What are the treatment options for fibroids?

Question

Hello doctor,

I have been having issues with my periods for five years, where I started experiencing pain in my belly button and sharp pains, especially during periods. As years went by, it got worse, and I had to seek medical attention. My stomach swells with bowel movements, and I experience bloating and constipation. I also have very terrible pains in my belly button, and the gynecologist prescribed Yasmin contraceptive tablets. After some time of taking them, I started to bleed with lots of painful cramps. I went back to the hospital and the gynecologist prescribed Microgynon Fe, which I have been taking until now. Last year I went for a fibroid screening and on my right side the doctors found a fibroid and they said it is 1.1 inches. Now my concern is that since last week, I started bleeding again, and I am having bad cramps that will not stop. I am still taking these Microgynon Fe tablets, but they will not prevent the pain. I am mostly affected on my right side, and it is so painful. I do not know what to do.

Please advise me.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

I am really sorry that you are going through so much pain. Given your history of menstrual issues, fibroids, and now prolonged bleeding with severe cramps, here are some things to consider.

The possible causes of your symptoms are

Fibroid growth or degeneration – Even though your fibroid was 1.1 inches last year, it could have grown or started degenerating, which can cause severe pain, bleeding, and right-sided discomfort.
Hormonal imbalance – Microgynon Fe (Ethinyl estradiol and Levonorgestrel) may not be the best fit for you, as some birth control pills can cause breakthrough bleeding or worsen fibroid symptoms.
Endometriosis or adenomyosis – Given your belly button pain (which can be a symptom of umbilical endometriosis) and severe cramps, endometriosis should be considered.
Ovarian cysts or other gynecological issues – A cyst on your right ovary could be causing pain and irregular bleeding.

What you should do next:

See a gynecologist as soon as possible. Since the pain is severe and persistent despite medication, you may need an updated ultrasound to check your fibroid size and other possible issues like ovarian cysts.
Request blood tests. Doing tests to check hormone levels, iron levels (to check for anemia from bleeding), and inflammatory markers could help understand the root cause.
Consider a different treatment approach. If your fibroid is growing or significantly affecting your quality of life, your doctor might discuss alternative treatments such as changing your birth control method (for example, progesterone-only options, IUDs (intrauterine devices), or other medications like GnRH (gonadotrophin-releasing hormone) agonists).
If the fibroid is problematic, procedures like uterine fibroid embolization (UFE) or even surgery might be discussed.
Regarding pain management, until you see a doctor, consider taking anti-inflammatory medications (like Ibuprofen, if safe for you) and heat therapy to help with cramps.

Would you like help finding a gynecologist or specialist near you? I highly recommend getting checked soon, especially given your worsening symptoms.

I hope this answers the query.

Please let me know if I can assist you further.

Thank you.