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Done with Dilation and curettage test. Having uterus fibroid. Cure?

Mar 2013
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Practicing since : 1998
Answered : 5621 Questions
Hi I am 34 yr old professional female,same partner for 5 years no previous health issues. In Feb this year i had a D & C to take out the polyps and they came back non cancerous (yay) this was back in Feb this year and was told i have an unterus fibroid on the wall and to come back if i have any issues. I was OK March, April and May, later this year in XXXXXXX i started spotting couple days before my period then it was OK - normal 7 day period. However this month I spotted for 6 days and bleeding very heavy for now 26 days. What could it be?
Posted Fri, 23 Aug 2013 in Vaginal and Uterus Health
Answered by Dr. Aarti Abraham 35 minutes later
Thanks for your query.
Firstly, with the bleeding you descibe, the following possibilities can exist -
1. Bleeding due to the uterine fibroid - you have mentioned it is a walnut sized fibroid, generally such small fibroids do not bleed, but if they are situated towards the lining of the uterus, instead of away towards the wall, they CAN cause such heavy bleeding. It would help if you upload the results of your ultrasound scan report.
2. Thickening of the lining of the uterus - this is called endometrial hyperplasia. You mentioned a history of uterine polyps, these are generally caused by excess of estrogen levels in the body. The same reason can cause the lining of the uterus to thicken. This is NOT cancer, and only some types of thickening lead to increased risk of cancer. This risk is less than 5 % , and that too only in certain types of endometrial hyperplasia. To know which type you are having, a biopsy of the uterine lining needs to be taken. This is best coupled with a hysteroscopy in which the interior of the uterus also can be visualized for any other pathology.
3. Thickening of the wall of the uterus, called adenomyosis.
4. Anxiety, stress, imbalance of thyroid hormones, ingestion of anti clotting medications - all these are possible reasons too.

In your case, I would ask you to visit your gynecologist, get a transvaginal pelvic ultrasound ( upload the report if done ) and go for a detailed evaluation for the above possibilities.
Do not worry, as you just had a D and C in february, which was completely alright ( non cancerous ), so I would ask you to put the thought of cancer out of your mind for now

Take care.
Please feel free to discuss further.
Above answer was peer-reviewed by
Follow-up: Done with Dilation and curettage test. Having uterus fibroid. Cure? 12 hours later
Dr XXXXXXX XXXXXXX I have had an ultrasound completed last week and the results came back clear. This is the second pelvic ultrasound that was completed ( One in XXXXXXX where the polyps were discovered and removed by way of D & C in Feb and another ultrasound on the Sunday just past due to my heavy non stop bleeding for over 25 days and the results came back clear, thats why they have referred me back to my gynecologist because the fibroid was too small that the ultrasound couldn't see it, though I had a hysterscopy and thats when they say they fibroid on the lining of my uterus, i have pictures though need to scan them through so you can have a look. I will see my local GP to see if they can email me the results that were sent to and from my gnnecologist in case they have missed anything and for a second opinion. Your information is so very much appreciated as my specialist is so busy and man of very few words, though whats happening to me can't be ignored. Thanks a million XXXXXXX
Answered by Dr. Aarti Abraham 40 minutes later

Thanks for writing back and for your kind words.

Please do attach the reports if possible.

Please have a second opinion definitely, as the bleeding you described is NOT normal and needs evaluation.

Could you specify WHEN you had a hysteroscopy - am slightly confused about the chronology of the events you describe.

Above answer was peer-reviewed by
Follow-up: Done with Dilation and curettage test. Having uterus fibroid. Cure? 10 hours later

Ok the chain of events are as follows:

Nov 2011 started abnormal bleeding eg: menstrual cycle spotting and Dec menstrual cycle lasting nearly 3 weeks, that's when i went to my GP. My GP a few tests, eg: checks for sexual transmitted diseases tests, pregnancy test ( all clear- had 4 partners in my life, came back all clear, then the GP prescribed Primolut N 5mg 1 tablet 3 times a day to manage the bleeding whilst we continued with tests, she ordered an ultrasound ( I think it was XXXXXXX 2012) where I drank I think 1 litre of water 90minutes before my ultrasound and had my kidneys checked then the weird stick inside my uterus to see what was happening inside me). Once the results were at hand they wrote out a referral for Dr Claude Calandra (Obsterican and Gnaecologist) well respected though i felt rushed every appointment I had with him. Though to his credit he ordered a D & C and within a few weeks i was in hospital ( Feb 2012) and there were approx 5 polyps cut out andthats when the fibroid was found on the lining of my uterus / whoem. This didnt come up in the ultrasound it was found at the time of the hysteroscopy ( where they inserted a camera and thats when they found what was in my lining of my uterus). So in March, April, May 2012 I had normal periods again I thought that was it i was cured... However in XXXXXXX the spotting started again though my period stopped after nearly 9 days. In July i started spotting around the 8th/9th then i had the flu and bleeding suddenly stopped for a 4 days... then around 12/13th i was bleeding as much as your palm in a pad after the 17th it was the worst bleeds ive had ( heavy, changing 2 times a day) i am still bleeding as at today. I went back to my GP though she left forthe UK so i have been seeing who ever is available to try and treat me....I have had another ultrasound on Sunday just past and that like the initial ultrasound has come back clear, I've also had a full blood examination and Iron studies on Monday, recieved my results a few hours agao, all is in order and comments are: Red cells, white cells and platelets are within normal limits ( Tests that were done have symbols FES* and FBE. I have been re referred to the Gnaeo specialist Claude Calandra. The GP has prescribed primolut N again to relieve me from bleeding.Im at the specialist this Monday ( Claude Calandra - i have been re referred for his thoughts). Is there anything you can think of that they may have missed? Hi Dr XXXXXXX the Hysteroscopy was done at the time of D & C Feb 2012 ( just thought id clarify that given the length of my previous email). Any thoughts or guidance would be highly appreciated whilst im on this journey of hopefully finding a fix ( not sure what my estrogen levels are and also had A PAP in Dec 2012 and was all clear.
Answered by Dr. Aarti Abraham 4 hours later
I appreciate the time and effort you have spared in detailing your history.
My thoughts remain essentially the same.
THe bleeding is not normal, and has a cause.
It could be the fibroid, or endometrial hyperplasia, or adenomyosis.
If the bleeding is controlled with Primolut N, then my opinion is that your OB GYN would schedule you for further workup in the form of hysteroscopy guided D and C again, though that is best done WHILE you are bleeding, to pick up the ongoing pathology.
Keep me posted.
Above answer was peer-reviewed by
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