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Is my 5 cm fibroid causing my back pain?

Dear Dr. Parker,

Thank you for being so available via email. I have never blogged nor responded to this type of med info. I was drawn to your information and presentation of same.

I have a 5cm submucosal fibroid, with no abnormal bleeding. The only symptom I appear to have is severe back ache, and pelvic (hip) pain. I have had an ultra sound, MRI, CT, saline infusion sonogram and an endometrial biopsy. I am 48 and not in menopause. I am healthy and have had two children naturally. Take no other meds.

All the doctors I have seen want to operate. They say the uterine size is an issue. I would like to keep my uterus, cervix, etc intact. Drs. say I am a great candidate for laparoscopic supracervial hysterectomy. Lupron does not interest me. Uterine Artery Embolization does not interest me. Hysteroscopy resection is now less of an option, they say this would have to be done numerous times because of size and Lupron needed.

My question – Would getting off the birth control pill (Ortho Novum 1/35 28 day) be of any benefit? Would this help in reducing the feed of hormones to the fibroid? Along with change in diet, deleting red meat, etc.

Would appreciate any reply or thought on this.

Thank you,

Dr. Parker’s Reply

I doubt that a 5 cm submucosal fibroid would be causing back pain. 5 cm is not big and if it is submucosal it is bulging inward towards the uterine cavity, not outward towards your back. I would recommend you get an opinion from a back specialist before you have a surgery that won’t help you. The MRI should also be able to see if the fibroid is pressing against the spine.

If the fibroid is only 5 cm, then a laparoscopic myomectomy would also be feasible, as would a laparoscopic supracervical hysterectomy. If MRI shows that most of the fibroid is in the uterine cavity, then hysteroscopic myomectomy should be possible if performed by a skilled hysteroscopic surgeon.

Birth control pills neither make the fibroids grow or shrink, so stopping the pill should not make a difference. The studies on diet are hard to do, but one study shows women have fewer (not smaller) fibroids if they never eat red meat.

You might also consider seeing a gynecologist who sees a lot of women with fibroids to make sense out of all of this for you.

Bill Parker, MD

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