I’m 33 years old and I have a fibroid. It causes me to have heavy periods and to be anemic. The tumor is noncancerous according to tests after a D&C. Is it possible to have it removed, but not have a hysterectomy, even though I am done having children?
Fibroids, by definition, are benign, or noncancerous. They are growths on the uterine wall (or inside or outside the uterus) that are composed of muscle and connective tissue. There may be one or many fibroids, and they can be very tiny or as large as eight inches in diameter.
Fibroids are quite common in women of reproductive age. They also are much more prevalent among African-American women than Caucasians. The most common symptom of fibroids is heavy periods, which can lead to anemia, as you are experiencing. Possible symptoms include severe menstrual cramps, bleeding between periods, pain during sexual intercourse, low back pain and others.
We do not know what causes fibroids, but they are somehow related to estrogen, since they usually disappear or shrink to a harmless size after menopause. Hysterectomies used to be routine for fibroids, but today, women frequently have several other options. Waiting until menopause to see if the fibroid shrinks is one possibility, particularly if you are in your 40s and the size and location of the fibroid do not pose any other kind of threat.
There are hormonal medications available that may help shrink the fibroid and reduce bleeding. These medications are not ideal because their benefits are only temporary and they have undesirable side effects. But they may be appropriate and effective treatments in certain circumstances.
A relatively new form of surgery, called myomectomy, removes the fibroid only, not the uterus. Three different surgical techniques of myomectomy may be used, depending on the nature of the fibroids. In almost one-third of cases, though, the fibroids grow back.
Discuss your options with your doctor and make your feelings about a hysterectomy known. Afterward, if your doctor continues to recommend a hysterectomy, get a second opinion. That is always a good idea prior to major elective surgery and it is not any kind of bad reflection on your doctor.
In some cases, hysterectomy really is the best choice, but you are completely justified in wanting to avoid one unless it is absolutely necessary. You should also be aware that a few doctors still believe in hysterectomy as the first line treatment for fibroids. In a few cases, health plans may have incentives that favor hysterectomy over myomectomy.