Response to readers

What to do about these fibroids

Dear Dr Rainford,

I am a 30-year-old woman diagnosed with fibroids. I was seeing a gynaecologist at the hospital and had a date for surgery. When the date arrived and I was admitted to hospital, it was then that I was told they could not perform the myomectomy as I had heart-related problems. I was disappointed but continued on with life.

At that time, I was referred to another hospital where I felt like a guinea pig. All they were doing were tests and more tests and nobody was saying anything to me. I became disillusioned with the whole process and just stopped going. My question is, what options do I have? Having it done privately is too expensive for me. I don't have any children as yet and my spouse and I have been trying but nothing. I feel bad and I cry all the time, especially when I see women with their babies. I need your help please.

Dear Reader.

Thank you for sharing your plight with me. First, I strongly encourage you to return to a gynaecologist for a review of your care since I believe this is the only way to effectively attempt to solve your problem. However, there are some issues that you can discuss with the doctor at the visit. Uterine fibroids do not always require surgical removal; however, there are some criteria that may prompt a woman to seek removal or a doctor to recommend it. These include but are not limited to abnormal bleeding that does not respond well to medication, symptoms of pain or pressure or if the fibroids are large.

From your letter, it was clear that both you and the doctors caring for you thought that surgery was appropriate. You also mentioned heart-related problems which should be reviewed at the visit. Finally, your most distressing problem seems to be your difficulty achieving pregnancy. Although fibroids can affect a woman's fertility, it is not usually a major cause and thus myomectomy is not a major treatment of infertility. You can re-examine if surgery is really necessary for you and also seek the possible causes of your difficulty in achieving pregnancy.

Contraceptive pills

Dear Dr Rainford,

I am 20 years old and I have been on the contraceptive pill, minigynon-30, for about a year. The last six months or so, I have been having very light periods. Before I was on the Pill, I used to have much more moderate periods but now it's much lighter and seems to be getting lighter each month. I need to know if this is normal or safe for me, so I can discontinue the use. Your advice is much appreciated.

Dear Reader,

When a woman is on the birth control pill, she no longer ovulates and as such no longer has 'normal' periods. The bleeding that she has is a withdrawal bleed which usually occurs during her pill-free week. It is not unusual for this bleeding to be lighter than her normal period and, in fact, the Pill can be used to treat heavy periods. Therefore, let me reassure you that your lighter periods are a normal side effect and I encourage you to continue with this method if you do not desire pregnancy at this time.

Dr Monique Rainford is a consulting obstetrician and gynaecologist; email: yourhealth@gleanerjm.com.