Dr. Brown

I'm 40 yrs old. My symptoms started when I was 38 with back pain. My symptoms have gradually increased to occasional leg pain and prolonged periods lasting 10-12 days. My pap smears have been normal. I've had several pelvic ultrasounds as well as hysterosonograms. These revealed numerous fibroids. One that is in the wall of the uterus but impinging on the uterine lining. I've seen 2 different GYNs. I've been told I need a myometomy. I had a pelvic exam last thurs (9/8) that included a pap & a saline ultrasound. I spotted for 2 days and then 2 days after I noticed a pinkish drainage. My periods often begin & end with spotting for several days. My doc saids its due to the fibroids. My period is due in 4 days. My cycle has become very irregular, anywhere from 24-28 days. I'm scared it could be something more serious. Any advice would be greatly appreciated.

[Elaine Brown, MD]

Hi!
Your symptoms almost certainly are caused by the fibroids.  It is very reasonable to assume that.  If you were my patient, I would probably also discuss the option of an endometrial biopsy with you -- that would rule out endometrial cancer.  Approximately 99% of fibroids are benign, so unless they are growing rapidly, they are quite unlikely to be malignant (cancer).  A myomectomy or hysterectomy would be reasonable.  Some other options include uterine artery embolization, or MRI guided ultrasonic ablation of the fibroids.  Depot lupron is a medication that can temporarily shrink fibroids and can make surgery easier and reduce blood loss. This can be used pre-operatively and results are often obtained within one month. After menopause fibroids naturally shrink and are less symptomatic.  You have many optioins, and which one you chose depends upon your wishes and what is available in your area.
Good luck!
Dr B