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Dr. Bob
Dr. Bob, Medical Doctor
Category: Medical
Satisfied Customers: 5430
Experience:  20 Years in Internal Medicine, Neurology and Sports Medicine
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I am waiting for a fibroid embolisation procedure in

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Hi there, I am waiting for a fibroid embolisation procedure in November 2017.
JA: What are all the symptoms you're experiencing (e.g. loss of appetite, fever, rash)?
Customer: I had an MRI scan very recently to diagnose the fibroid, size and current state. This single fibroid has caused my endometrial canal to become displaced, what does this mean? and also there are secretions around my cervix, which may be residue from the fibroid or a broad based small polyp. The consultant talked about voids. I understand some of the language but not all. I have never had issues with my cervix before, obviously i am concerned but have been reassured, all is non malignant, but the consultant wishes to explore whether it is a polyp or secretions. The fibroid is 12 cm and intramural, diagnosed in 2016.
JA: Are you keeping a personal medical record while dealing with this?
Customer: yes I make notes in diary.
JA: Anything else in your medical history you think the doctor should know?
Customer: No, nothing of any significance. I do take 5 x 5 mg of Northeristone to relieve or stop bleeding/periods, while I am waiting for procedure. I do get pressure symptoms, painful wind and occasional spotting, which scares me, as i now have a severe blood phobia, which makes me pass out. Last year, I had a very heavy bleed with clots, went to A&E, as never experienced this before and they discovered the fibroid. Have had scans, biopsies etc and thankfully, all clear

Hello. The endometrial canal is the passageway down the center of the uterus. When fertilization occurs, this is where the egg implants to begin its growth. When fertilization does not occur, this is where the mentsrual blood comes from as the lining of the canal is shed. Does this make sense? It is common for fibroids, particularly larger ones, to press on one side of this canal and deform or displace it to one side. This is usually a completely benign situation.

Customer: replied 1 month ago.
It does make sense., however, my other questions are what are broad based polyps and why might it be secretions from the fibroid. How does this get checked? The radiologist also spoke about signal voids, what is this?
Although I am on Northeristone, am I still at risk of serious bleeding while awaiting treatment. I find this very scary and had to have counselling after my bleed last year. It was in fact a very heavy period. Sometimes I am overwhelmed by it all and will take a panic attack. I carry on, but fear does get in the way.

"Signal voids" is a technical term referring to flow through blood vessels. This means there is good circulation to the area. Endometrial polyps are overgrowths of the lining of the uterus. They are common in women between 20 to 40 years of age. They are fingerlike growths that attach to the wall and can be as small as a sesame seed or larger than a golf ball. There may be just one or many present. While the cause is not known, they tend to grow when there is more of the hormone estrogen in the body. Most endometrial polyps are not cancerous. Very few turn out to be cancerous or precancerous. The chance of cancer is higher if you are postmenopausal, on Tamoxifen, or have heavy or irregular periods.

When we speak of a polyp being "broad based" this means the attachment to the wall is longer, rather than a polyp which has a thin stalk (e.g "peduculated polyp"). Polyps can sometimes result in a slight watery or bloody discharge, as can fibroids if they irritate the lining of the endometrium.

Customer: replied 1 month ago.
the polyp or secretions from the fibroid' are near the cervix, not the womb, from my understanding. Also what can cause them if they are indeed polyps and not secretions. I never had this last year? How does the consultant check?
What is the risk of serious bleeding while on Northeristone, as this really worries me, as i have had to wait so long 1.5 years. i have had to really argue my case to get this procedure in november.
Customer: replied 1 month ago.
Hi there.
Please view my last set of questions as i do not think you have answered them. Thank you.

The uterus and cervix are connected. The opening of the uterus (the endometrial canal) runs through and opens at the cervix, so you cannot separate them. The cervix is essentially the lower portion of the womb. While the cause of polyps is not known it is believed to be related to hormone levels, so the norethisterone may be responsible. Your specialist may be able to visualize them with a special scope that goes into the vagina and cervix, called a hysteroscope.

Does this make sense? Do you have any follow up questions or concerns?

Customer: replied 1 month ago.
My final question is to do with bleeding while on the medication, namely Northeristone. I can have pink spotting and slight bleed, but as above i get so anxious this will go into a serious bleed prior to my diagnosis in 2016.
Does the womb lining still grow while taking this medication?
I have been advised I must stop taking the above prior to my procedure and that this bleed could be very heavy, which i am dreading. This is my final concern. Thank you.

Menstrual spotting and breakthrough bleeding are common side effects of using hormones such as norethisterone. Heavy bleeding is not common. In fact, this is what they are often used to treat. Effects on the womb lining (endometrium) show considerable variability among individuals, but there can be increased density of the microvasculature (small blood vessels) and increased fragility of such vessels. Over time there may be atrophy of the lining. Either way, withdrawal bleeding should not be heavy, and can be managed by your gynecologist if needed.

Hello. How are you feeling today? Do you have any follow up questions for me?

Let me know if you do and I would be happy to help further.

If you have no more questions, a positive rating would be much appreciated.

Thank you,

Doctor-Bob

Customer: replied 1 month ago.
Hi There,
I have one final question.
I take between 4 to 5 mg of Northeristone tablets daily.
I have got used to them, however, I have put weight on and my shape has changed from slim to plump. I feel heavier.
I also get sore colic within hours of taking them, which can be really frustrating and often painful, especially in the evening.
I usually go to the toilet as it is like a build up of wind then this relieves it and the wind, bloated feeling is gone. this has only happened since I have taken these tablets. Sparkling water and Milk of Magnesia also helps. I have no problems using the loo but it can trigger cramps where I have this fibroid and that can hurt, like pressure pains.
Do these tablets cause this and make you put on weight?
I have a healthy diet and drink water and lacto free products as creams and cheeses (dairy) add to this problem?
Thank you
Customer: replied 1 month ago.
Please could you answer my final question, as above? thank you.

Yes, of course. Many of the side effects you are experiencing are known side effects of this medication. It is a hormone, so it can have widespread influences on multiple organ systems. It also may promote fluid retention and weight gain. You should talk to your gynecologist about this, as there are other preparations that can be tried that might be more tolerable to you. Your diet may be a factor but is not likely to be responsible for these symptoms.

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