Managing Heavy Menstrual Bleeding and Pain from Uterine Fibroids

The suffering caused by long-term uterine fibroids?

I have heavy and painful menstrual periods, which led to the diagnosis of uterine fibroids.
Since my last period began in early October, I visited a gynecologist and received an injection to stop menstruation.
Without the injection, I experience severe pain, but I continue to have heavy bleeding.
After the injection, the bleeding remains heavy, and my lower back is very sore.
I'm unsure whether I should continue taking the medication prescribed by my doctor.
I really want to have a hysterectomy, but my doctor says I'm still too young.
However, I've been suffering from excessive menstrual bleeding—it's like a faucet—and abdominal pain for years.
Is there a way to resolve my issues without having to remove my uterus?

Xiao Yu, 20~29 year old female. Ask Date: 2005/11/17

Dr. Xu Junzheng reply Obstetrics and Gynecology

You can try medication to control menstrual flow, and surgery can also involve the removal of only the uterine fibroids.
Thank you!

Reply Date: 2005/11/17

More Info

Managing heavy menstrual bleeding and pain due to uterine fibroids can be a challenging experience, especially when it significantly impacts your quality of life. Uterine fibroids, which are non-cancerous growths in the uterus, can lead to symptoms such as heavy menstrual bleeding, pelvic pain, and discomfort. It’s understandable that you are seeking relief from these symptoms, especially given the severity of your situation.

From your description, it seems that you have been experiencing heavy menstrual bleeding for an extended period, which has not improved even after receiving a hormonal injection intended to manage your symptoms. This suggests that your fibroids may be particularly large or numerous, or that your body is not responding as expected to the treatment. The fact that you are experiencing persistent pain and discomfort, along with heavy bleeding, indicates that further evaluation and management may be necessary.

Here are some options to consider for managing your symptoms without resorting to a hysterectomy (removal of the uterus):
1. Medication Adjustments: If the current medication prescribed by your doctor is not providing relief, it may be worth discussing alternative medications. Options include nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief, hormonal treatments such as birth control pills, or other medications specifically designed to reduce menstrual bleeding, such as tranexamic acid or hormonal IUDs (intrauterine devices).

2. Minimally Invasive Procedures: There are several minimally invasive procedures that can help manage fibroids without removing the uterus. These include:
- Uterine Artery Embolization (UAE): This procedure involves blocking the blood supply to the fibroids, causing them to shrink and reducing symptoms.

- Myomectomy: This surgical procedure involves the removal of fibroids while preserving the uterus. It can be performed through various techniques, including laparoscopic (minimally invasive) surgery.

3. Lifestyle Modifications: Sometimes, lifestyle changes can help manage symptoms. This includes maintaining a healthy diet, regular exercise, and stress management techniques such as yoga or meditation. These changes can help improve overall well-being and may reduce the severity of symptoms.

4. Regular Monitoring: Since you mentioned that your doctor believes you are still too young for a hysterectomy, it’s important to have regular follow-ups to monitor the size and symptoms of your fibroids. This will help in making informed decisions about your treatment options as your situation evolves.

5. Consultation with a Specialist: If you haven’t already, consider seeking a second opinion from a specialist in reproductive endocrinology or a gynecologic oncologist. They may offer additional insights or treatment options that could be beneficial.

6. Alternative Therapies: Some individuals find relief through alternative therapies such as acupuncture, herbal supplements, or dietary changes. However, it is crucial to discuss these options with your healthcare provider to ensure they do not interfere with your current treatment plan.

In conclusion, while the prospect of managing heavy menstrual bleeding and pain from uterine fibroids can be daunting, there are various options available that do not necessarily involve a hysterectomy. It is essential to have open and ongoing communication with your healthcare provider to explore these options and find a treatment plan that works best for you. Remember, you are not alone in this journey, and there are resources and support available to help you manage your symptoms effectively.

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