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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Fibroids In Uterus

I have experienced painful periods since my 2nd child was born in 2003. I have heavy bleeding, clotting and extended periods that are irregular. Recently I started having random symptoms of a UTI, so I had an ultrasound and 2 fibroids were found, 2cm and 4cm. There was no UTI either. My options for the fibroids were a monthly shot that would put me into menopause for 6 months, the pill (which I have tried) or my request of a partial hysterectomy. I feel a partial hysterectomy is more of a long term solution. I am meeting with my OB in October to discuss this option. Please advise if a hysterectomy is a good option. I am a 45 year old white female who has given birth to 2 kids and will not be having anymore.
Mon, 21 Aug 2023
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OB & GYN Specialist,  's  Response
Hello,

Fibroid is a common cause of heavy menstrual bleeding. The size of your fibroid is not something that warrants immediate surgery. You can consider any one of the following medical therapies for 3 months or so and see if that is responding.
One of these options can be considered:
1. Tranexamic acid + Mefenamic acid during periods
2. UPA tablet for 3 months
3. Progesterone releasing intrauterine device
4. Non surgical procedures like uterine artery embolization, MRI guided focused ultrasound

You have not mentioned the location of the fibroid. If it is submucosal you can remove my hysteroscopic approach. If it is sub serosal you can remove through laparoscopy. But mostly I feel medical therapy will work for you. Tranexamic acid plus mefenamic acid will be the first best option. If the medical therapy does not work for you in the next 3 months then probably you can think of more definite procedure.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Praseetha Narayanan, OB & GYN Specialist
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Suggest Treatment For Fibroids In Uterus

Hello, Fibroid is a common cause of heavy menstrual bleeding. The size of your fibroid is not something that warrants immediate surgery. You can consider any one of the following medical therapies for 3 months or so and see if that is responding. One of these options can be considered: 1. Tranexamic acid + Mefenamic acid during periods 2. UPA tablet for 3 months 3. Progesterone releasing intrauterine device 4. Non surgical procedures like uterine artery embolization, MRI guided focused ultrasound You have not mentioned the location of the fibroid. If it is submucosal you can remove my hysteroscopic approach. If it is sub serosal you can remove through laparoscopy. But mostly I feel medical therapy will work for you. Tranexamic acid plus mefenamic acid will be the first best option. If the medical therapy does not work for you in the next 3 months then probably you can think of more definite procedure. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Praseetha Narayanan, OB & GYN Specialist