, pelvic organ prolapse, weight gain, etc. however, I already have some bladder and sexual problems from my currently enlarged uterus, but I'd be looking at 6-ish weeks of recovery from surgery, vs 1,000+ potential days of pain and bleeding until menopause.

Any thoughts/advice would be appreciated!

Personally my preference is not to take hormones. This would rule out provera and the iud. Fibroids can grow huge when given a steady supply of hormones be it progesterone or estrogen. Hysterectomy is over diagnosis. Since you posted I would suggest getting the fibroid embolized. This means cutting off its blood supply. Procedure is called UFE or UAE and is performed by Interventional Radiologist. The fibroid will shrink to virtually nothing. This is the best non invasive treatment for fibroids. Highly recommended!

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Originally Posted by Huckabjl I'm 36, and I have 5 children. About 3 years ago my periods became very heavy and extremely painful, and very disruptive to my life. Two weeks ago I had an endometrial biopsy and a series of ultrasounds done. They found one small fibroid, but normal endometrial lining, ovaries, etc. They have offered me three options: provera, an IUD, or a hysterectomy. They're pushing me pretty hard towards an IUD, but my research makes me more uncomfortable than comfortable with the idea. One obstacle is that I have to have the surgery between May and August, due to my school schedule. I know sometimes it take up to 6 months to get the body adjusted to an IUD, and that would put me out of my window. Also, I have zero desire to preserve my fertility, as I have been done having children for 10+ years. Having surgery seems like the best option for me, but I fear sexual side effects, pelvic organ prolapse, weight gain, etc. however, I already have some bladder and sexual problems from my currently enlarged uterus, but I'd be looking at 6-ish weeks of recovery from surgery, vs 1,000+ potential days of pain and bleeding until menopause. Any thoughts/advice would be appreciated!

I agree with sisterduke ... ask for a referral to an Interventional Radiologist to see if you're a candidate for Uterine Artery Embolization/Uterine Fibroid Embolization (UAE/UFE). It's not done by a gynecologist, which is why they often do not even know about it (even though it's been around for decades and is very safe and effective). It's a super fast and easy procedure with a very short recovery of a few days to a week.

Good luck and let us know what you decide!

To clarify: my doctor doesn't feel that the fibroid is the cause of my pain and heavy bleeding, because it's small (1.3cm). They feel it's either a hormonal imbalance or just dysfunctional bleeding.

I don't think it's a hormonal thing because it's been going on for years, but it's gotten progressively worse over the past few months.

The thing is, I'm right in the "normal" window for everything. Blood count, cycles, flow days...all normal. But I know something is wrong, and feels different.

From my experience it's the fibroid. They are toxic and highly hormonal. Doctors have a tendency to down play them.

If you treat the fibroid via UAE/UFE... then you'll know if that's your problem or not. You can always progress to having a hysterectomy if needed in the future. Even small fibroids can cause a lot of problems - everyone is different. I have a friend with a 2 cm fibroid that caused her hell until it was removed and she's been fine since.

For my decision process in treating my fibroids, I looked at it this way... I wanted to try all less-invasive alternatives before / IF I ever I had to resort to hysterectomy. Many women have a good result from hysterectomy and wished they did it sooner, but many do not ... and suffer awful side effects and regret having a hysterectomy. But at that point there is nothing you can do. Even if there was a very low likelihood of having bad side effects, statistics do not matter if you're one of the unlucky ones! I didn't want to regret my decision, so that's why I tried alternatives first and I have been very happy with that decision.

Everyone is different and has to make their own decision based on what they are comfortable with. Only YOU have to live with the outcome. We can all give our advice, and your doctor can give you recommendations... but only you can decide what is best for YOU! Good luck and please let us know what you end up doing ... and more importantly.... how things are afterward!

Huckabjl,

In May 2016, I had endometrial ablation (removal of the endometrial lining) as a measure to reduce my heavy menstrual bleeding, it is not used to prevent cramps and pain and therefore it was suggested that I also inserted the Mirena coil to help with any pain. My heavy monthly flooding was reduced to very light bleeding and solved that particular issue, despite having an enlarged uterus that was bulky from 7 fibroids, the largest being 6 cm which resulted in a 5 months pregnancy sized uterus.

An endometrial ablation does not prevent pregnancies so you will still need some form of contraception but maybe it is something that you can research further. It is done as an out patient procedure and recovery is extremely quick with minimal pain other that cramping following the procedure and light discharge that can last for 1-2 weeks.

In August 2016, I removed the Mirena coil because I developed an ovarian cysts but my bleeding has remained lighter that before the procedure.