WOMENS-HEALTH Messages for October, 2000: Re: age/ fibroids/ cervical cancer/ birth control pills

Re: age/ fibroids/ cervical cancer/ birth control pills

From: anonymous@obgyn.net
Tue, 10 Oct 2000 20:32:52 -0500 (CDT)

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Reply: Mary: "Re: age/ fibroids/ cervical cancer/ birth control pills/thank YOU"

At Tue, 10 Oct 2000, Mary wrote: >
>I am 43 and had cryosurgery for cervical cancer 21 years ago. This year
>I broke down and visited my ob/gyn after missing for 4 years....
>
>Ok the horrible periods were because of fibroids (3) and have improved
>with the use of Aleese.
>
>I have also had laser surgery for displasia this year, so possible the
>cancer was "thinking" of recurring.
>
>I do have hypertension, now if this is a result of the stress level in
>my life which has increased this year or the OC, I can't say.
>
>My ob gyn has mentioned a hysterectomy. It is my option, of course.
>
>Am I correct in some of the following observations from reading the
>posts.
>1) the fibroids can get worse over the next few years and start causing
>more pain.

This might happen, but it is not for sure.

>2) they might be a reason for frequent urination, or even occasional
>"leaks"

Fibroids can make this worse sometimes, but the damage of childbirth and declining estrogen levels are the real culprit.

>3) with fibroids I will have to be on OC until a menopausal age, and the
>OC might quit working on the bleeding

The OCs might control the bleeding, but the results are variable from patient to patient.

>4) if I opt for the hysterectomy yes I will go for removal of ovaries
>and therefore will be on HRT anyway for the next few years.

If you have your ovaries removed, you will likely need HRT, and if you do not, it may still be a few years.

>5) how will HRT affect hypertension? With the HRT levels being lower
>than the hormone levels in OC won't that be better for hypertension?

HRT does not typically effect HTN.

>6) I am in one of those positions where it is a"good" time for the
>surgery if there is ever a "good time" and am partly contemplating this
>as it seems a bit inevitable and maybe I should just get it over with.

Nothing is inevitable, because these problems do not DEMAND hyst, they only SUGGEST hyst. However, if you feel the benefits are in your favor, then the sooner you have it, the longer you are going to feel better.

>
>7) I see many opinions loving and hating the hysterectomy, and I do have
>a great deal of faith in my OB/Gyn as he has always had good advice in
>the past, and he was a 2nd opinion doctor 21 years ago. So I am not
>concerned that he will "screw up" the surgery.( the first said conal
>biopsy and hysterectomy in 5 years and no more kids)
>
>But are the physical side effects just luck of the draw no matter how
>good the surgeon?

A good surgeon is going to give you the best chance, but even the best surgeon in the world is going to have complications, and suboptimal outcomes, at least partially because we cannot see into the future. Still, a good surgeon that you trust is really the key to success.

>
>I also have seen that women with hysterectomies have a higher risk of
>heart disease..... is this the case? My mom had her first heart attack
>at 65...she also had a full hysterectomy many many years ago. should I
>be concerned as I am "so young" that I am putting myself at risk? But
>aren't I also putting myself at risk taking the OC?
>MK

Removal of the uterus itself does not raise your risk of heart attack. Menopause, whether surgical or natural does raise that risk, which is probably alleviated to some degree by HRT, but the data is not all in on that. and yes, the OCPs are an additional risk factor.

--
William D. McIntosh, MD, FACOG
Clarksville, TN

This is for educational purposes only, and is not intended to be replacement
or substitute for consultation and examination by an appropriate medical
professional.  Due to time constraints, private e-mails cannot be answered.

Next message: Ms.: "Megestrol Acetate (Megace) vs. Birth Control"
Previous message: Emme: "Question for Dr. McIntosh re. an earlier response of his"
In reply to: Mary: "age/ fibroids/ cervical cancer/ birth control pills"
Next in thread: Mary: "Re: age/ fibroids/ cervical cancer/ birth control pills/thank YOU"
Reply: Mary: "Re: age/ fibroids/ cervical cancer/ birth control pills/thank YOU"

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