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Recent ultrasound showed fibroid increased in size. Having bleeding. Taking Vivelle dot and prometrium. Alternate treatment?

Mar 2016
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Practicing since : 2011
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I had one ovary removed when I was 34 (1995) and the other one removed Dec. 2011. Since then, I have had episodes of bleeding which cause me great distress, though I have now had 'surgical menopause'. I am on .075 Vivelle dot and recently upped the prometrium to 400 mg. a night, yet I am still bleeding. Recent ultrasound showed a fibroid that increased in size from 1.0 cm in Feb. 2013, to 1.75 cm. My GYN advised to continue with the HRT as above and that should stop the bleeding. My concerns are as follows: 1.) If I just continue as is, is the estrogen feeding the fibroid such that it will continue to give me problems? 2.) Am I in this for the rest of my life since I will not have a normal menopause? 3) Should I consider a hysterectomy of just the uterus or perhaps alternate treatment for the fibroid? Thank you so much.
Posted Mon, 15 Jul 2013 in Women's Health
Answered by Dr. S Patra 1 hour later

Thanks for writing to us. Followings are my comments regarding your query:

1) At this stage, size of uterine fibroid is very small and above medicines are quite helpful to regress the fibroid to some extent. Both estrogen and progesterone med are needed as HRT in this age group to get beneficial effects. Therefore, it is wise to continue above medicines as per your doctor's recommendation. Follow up visit with ultrasound scan is also advisable.

2) Menopause has a wide starting range and most of the women usually expect it in the age range of 42–58 years. You would definitely get normal menopause within few years and until then, you need to continue above medicines.

3) Total hysterectomy is the ideal and definite treatment option at this age group. Considering the state of MS, some alternative treatment options for fibroid are as follows:
a) insertion of Levonorgestrel-IUD b) drugs like danazole or GnRH analogue to shrink fibroid c) ultrasound fibroid destruction d) myomectomy or radio frequency ablation e) proper clinical examination and other relevant investigations. Take healthy diet with iron & calcium supplements. Maintain your genital hygiene properly.

Hope, it helps for your information. If you have any other query, you can freely ask me.

Wish your good health and take care yourself.

Dr Soumen
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