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Suggest Treament Uterine Fibroids
Question: I am a 51 year old with uterine fibroids the largest is 5 cm. I am not symptomatic. My gynecologist is recommending a robotic hysterectomy. I am not convinced this is necessary since I will certainly be in menopause soon and then they should shrink or at least stop growing. I am told my uterus is as large
as a 5 month pregnancy approx 11cm x 8cm x 9cm.
I also have a history of meningiomas and am quite concerned about regrowth if I have to take hormones therefore am not really wanting to shock my body into menopause. Need another opinion,
as a 5 month pregnancy approx 11cm x 8cm x 9cm.
I also have a history of meningiomas and am quite concerned about regrowth if I have to take hormones therefore am not really wanting to shock my body into menopause. Need another opinion,
Brief Answer:
Hysterectomy not absolutely necessary.
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
1) If you are not symptomatic you can opt to not have surgery but rarely the fibroids become cancerous.
Also the hysterectomy is needed as 5 cms fibroid is not going to shrink more than 1 -2 cms after menopause. This will not reduce the size of your uterus much from 11cm x 8cm x 9cm. Sometime the fibroid continue to grow even after menopause.
2) Tell him to leave the ovaries behind. This way you will not need hormones as it is your ovary and not uterus which provides hormones.
So you do not need to worry about meningioma regrowth.
To summarise you can opt to not have hysterectomy but at your own slight risk.
Feel free to consult me directly
http://bit.ly/drsombiswas
Regards
Dr. Som Biswas M.D.
Mumbai
Hysterectomy not absolutely necessary.
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
1) If you are not symptomatic you can opt to not have surgery but rarely the fibroids become cancerous.
Also the hysterectomy is needed as 5 cms fibroid is not going to shrink more than 1 -2 cms after menopause. This will not reduce the size of your uterus much from 11cm x 8cm x 9cm. Sometime the fibroid continue to grow even after menopause.
2) Tell him to leave the ovaries behind. This way you will not need hormones as it is your ovary and not uterus which provides hormones.
So you do not need to worry about meningioma regrowth.
To summarise you can opt to not have hysterectomy but at your own slight risk.
Feel free to consult me directly
http://bit.ly/drsombiswas
Regards
Dr. Som Biswas M.D.
Mumbai
Above answer was peer-reviewed by :
Dr. Yogesh D
I do know that he is consulting with a reproductive endocrinologist about taking my ovaries or not. What would be the risk/benefits of leaving. Risk would be Ovarian cancer?
Benefits would be not needing HRT although they probably won't produce hormones more than a couple years at most anyhow correct?
Also I am confused about the amount of hormones in birth control which I am on vs. HRT. Which has more and if birth control has more than its probably a mute
point. How soon do I need to get off birth control? My guess is that it is providing me protection from perimenopause symptoms.
My birth control is Orsythia (levonorgestrel 0.1mg and ethinyl estradiol 0.02 mg tablets USP)
Benefits would be not needing HRT although they probably won't produce hormones more than a couple years at most anyhow correct?
Also I am confused about the amount of hormones in birth control which I am on vs. HRT. Which has more and if birth control has more than its probably a mute
point. How soon do I need to get off birth control? My guess is that it is providing me protection from perimenopause symptoms.
My birth control is Orsythia (levonorgestrel 0.1mg and ethinyl estradiol 0.02 mg tablets USP)
Brief Answer:
Do not worry
Detailed Answer:
Dear XXXX,
Risks of ovarian cancer is like risk for breast cancer or any other cancer. You cannot keep taking out your organs thinking they will develop cancer later. And in that way you should be more worried about the fibroids becoming cancerous than your ovaries. Tell your surgeon to leave the ovaries behind. Also get BRCA 1 & 2 gene tested if you are worried about ovarian cancer.
HRT is not needed in all postmenopausal women, only those who are severely symptomatic. We cannot predict now whether you will be symptomatic or not.
HRT hormones generally have higher hormones than birth control pills if you consider over the long term as they are taken continuously for years.
Also if you are worried about meningiomas recurring then why are you on hormones of birth control pills and not using condoms or copper IUD.
My advice-
1) remove uterus, leave ovaries behind.
2) Stop pills and use condoms.
3) Do not worry about HRT till you are symptomatic.
Regards,
Dr. Som Biswas MD
Do not worry
Detailed Answer:
Dear XXXX,
Risks of ovarian cancer is like risk for breast cancer or any other cancer. You cannot keep taking out your organs thinking they will develop cancer later. And in that way you should be more worried about the fibroids becoming cancerous than your ovaries. Tell your surgeon to leave the ovaries behind. Also get BRCA 1 & 2 gene tested if you are worried about ovarian cancer.
HRT is not needed in all postmenopausal women, only those who are severely symptomatic. We cannot predict now whether you will be symptomatic or not.
HRT hormones generally have higher hormones than birth control pills if you consider over the long term as they are taken continuously for years.
Also if you are worried about meningiomas recurring then why are you on hormones of birth control pills and not using condoms or copper IUD.
My advice-
1) remove uterus, leave ovaries behind.
2) Stop pills and use condoms.
3) Do not worry about HRT till you are symptomatic.
Regards,
Dr. Som Biswas MD
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
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