Hysterectomy the answer??

  For the past year (perhaps longer but only tested every 3 months this year) my Ferriten level has been at a 4 despite iron supplementation (when able to tolerate)  They have done a complete upper/lower GI work up and everything was normal, stated it was probably from heavy menstrual cycles.  I had a transvag ultrasound compelted and found a fibroid (3cm) in left side of uterus. I was referred to OB/GYN and went for the appt yesterday.  He told me that according to US, I also had a thickened lining of the uterus (1.3cm) and a larger than normal uterus.  He told me that I will have a number of options (birth control, mirena, ablation, or hysterectomy)  he told me that I may want to seriously consider a hysterectomy because over time the fibroid will grow and cause discomfort and I already have serious side effects from the heavy bleeding. He took a sample of the uterine lining, told me not to panic and wait for the results to see if it showed polyps.  I have a few questions 1) what could the uterine tissue samples show and what does it mean to have enlarged uterus and lining  2)Is it premature to discuss hysterectomy already? (I am 33, done having kids)  3) I would really prefer not to be on the pill, my husband had a vasectomy so that I wouldn't have to deal with side effects I have had in past from birth control. any suggestions from ppl that may have gone through this would be appreciated?  The doctor told me that the side effects from hysterectomy are not that bad as long as they leave the ovaries.  I am in a little bit of a panic and not sure what route would be best.  

[Elaine Brown, MD]

Hi!
If you were my patient, I would try to reassure you.  The uterine tissue is very likely to be completely benign, and the worst thing that I would expect to find would be polyps.
The enlarged uterus is probably a consequence of the fibroid, and also is not anything to be too concerned about.  The reading that I have done suggests that in cases similar to yours, the two BEST options (fewest side effects and best results) were the Mirena IUD and hysterectomy.  I would probably try to talk you into trying the IUD for awhile to see if it would work for you before going to hysterectomy.
I would suggest cleaning the lining of the uterus with progesterone before inserting the IUD though.
Good luck!
Dr B

[rtjrevie]

Hi Dr. Brown,
Thank you for the answer, it is reassuring.  I got a phone call yesterday stating that it was benign! Ya! My doctor suggested that I start Medroxyprogesterone QD x 12 days. He stated to try this for 3-4 months to see if it decreases my bleeding at all. I have tried to read up a little bit on the use of progesterone but am having trouble understanding it.  I read that it should be used if there are no possible reasons for the bleeding such as fibroids. Will the Progesterone decrease the bleeding? Should I be focusing on decreasing the bleeding or trying to resolve the problem such as removal of fibroid? I have heard some people have trouble with Mirena and the side effects? Are the side effects bad or am I just hearing worse case senarios?  I am sorry I am asking these questions to you, but I now need to wait 3 months before I meet with my doctor.  I do appreciate your time and answers. Thank you for the help.

[rtjrevie]

One more question to add...will this (progesterone) decrease my blood flow or increase it? I really do not want it to increase, it is already bad enough. I can't imagine it getting much worse!