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Ask Dr. K: Surgical treatment of painful fibroids can be an option

DEAR DOCTOR K: I saw my doctor for intense pain and heavy bleeding during my periods. It turns out I have fibroids. What are my treatment options?

DEAR READER: A fibroid is a lump or growth in the uterus. The uterus is made of a special kind of muscle. The muscle doesn’t do much most of the time, but once a month, it ejects the bloody discharge that collects inside it. During pregnancy, it expands to accommodate the growing baby. And, of course, the uterus squeezes out the baby at the time of birth.

Fibroids are balls of uterine muscle. They are almost never cancerous, but they can cause severe pain and discomfort, most often during menstrual periods. In some cases, fibroids can cause infertility or repeated miscarriages. Fortunately, many treatment options exist.

Fibroids can be as small as a pea or as large as a basketball (really). They are usually round and pinkish, and they can grow anywhere inside or on the uterus. (I’ve put an illustration on my website, AskDoctorK.com.)

Some women with fibroids do not have symptoms and may not realize they have them until a gynecologist feels them during a pelvic exam. Small fibroids that are not causing symptoms and don’t interfere with fertility do not need to be treated.

In other cases, women experience pain and heavy bleeding. A doctor may prescribe medications that stop the ovaries from making the female hormone estrogen, which fibroids need in order to grow. This controls excessive bleeding and temporarily shrinks the fibroids. When the medication is stopped, periods return and fibroids start growing again.

Fibroids that cause severe symptoms or interfere with fertility may be surgically removed.

Fibroids often shrink on their own after menopause.

Send questions to Anthony L. Komaroff, M.D. through his website: www.AskDoctorK.com or mail him in care of Universal Uclick, 1130 Walnut St., Kansas City, MO 64106.

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