QuestionI am 41 with one child and plan to have no more. The date of my last period was Dec. 23. I have had fibroids for several years. And I have had ovarian cysts ocassionally. I've had heavy periods for a few years. In May I had almost monthlong bleeding and become anemic. I had a 6 cm cyst. I started using progesterone cream from a compounding pharmicist recommendation. That stopped the in between period bleeding and the cyst is gone.
Now, six months later, periods are lighter, but a couple of days longer. I also had an ultrasound. I have a couple of small fibroids (which I've had a few years) and my uterine lining is thickened to about 138, enlarging it.
My gyn recommends a D and C (never had one) and then uterine abulation right afterwards. All under general anesthesia (which I've had problems with in the past). My insurance requires that I have a D and C first. He said the abulation would be best for me. It may even stop my periods.
My anemia is better. I'm on the low end of normal in all blood work now, but improving. Though my RDW is a little high at 15.9. A uterine biopsy turned out normal. But my Gyn said I do have a increase in cell production in some areas of uterus and that is causing in between bleeding. But he said that is a hormonal problem, even though my hormone bloodwork is normal.
So should I have all this done now? I am more nervous about general anesthesia than anything. I had an exploratory laporoscopy nine years ago for the beginning of all these problems. Nothing find but small fibroids and a small cyst. I guess the major difference is now I've been anemic and uterine lining has thickened.
What are pros and cons of this and the abulation? Will it really make me feel better and stop my problems? I know it doesn't get rid of fibroids and cysts, and if those are my problems, why subject myself to all this. The progesterone cream has really worked some wonders, though slowly. I'm very sensitive to meds, so don't take anything else, other than iodine tablets from my pharmicist. Have slow metabolism and low bp/heart rate.
thanks in advance.
AnswerIf you are 41 years of age with an endometrial thickness of 13.8cm, you should have a D&C in order to assess any pathology in your uterus. If you are no longer complaining of heavy bleeding and only have light periods that do not last longer than 14 days at a time, you do not need the ablation. HOwever, if you continue to have abnormal bleeding inbetween your periods and can, perhaps, be bleeding due to the fibroids, the ablation may help. You did not mention how large the fibroids that you have are measuring. If they are small and do not cause the bleeding, you need not have the ablation. The ovarian cysts come and go and are not affected by progesterone cream use, a D&C, or the ablation. If the ovarian cyst is larger than 6cm AND is causing you discomfort, it should be removed. If your fibroids grow and are causing intractable bleeding AND your ovarian cysts grows, you should have a hysterectomy, which will solve all your problems.If you do have the ablation, you may still have fibroids but the bleeding should stop and you will no longer get a period each month. Good Luck.
