WOMENS-HEALTH Messages for July, 1999: Re: Fibroids and pain

Re: Fibroids and pain

From: anonymous@obgyn.net
Sat, 31 Jul 1999 12:01:04 -0500 (CDT)

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At Fri, 30 Jul 1999, Niels wrote: >
>I have an 8cm fibroid, and also have a lot of pain. The pain is mostly
>right sided pelvic pain, and is very severe. I also have a lot of
>pressure, particularly on my bladder.

An 8cm fibroid is about the size of a grapefruit, so it's no wonder you are having pain. When I took my oral board exams, I was told "don't tell them that fibroids or adhesions (scar tissue) cause pain or they will fail you." Obviously, both can cause pain. Rest assured that most gynecologists I know have no problem believing that fibroids cause pain.

There are a number of things you can due to fix this problem, but, unfortunately, the best results will likely come from surgery. Non-surgical options include medications like ibuprofen for the pain, or monthly shots of a GnRH agonist to shrink the fibroids. Despite this, many fibroids return once the shots are stopped, and, the shots can have very strong side-effects. Surgical options include myomectomy (removing just the fibroid and not the uterus), hysterectomy (removing the fibroid and the uterus), embolization (a new technique that is somewhat controversial, where the blood supply to the fibroid is shut off; this should not be done if you are considering becoming pregnant), and myocoagulation (another newer technique that may not work on a fibroid as large as 8cm). Most gynecologists would recommend either the GnRH therapy or the myomectomy. The hysterectomy would be a very reasonable choice if you are finished childbearing and/or have other gynecologic problems.

Good luck with everything.

--
David Ashley Hill,M.D.
Associate Director
Department of Ob/Gyn
Florida Hospital Family Practice Residency
Orlando, FL
http://home.mpinet.net/dahmd

Next message: Lisa: "small CRL by ultrasound at 8 weeks gestation"
Previous message: D. Ashley Hill, M.D.: "Re: menstrual cycle"
In reply to: Susan: "HRT,WHAT ELSE?"
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