Q. I'm almost 50. For the past five years, I've experienced heavy bleeding. Three years ago my doctor found one fibroid but now there are three, which puts me at a four-month-pregnant size. The drug Ovral 28 has slightly improved the bleeding and regulated my cycle, but my doctor thinks I may need a hysterectomy.
I've read about endometrial ablation to remove the uterine lining and fibroids. Can you tell me what the size of the fibroids should be to do this? What are the complications of this procedure?
A.Good news if you don't want a hysterectomy: you probably won't get one. Hysterectomy used to be one of the most common surgeries in the U.S., and many feared that women were needlessly having them. To help address this potential problem, several groups developed guidelines for when a woman should have a hysterectomy. These guidelines depend on the amount of the woman's bleeding, the cause of the bleeding and other symptoms, and when the woman is expected to reach menopause.
The size of the fibroids is a factor, but only in that larger fibroids tend to cause more symptoms. The primary symptom of concern is abnormal menstrual bleeding, which you have been experiencing. Since you are almost 50, you can expect that your periods will end soon. When your periods end, the bleeding will likely stop. Other concerns about the fibroids are that their size may cause problems, much like the pregnant woman notices some symptoms. For example, a large fibroid may push on the bladder, making you urinate more frequently.
However, as your gynecologist said, if you are not bothered by this symptom now, you will not be in the future. The fibroids won't grow after menopause (they may shrink), and so you should not have any new symptoms.
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