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Should I worry about my fibroids even with normal periods?

Dr Nandita Palshetkar |36 Answers |Ask -Follow

Gynaecologist, IVF expert - Answered on Dec 06, 2024

Dr Nandita Palshetkar is the medical director of Bloom IVF.
She is a pioneer in ICSI, laser hatching, spindle view, oocyte and embryo freezing, IMSI, in vivo vaginal culture, metabolomics, embryoscope and spindle check technologies.
With over 30 years of experience, Dr Nandita is managing 10 centres across India.
She has written over 100 papers, edited 25 books and given over 1,000 lectures and speeches.
She has also won several prestigious awards, including the Dronacharya Award (2021), the Bharat Gaurav Award at the House of Commons in London (2014) and the Inspiring Gynaecologists of India (2018) to name a few.
Dr Nandita completed her MBBS from Grant Medical College and Sir J J Hospital, Mumbai, and her MD in obstetrics and gynaecology from Mumbai University."... more

Question by D on Dec 04, 2024Hindi

I am 51. I have been diagnosed to have multiple fibroids. 3 Months ago, my bleeding did not stop and was told it was due to my fibroids and had to be given hormones treatment to stop. But, since then I had 2 normal periods. Right now, I am not taking any medicines. What further action I need to take for my fibroids issue. Please advise.

Ans: Hello
You are 51 with fibroids, with menorrhagia
Firstly,
1) We Need to get usg 3 D pelvis done with fibroid mapping.
2) Blood test to see for CBC, tsh , prolactin, tsh level
Since you are 51 and if your hemoglobin is maintained and bleeding controlled, we can wait and observe with regular usg monitoring for fibroids
Since you are 51, there are chances of you being in perimenopause and menopause, so there are chances fibroids reduce in size, and you become asymptomatic because post menopause estrogen level drops and fibroids are estrogen dependent.
If wish to go for conservative management:
a) Cyclic Oc pills or continuous Oc pills to create pseudoamennorhoea which will control dysmenorrhea and bleeding
B) Lupron Depot is a synthetic hormone that reduces the body's production of estrogen and progesterone, causing a temporary menopause-like state. This can shrink fibroids, stop menstrual periods, and improve anemia.
Uterine fibroid embolization:
This minimally invasive procedure involves injecting small particles into the uterine artery to block blood flow to the fibroids.
Radiofrequency ablation (RFA):
This treatment uses microwave energy to treat smaller fibroids in people who haven't reached menopause.
Progestin-releasing intrauterine device (IUD)
This option is for women with fibroids that don't distort the uterus. It can reduce heavy bleeding but doesn't treat the fibroids.
But if symptoms like
Heavy periods
Pain
Frequent periods
Drop in hemoglobin
Disturbed quality of life
Then best option will be removal of uterus keeping ovaries intact if ovaries are healthy to maintain hormones.

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