How do Fibroids Cause Infertility and Heavy Menstrual Bleeding?

One Comment

1. Joy
   Posted January 9, 2012 at 12:59 pm | Permalink

   Dear Dr. Parker,

   In 2009, I discovered that like many Black women I was afflicted with fibroids. The last ultra sound result in June 2010 revealed that I had “an anteverted 10cm uterus with a 5.2cm intramural fibroid, causing distortion of the endometrium, suggesting submucous extension. A 9.0mm subserosal fibroid is in the anterior fundus. The endometrium is 6.5mm and thick.” Two separate attempts were made to perform a biopsy and curettage but it would seem the fibroid’s position and the fact that I was bleeding at the time prevented a conclusive determination. I was immediately told that I should have a hysterectomy, but resisted the idea of losing my womb. I sought several ‘second opinions’ and was constantly told the same thing.

   In the meantime, during my periods, which could last anywhere from 12-20 days, I suffered extremely heavy bleeding (saturating super Tampax tampons and pads every 2-30 minutes for several hours and accompanied by glass coaster-sized clots) and pain severe enough to require morphine drip treatment at medical facilities on a few occasions (have since been prescribed Ponstan Forte 500mg for the pain, which I must take 3 days before period begins). Attempts were made to stop my periods altogether (Depro Provera and various contraceptive pill regimes) all to no avail. I also tried alternative treatments (acupuncture and various herbs, including Dong quai, Red raspberry leaf, Shepherd’s purse, Lady’s mantle, Yarrow, etc, as well as the enzymes Fibrovera and Neprinol – which I took together) in an attempt to find a treatment that would allow me to keep my womb, but it was all for nought. So finally, I have thrown in the towel and partially accepted that I may have to lose my womb. Due to all the heavy bleeding, my haemoglobin levels are low – 6.5 in November 2011 – and so once again, my gynaecologist tried to stop my periods in an attempt to raise my iron levels by putting me on the pill, Yasmin, with the ultimate goal of performing a hysterectomy this year (Trihemic makes me vomit, so that’s a no-no). Only thing is, I started Yasmin in early November 2011 and after initially retarding my period for a week or two, my flow has now been going nonstop (now 2nd week January 2012). The pill has had some effect as I no longer suffer the ‘deluge’ I had before, but it’s still there. Volume fluctuates, sometimes moderate with some clotting and pain and sometimes very light). So, I’m due to start Zolodex this week to see if that will prove more successful.

   The problem is that I live in a country where treatment options for fibroids are very limited, with hysterectomies and myomectomies being the only two procedures and the laproscropic versions of those only being introduced 2-4 years ago. Is there really nothing else that can be done for me? I have tried to be as thorough as I can in presenting my case to you in order that you may best suggest a solution without actually having examined me.

   I am really looking forward to your response.

   Best regards,

   Joy

   Joy,
   I totally understand your dilemma – it is a story I hear all the time from women I see for second, third, fourth opinions. You do have options, but you will need to find qualified doctors to provide them for you.

   One option is an endometrial ablation; cauterization of the uterine lining cells to stop the bleeding. See more about this here: http://www.fibroidsecondopinion.com/hysteroscopic-myomectomy/

   A similar technique, hysteroscopic myomectomy, may be used to remove part of the fibroid in order to gain access to the uterine cavity so that the ablation can be performed.

   Another option is uterine artery embolization. This procedure is performed by interventional radiologists and has excellent results for heavy bleeding, around 90% success rates. You can see more about this here: http://www.fibroidsecondopinion.com/uterine-artery-embolization/

   And, as you mention, myomectomy can remove the fibroid and also eliminate the heavy bleeding without a hysterectomy. Based on the size of the fibroid, this should be very straight-forward in the hands of a gynecologist who regularly performs this procedure.

   Hopefully, you can find someone to provide you these other options. Hysterectomy should not be necessary.

   Bill Parker, MD