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Dr Ted Manos
Dr Ted Manos, Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 350
Experience:  40 years experience; Board certified Ob-Gyn
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Since 2012, I have experienced heavier-than-normal bleeding,

Customer Question

Hello. Since 2012, I have experienced heavier-than-normal bleeding, among other symptoms. In 2013, I learned that I had a uterine fibroid. The OB/GYN doctor said that my heavy bleeding wasn't related to my fibroid. I later learned that wasn't true. In May 2014, I was diagnosed with fibromyalgia and chronic fatigue syndrome.I haven't seen that OB/GYN since about a year before I was discharged from the military in May 2014. I asked about surgical removal of the fibroid, and he advised against it. Now my healthcare is only from or referred to by the VA.I read that the amount of blood and fluid lost is usually between 4 and 12 teaspoons each cycle. I resumed using my Diva Cup (menstrual cup) because even the Ultra absorbency tampons cannot keep up with my flow during the first 2 to 3 days, and have been keeping track of my fluid loss this time. I have already lost 12 teaspoons (59.2 ml) in 2 days of a 7-day period.I don't know if it's my age, fibromyalgia, or a combination of the two, but between my heavy bleeding, frequent bowel movements, gas, and migraines, my time of the month puts me even more so out of commission. I know that menstrual migraines are the result of the drop in estrogen level.Some women in my online fibromyalgia support group suggested that it may be endometriosis, and endometriosis is related to fibromyalgia. I don't know if any doctor I have seen has considered endometriosis. I'm sure that they have. I wasn't aware that fibromyalgia was related to endometriosis, but found some information online. I read that studies have shown that women who have endometriosis are more likely to develop fibromyalgia, but the connection to fibromyalgia is still being researched.I am waiting on the referral for my annual pelvic ultrasound. I haven't had a diagnostic laparoscopy; only a pelvic ultrasound.I haven't mentioned my blood loss to my current GP yet because I just made the discovery, but I will this week. I don't want an IUD or ablation because I don't want to eliminate the possibility of having children in the future.I have had a longtime fear being on a hormone-containing medication because it isn't normal. I think that the only hormones I'd be willing to go on are bioidentical ones, and I know that the VA would not cover that. There is only one doctor in my state who does bioidentical hormone replacement therapy.Do you know what other options I have? Thank you in advance.
Submitted: 11 months ago.
Category: OB GYN
Expert:  Dr Ted Manos replied 11 months ago.

Hello, I'm Dr Manos, obgyn. The location of the fibroid will determine if it could effect the period. The uterus is like a pear and the fibroid could be like a barnacle and be under the surface of the uterus and not deeper in the core such as a pear with seeds in the middle. An ultrasound can clear up that question and show whether the inner lining of the uterus is in synch with the ovaries or even suggest endometriosis. Most views of fibromyalgia are speculative including endometriosis. If the fibroid is in the uterine endometrial cavity it can be removed through the cervix with or without a hysterscope if it sits entirely in the cavity like a grape or larger.

Expert:  Dr Ted Manos replied 11 months ago.

bioidentical hormones are naturally occurring but don't build up any appreciable levels to make a difference as getting through the stomach and then the liver is tricky. Synthetic agents are designed to get through and the histology changes one see on let's say the endometrium are similar to the purely natural stuff. It's all a choice in the end.