"I think I'll call it Shirley," I told my husband.
"It" is the uterine fibroid my primary care physician was concerned about last month. The subsequent CT scan she ordered for me revealed that I actually have TWO rather large fibroids (9 cm and 8 cm) pressing against my bladder.
Naturally, I named the other one Laverne.
I just got back from the ob/gyn referral to figure out what to do about them.
If I'm lucky: Not much.
"Uterine fibroids shrink naturally after menopause," the doctor told me. "If you were ten years younger, I'd say definitely have them removed. But since the average age for menopause is 53..."
Uh, yeah. I will be reaching that milestone a week from today. The birthday; not "the Change." I still have regular periods and have few symptoms that indicate that will stop any time soon. No hot flashes, for instance.
"Don't worry - you will," the doctor said.
As long as Laverne and Shirley don't bother me, we may as well just wait for them to leave on their own.
True, they might be responsible for making me have to pee more often than I used to (something I chalked up to my advancing age) -- but their position inside my body hasn't bothered me much at all. In fact, although I've known I've had uterine fibroids for many years, I had NO IDEA they had grown so large - and never noticed them until the primary care physician found Shirley.
"Because of their size, no one would argue with you if you wanted them removed," the doctor continued. I presumed she was talking about my insurance company.
"And some women would have them removed just for reasons of vanity," she said. She estimated that I would lose a full three inches off my waist if the fibroids were gone.
There are a few options. Most are surgical; all have risks. I discovered that they CAN be removed laparoscopically, but if complications occur I could end up having an all-out hysterectomy. They can also be shrunk via drugs -- but that would involve inducing early menopause. "And then you would have all the discomforts associated with that," my doctor explained. "When the treatment is done, you might not have your period again. But -- you might."
And then I would end up going through menopause a SECOND time. That doesn't sound too appealing, either.
Given the information we have right now, I'm leaning towards keeping the girls a while. But there are two other factors that might cause the doctors to recommend immediate removal:
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1. If there is evidence that the fibroids are growing at a quick clip.
2. If the fibroids are robbing me of my body's stores of iron.
The latter is a bit hard to determine, as I have thalessemia minor - a genetic anemic condition common to people of Mediterranean descent. Anemia always shows up on my blood tests - but the usual prescription of iron supplements is NOT beneficial.
I've never fully understood why. In fact, I did not know I had this condition until my newborn daughter's pediatrician discovered it in her.
The doctor tried to explain to me why my thalessemia and iron stores are two entirely different issues and I don't quite understand that, either.
She's ordered another blood test to check on my iron, as well as my levels of FSH, which would indicate whether there is danger of the fibroids getting too big too fast.
Fingers crossed that I can continue to live peacefully with Laverne and Shirley for a while longer.
Good for you. Also keep in mind that fibroids have two periods of natural growth spurts, one of them at menopause, just before they're about to shrink and calcify, so #1 above wouldn't necessarily be a concern. I haven't heard of fibroids robbing the body of iron, unless they're inside the uterus and causing heavy menstrual bleeding. Even then they can be removed with a myomectomy, or a resection if they're small, leaving the female organs intact. Have you seen the "female anatomy" video at hersfoundationDOTorg? It talks about fibroids. Also, HERS has an incredible book out called THE H WORD you can get from Amazon that goes into great detail about fibroids, menopause, and hysterectomy in general.
Posted by: deniseland | May 14, 2009 at 05:01 AM
Thanks for the information and link.
Ironically in a post about my uterine fibroids, I thought mentioning that my regular periods are extremely heavy was Too Much Information. But yeah - that is why she is concerned about my iron stores.
Posted by: Donna | May 14, 2009 at 06:41 AM
I came to mine in the opposite way. After weeks of wanting to sleep All. The. Time. we determined that fybroids were causing excessive blood loss. Just had my appointment with the gyno today to discuss options. My pair are 7cm and 6cm, so too large for laproscopic removal. We're discussing hysterctomy vs uterine artery embolization.
Posted by: Monica | May 21, 2009 at 05:15 PM
Yikes - my gyno didn't think embolization was a viable option for me. And my girls are bigger ... maybe they are in a better position for laproscopy? Anyway - I wish you luck w/yours!!
Posted by: Donna | May 21, 2009 at 05:36 PM