Uterine Fibroids: When to Seek a Second Opinion

Uterine fibroids

Hello, in September 2015, I experienced continuous menstruation and went to a clinic for an examination, where a uterine fibroid of about 3 cm was discovered.
Afterward, I took medication to manage my menstrual cycle, which improved significantly.
However, recently my menstrual cycle has become irregular again.
I went to the hospital for further examination (including a transvaginal ultrasound and hysteroscopy), and the hospital stated that they did not see any uterine fibroids.
Should I consider getting a second opinion or seek another examination?

Xiao A, 20~29 year old female. Ask Date: 2017/07/03

Dr. Huang Jianzhong reply Obstetrics and Gynecology

In September 2015, due to irregular menstrual periods, I went to a clinic for examination and was found to have a uterine fibroid approximately 3 cm in size.
Afterward, I took medication to manage my menstrual cycle, which improved significantly.
However, recently my menstrual cycle has become irregular again, so I went to the hospital for further examination (including a transvaginal ultrasound and hysteroscopy).
The hospital stated that they did not see any uterine fibroids.
Should I consider getting checked at another facility?
Answer: There is no need to seek another facility for examination, as a 3 cm uterine fibroid is unlikely to have a significant impact.
It is recommended to follow up in about 9 to 12 months.

Reply Date: 2017/07/03

More Info

Uterine fibroids, also known as leiomyomas, are non-cancerous growths of the uterus that often appear during childbearing years. They can vary in size, number, and location within the uterus, and while many women with fibroids experience no symptoms, others may suffer from heavy menstrual bleeding, prolonged periods, pelvic pain, and other complications. Given your history of a 3 cm fibroid diagnosed in 2015 and your recent experience of irregular menstrual cycles, it is understandable that you are concerned about the current state of your condition.

When it comes to seeking a second opinion regarding uterine fibroids, there are several factors to consider:
1. Symptoms and Changes: If you are experiencing changes in your menstrual cycle, such as increased irregularity or heavy bleeding, it is important to address these symptoms. While fibroids can sometimes shrink or become less symptomatic, new or worsening symptoms may indicate the presence of other issues, such as new fibroids, adenomyosis, or even other gynecological conditions.

2. Diagnostic Discrepancies: You mentioned that a recent examination, including a transvaginal ultrasound and hysteroscopy, did not reveal any fibroids. This discrepancy from your previous diagnosis raises valid concerns. Diagnostic imaging can vary in sensitivity and specificity, and sometimes fibroids may not be easily visualized, especially if they are small or located in certain areas of the uterus. If you feel that your concerns have not been adequately addressed or if the findings seem inconsistent with your symptoms, seeking a second opinion is a reasonable course of action.

3. Consulting a Specialist: If you haven't already, consider consulting a gynecologist who specializes in reproductive endocrinology or a gynecologic oncologist. These specialists may have more advanced diagnostic tools and a deeper understanding of complex cases involving fibroids and menstrual irregularities.

4. Treatment Options: Depending on the findings, treatment options for fibroids can range from watchful waiting to medication, and in some cases, surgical intervention may be necessary. If you are not satisfied with the explanations or treatment options provided by your current healthcare provider, a second opinion can provide you with additional perspectives and options.

5. Personal Comfort and Trust: Ultimately, your comfort and trust in your healthcare provider are paramount. If you feel that your concerns are not being taken seriously or that you are not receiving the level of care you deserve, it is entirely appropriate to seek a second opinion. This can help you make informed decisions about your health and treatment options.

In conclusion, if you are experiencing irregular menstrual cycles and have concerns about the presence of uterine fibroids, seeking a second opinion is a prudent step. It is essential to have a thorough evaluation and to discuss all your symptoms and concerns with a qualified healthcare provider. This will ensure that you receive the appropriate care and management for your condition. Remember, your health is a priority, and you deserve to have clarity and confidence in your treatment plan.

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