#free ask the doctor
What to Ask About Fibroids
What kind of fibroids do I have, and how large are they?
The size, location and shape of the fibroid determine the best treatment.
Can fibroids affect my fertility, and if so, to what degree?
Size and location of the fibroid can reduce fertility by as much as 70 percent or not at all. The key issue is whether the uterine cavity is distorted, interfering with an embryo s ability to implant and thrive.
Fibroids run in my family. Should I plan to have children sooner rather than later?
Most doctors today will say it s always wise to have children sooner rather than later because a woman s age plays such a significant role in the quality of her eggs and potential complications during pregnancy. Fibroids can affect conception and cause miscarriage. They also tend to develop earlier in African-Americans than in other women often appearing in their 20s instead of their 30s.
What are my treatment options?
Hysterectomy. or surgical removal of the uterus, is the only absolute cure for fibroids, but it shuts the door on future pregnancies, requires hospitalization and can take six weeks for recovery. Uterine artery embolization is a popular alternative that typically involves only one night in the hospital and a week of rest. But some studies suggest it can affect ovarian function, so it s not recommended for women who still want children. Myomectomy, or removal of the fibroids while leaving the uterus intact, is the recommended treatment for women trying to get pregnant, but it carries a risk of recurrence, and its effect on fertility hasn t been studied.
How can I tell if I really need treatment?
Diagnostic tests are more sophisticated than ever in measuring the size and location of fibroids and helping the doctor predict their effects if they re not already obvious. There is also a questionnaire patients can complete about their symptoms and quality of life that helps gauge how severe the disease is and whether treatment is necessary.
Do you specialize in any particular treatment? If so, how many of those surgeries or procedures have you performed?
Interventional radiologists generally perform embolization, while ob/gyns do hysterectomies and myomectomies. Experience, and the doctor s track record, are critical considerations in choosing a doctor.
If I have a myomectomy, what is the risk of scarring and any subsequent effect on my fertility?
There have been no studies of this, even though myomectomy is the preferred treatment for potential mothers. So for now, scientists do not have reliable information on this one way or the other.
What is the risk of my fibroids growing back with each procedure?
Fibroids can recur, unless the uterus is removed, and the risk varies slightly with each of the new procedures.
Am I a candidate for drugs, and what are their side effects?
The medicines currently approved for treating fibroids can trigger early menopause. with symptoms that include hot flashes and, over time, bone loss. Moreover, their benefits last only as long as the drugs are taken. As a result, they are usually prescribed to women in their late 40s or early 50s who are presumed to be close to menopause, when most fibroids shrink on their own.
I am claustrophobic. Should I undergo M.R.I. – guided ultrasound for my fibroids?
During this outpatient procedure, the patient lies in a magnetic resonance imaging tube similar to the ones used for diagnostic tests. It could be unpleasant for someone anxious about enclosed spaces. Ask your doctor about sedation.
Are there foods to avoid, or other natural treatments, to ease my symptoms without medical intervention?
The Internet has more ads for natural treatments than some women have fibroids. Ask your doctor before you try them, and check to see if they ve ever been scientifically studied.
Publish date: 10/23/2008