Inquiry Regarding Treatment Options for Heavy Menstrual Bleeding and Fibroids
Greetings! I’m a 27-year-old female (currently only using Tylenol or Ibuprofen as needed for abdominal discomfort) and I would like to discuss the treatment alternatives my gynecologist has suggested for managing my heavy menstrual bleeding. Let me share my background: I have consistently experienced long menstrual cycles lasting around eight days, accompanied by excessive bleeding. Recently, I reached a point where the situation is becoming overwhelming. Approximately two months ago, I underwent laparoscopic myomectomy to address a pendunculated subserosal fibroid. During that procedure, my doctor also discovered and removed some cervical polyps. To illustrate the size of the fibroid, it was similar to forming a C shape using both hands. My gynecologist mentioned that this fibroid likely began developing when I had my first period at around age 11 or 12. This surgery was necessary because I had endured continuous bleeding for four months, noticed an increase in abdominal size, and experienced ovulation bleeding each month for about two years. After the operation, my gynecologist mentioned that if my heavy flow continues, she could prescribe progesterone, either for daily use or just during my menstrual cycle. She did alert me to potential side effects, including acne and weight gain. However, I am puzzled because she also told me I possess a gene that causes a rapid recurrence of fibroids and polyps. Would it make sense to consider birth control to mitigate this issue? I’ve read discussions within the fibroid community suggesting that progesterone might actually accelerate the regrowth of fibroids based on some recent studies. I want to clarify these points, as I lack the expertise to evaluate such research accurately. Additionally, I have a family history of strokes on both sides, which I assume eliminates estrogen and tranexamic acid as viable options for me. It might be relevant to mention that recent blood tests indicated low values for MCV, MCHC, and MCH. I’m uncertain about the cause of this, as it only surfaced after my initial gynecological appointment and persisted post-surgery. My doctor initially suspected anemia but later reassured me it is not. I find this confusing because I assumed it might be symptomatic anemia due to heavy menstrual bleeding, especially since I’ve had normal blood tests previously, but she has referred me to a general practitioner for further insight. Ultimately, I am trying to identify ways to manage heavy bleeding without resorting to birth control or an IUD while also determining if I need to take proactive measures to prevent the recurrence of fibroids and polyps. Currently, the only monitoring recommended for the fibroids is an ultrasound every two years. I sincerely appreciate your time in reading my lengthy message. Thank you!
Answers (1)
8/18/2025, 4:21:15 AM
OpenHealth AI
It's understandable that you're feeling overwhelmed with the situation regarding your heavy menstrual bleeding and fibroids. You've been through a significant surgical procedure, and it's natural to seek clarity and effective management strategies. Let's break down what you've shared and explore your options.
Main Points:
- Heavy menstrual bleeding can stem from fibroids and polyps, which you've had surgically addressed.
- Your gynecologist has suggested progesterone, but you're concerned about its potential side effects and the risk of fibroid recurrence.
- You have a family history of strokes, which may limit certain treatment options.
- Blood test results indicate some issues with red blood cell indices, possibly relating to anemia or another underlying condition.
Explanation:
Heavy menstrual bleeding (hypermenorrhea) can be challenging, especially when linked to fibroids and polyps. Some treatment options include hormonal therapies that can help regulate bleeding, but they may come with side effects or concerns, as you've noted.
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Progesterone: While it can help reduce heavy bleeding, some studies suggest it may not extend fibroids' growth. If you're considering this option, it's essential to discuss your specific concerns with your gynecologist to determine if the potential benefits outweigh the risks.
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Birth Control Pills or IUDs: These can help manage heavy bleeding and prevent fibroid regrowth due to their hormone regulation. However, if you prefer to avoid these methods, it's worth discussing alternatives.
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Monitoring and Lifestyle Changes: Regular monitoring via ultrasound can help track fibroid development. Additionally, a healthy lifestyle (eating a balanced diet, staying hydrated, and managing stress) might support your overall health and may help alleviate heavy bleeding.
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Anemia Concerns: The indicators from your blood tests (MCV, MCHC, MCH) could suggest microcytic anemia, often caused by iron deficiency. It would be beneficial to further explore this with your general practitioner, especially related to your menstrual flow.
Next Steps:
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Consult Your Gynecologist: Discuss your hesitation about hormone therapy options (progesterone and birth control). Ask specific questions regarding the research on progesterone and fibroid regrowth.
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Further Blood Test: Follow through with your general practitioner regarding the anemia indicators. It’s crucial to understand if there’s an underlying issue that needs attention.
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Consider Dietary Adjustments: Focus on iron-rich foods (like leafy greens, beans, lentils, and fortified cereals) and vitamin C (to enhance iron absorption) and maintain balanced nutrition.
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Keep a Symptom Journal: Monitor your menstrual cycles, bleeding patterns, and any symptoms you experience. This information can be very helpful for your healthcare providers to tailor a personalized management strategy.
It's completely valid to seek a treatment approach that aligns with your health needs and preferences. You're taking proactive steps by seeking information and exploring your options. Please let me know if you have any other questions!
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