Topics of Interest

Fibroids after Menopause

Dear Dr. Parker,

I would like to thank you very much for the most comprehensive website on fibroids and their treatment.  The time and effort you put into maintaining and updating that site is greatly appreciate by every woman who has to deal with them.

I know you are a very busy man, but wanted to ask you a quick question.  If fibroids shrink by 50% after menopause, what would be an approximate shrinkage of the 20-22 week uterus with multiple fibroids (the largest being around 10-12cm) and how long it may take for the symtomps of bulk and pressure to go down?  On your web site, you mentioned that it could happen 6 months or more after the last period for firboids to start shrinking.  Can I expect that my uterus may shrink from 20-22 weeks to 12-14 weeks, or more like 16-18-weeks?  If that is the case, is abdominal myomectomy reasonable at the age of 55 with periods happening every 3-4 months now?

Thank you very much for you opinion.

 

The 50% shrinkage number is based on volume (not diameter), so it would more likely be closer to 16 weeks about 6 months after your last period.  An abdominal myomectomy is certainly reasonable – I have done myomectomies for women even after menopause, when they did not get enough shrinkage to make them comfortable.

Thanks for the kind words about the website,

Bill Parker, MD

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Disclaimer: The ideas, procedures and suggestions contained on this web site are not intended as a substitute for consulting with your physician. All matters regarding your health require medical supervision.

6 Comments

  1. Maria Fernandez
    Posted June 19, 2011 at 11:23 am | Permalink

    Hi Dr. Parker, I would appreciate if you could answer my question.
    I went into early menopause at the age of 41. I have been on hormone replacement theraphy for the last six years. I have tried to stop hormone theraphy but I am not able to because the hot flashes, night sweats and imsonia return.
    I have 4 intramural uterine fibroids ranging in size from 3cm to 6cm and a uterus size of about 15 weeks. I have pressure and some pain. My GYN suggested a hysterectomy which I don’t want to do.
    my questions is this:
    Is myomectomy appropriate for a menopausal woman on HRT? What is the likelyhood of fibrods returning if a myomectomy is performed and I continue with HRT?
    I really appreciate your help. Thank you.

  2. Posted June 19, 2011 at 12:03 pm | Permalink

    I was sitting at the computer when your e-mail came in. You do not need a hysterectomy. A myomectomy is perfectly reasonable treatment and in the hands of an expert laparoscopic surgeon, very likely can be performed laparoscopically as an outpatient with about a 10 day recovery.

    The likelihood of new fibroids growing, with or without hormone therapy, is almost nil since the doses of hormones are well below the peak amounts made by the ovary during a menstrual cycle.

    You should consider getting a second opinion from a gynecologist who performs laparoscopic myomectomies on a regular basis.

    I hope this is helpful,

    Bill Parker, MD

  3. Amy
    Posted July 2, 2011 at 5:39 am | Permalink

    I’m 56 and in the same situation as the woman above – finally had my lap myomectomy 4 days ago! Yay!

    A couple of questions: I had no idea that I have a lot of adenomyosis… so my uterus is still quite enlarged despite the removal of two large fibroids… I’m wondering what could have caused this and how long I’ve had the condition. I looked at the possible causes and am wondering if an earlier endometrial ablation or d & c’s could have caused the adenomyosis… I had been told that my endometrium “grew back” — is that even possible? Or do you happen to know (or even venture a guess) if the endometial ablation (using a rollerball) or the d & c’s could have inserted some endometrial cells into the uterine muscle and caused the adenomyosis? I’m hoping the loss of the fibroids will help with a little incontinence, increase the amount of urine I can hold, and decrease some pain during intercourse… but I didn’t count on having this other condition! Thanks!

    Although rare, it is possible for endometrial ablation to bury lining cells that lead to adenomyosis. If the adenomyosis was present before surgery, it should have been detected with an MRI. If the adenomyosis is new, as the result of the ablation, it is likely to be more superficial and might be treatable with a Mirena-IUD. See: http://www.fibroidsecondopinion.com/adenomyosis/

    I hope this is helpful,

    Bill Parker, MD

  4. Posted July 7, 2011 at 6:18 am | Permalink

    Dear Dr Parker
    I am 51 and postmenopausal 2 years. I was diagnosed with a 10cm intramural fibroid about 5 years ago but with no symptoms. Then earlier this year I had pain and bleeding and my gyno did a hysterscopy and currette and confirmed it was a degenerating fibroid. Pathology results showed some abnormal cells but not cancer. This doctor recommended doing the hysterscopy again in about 3 months and watch it. I went to another gyno for a second opinion. He recommended a hysterectomy although he did contact the pathologist who analysed the results and said they were probably over read in regards to the abnormality. He recommended a total hysterectomy and at the time I was scared and thought it would be best to get rid of everything and have no worry about cancer. Now 2 weeks before the surgery I am beginning to wonder if I have made the right choice. I have not had any more pain or bleeding and I am worried major surgery is not a good idea. Also I am beginning to think I shouldn’t remove my ovaries. Finally I am worried about loss of sexual pleasure by removing my cervix. I think now it might be better to wait a while and see how things go rather than have such radical surgery. Do you think waiting would be safe or should I have the surgery? Thank you for your time.

    If your doctor is worried about cancer of the uterine lining cells (found on the D&C), then a repeat biopsy makes sense if the cells are not thought to be cancer now.

    If the doctor is concerned about another type of cancer – cancer of the uterine muscle (called sarcoma), then you might ask them to perform this protocol from Japan:
    http://www.fibroidsecondopinion.com/fibroids-and-cancer/

    For more information about removing the ovaries, see the bottom of this page:
    http://www.fibroidsecondopinion.com/hysterectomy-for-fibroids/

    The top of the same page discusses pros and cons of removing the cervix.

    I hope this is helpful,

    Bill Parker, MD

  5. sandy locapo
    Posted October 2, 2011 at 6:07 pm | Permalink

    I am 53 and was told about 4 years ago I have fibroids. I was still having my period very heavy at the time and she explained that being the reason why. She also said they would get smaller with menopause and then disolve. My period has might as well say stopped since Jan of 2010 I think I have had it twice. BUT lately I find when I have to pee most of the time it is pinkish and sometimes bits of clotting so I am thinking this is the fibroids disolveing? I feel presure on my blatter a lot now but really no pain. Is this what I should be expecting? Do you recomend a doctor in the Boston area?

  6. PATIENCE
    Posted July 28, 2012 at 6:51 am | Permalink

    i am 52 still having regular monthly menstrual flow because of fibroids sizes 46mm&25mm,doctors said they will shrink after menopause is it true

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Fibroid Doctor William H. Parker

Dr. William H. Parker is a board-certified Fellow in the American College of Obstetricians and Gynecologists. Dr. Parker is an internationally recognized expert in fibroid surgery and research. Based in Los Angeles, California, he is considered one of the best fibroid surgeons for abdominal and laparoscopic myomectomy in the United States and abroad. He has been chosen for Best Doctors in America and Top Doctors every year beginning in the late 90's.

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