Gynecologic Health

Understanding Abnormal Uterine Bleeding: Part 2

Summary & Participants

As many as 20 to 50 percent of all women develop fibroids. These benign muscle tumors usually grow in the uterus, and can cause pain, and in some cases, infertility. Join our panel as they discuss abnormal bleeding and fibroid concerns.

Medically Reviewed On: July 09, 2008

Webcast Transcript

MARTIN GOLDSTEIN, MD: Yes. This is a large growth. It was provoking significantly heavy bleeding. In addition to the submucous fibroid on the hysterogram, we also can see a small polyp, which doesn't show up as well. It's at about the 11 o'clock position in reference to the fibroid.

PAUL MONIZ: How long did it take you to find this after Valerie came to see you?

MARTIN GOLDSTEIN, MD: We had the hysterogram performed as soon as Valerie stopped bleeding, which was several days after she saw me. To provoke further cessation of bleeding, we used a medication called Lupron, which is a gonadotropin releasing hormone agonist. This is a medication that works by inhibiting estrogen production from the ovary. It temporarily will make a woman menopausal.The ovary then stops producing estrogen. Fibroids will shrink because fibroids are stimulated and will grow from estrogen.

Fibroids will frequently grow if somebody is on birth control pills. One of the first ways of treating heavy vaginal bleeding with menses by many doctors is to put the patient on birth control pills. I think it's very important to make a diagnosis before you start a treatment. In some cases, the management and treatment can aggravate the initial process that's happening.

PAUL MONIZ: Valerie, let's bring you into this again. While you're going through this workup, physically what are you feeling? Are these diagnostic tests painful or uncomfortable?

VALERIE: None of them were painful or uncomfortable. I was fine.

PAUL MONIZ: What about psychologically? Obviously, you were concerned?

VALERIE: Psychologically, I was concerned, but I was relieved that I was getting help and was going to become healthy. So, my outlook and my sense of well being were beginning to be more reassured.

PAUL MONIZ: You came to the conclusion that hysteroscopy was indicated?

MARTIN GOLDSTEIN, MD: I felt it was necessary to remove the myoma. We knew that Valerie did not have a malignancy. We did a biopsy of the endometrial lining. We found that there was no malignancy present. We did a hysterogram, which demonstrated a large submucous fibroid. This being the cause of the bleeding, it was necessary to do something to remove the fibroid. The options were either to remove the fibroid with the uterus and perform the hysterectomy, which Valerie did not want as an option, or to do some procedure to remove the fibroid.

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