Post UAE 4/18/00 / D&C 2/20/01

February 23, 2001

Hi group!

I been reading many letters regarding Post UAE from this group and I do

appreciate all the input regarding the problems that can arise after UAEs...I

too share in the bloating, spasms in my legs, sleepless nights, and I

especially love nights when the covers are on, than off, also hate that

feeling of sweat in the back of the neck!!

YUK!! ( because I am 51 years old I am hoping all this may be the beginning

of menopause)!

I will give an update regarding my D & C and hysteroscopy (2/20/01). I believe

I came through better than I thought ... the good news is there were no

cancerous polyps ..but the bad news was that a part of the fibroid broke off

and was in my uterus causing the prolonged spotting. Also, from what my

husband understood,

there was not as much shrinkage regarding the fibroids as was hoped for. (one

fibroid was the size of a 16 week pregnancy).

I do feel much better since the UAE, but I must add I had no idea that there

could be so many problems afterwards... I am glad that I choose the UAE over

the hysterectomy mostly because I am still enjoying life and I still have all

my parts intact!!

My doctor of 30 years gave me HIS only choice which was quote " live with the

growing fibroid or get a hysterectomy. "

I will see my GYN on March 7, and SHE will be able to explain to me what my

next steps will be.

I am taking medication for thyroid (Synthroid is a hormone drug)...I am

wondering if there could be a connection with the growth and development of

fibroids and being on this pill. (just a long shot thought!!) Also, for

those who are taking Soy and have a thyroid condition...you should not be

taking this product because it neutralizes the medication (read in Prevention

Magazine).

Will keep in touch...keep sharing your thoughts and info!

Janet

February 23, 2001

In a message dated 01-02-23 21:29:26 EST, you write:

<< I am taking medication for thyroid (Synthroid is a hormone drug)...I am

wondering if there could be a connection with the growth and development of

fibroids and being on this pill. (just a long shot thought!!) Also, for

those who are taking Soy and have a thyroid condition...you should not be

taking this product because it neutralizes the medication (read in

Prevention

Magazine).

>>

Wow! That's interesting to know about the soy and Synthroid.

I doubt the connection between Synthroid and the growth and development of

fibroids, though. Right at the same time that I was diagnosed with my 18-week

size fibroids, I was diagnosed with hypothyroidism. It was only then that I

was put on Synthroid.

February 23, 2001

Janet - i have a very similar situation to yours i believe...i had a UAE on

4/6/00 with a rather large uterus and little shrinkage at my 3 month post

sonogram...i'm very close to your age and was thrown into a full menopause as

a side effect of UAE which made me very happy in the hopes of additional

shrinkage and the relief of no more anemia...i recently have been experincing

spotting as well and have been feeling lots of my original bladder pressure

symptoms...i'm interested in hearing more details about the part of the

fibroid that broke off in your uterus???...i'm due for another trans vaginal

sonogram on 3/1/01 to see what's going on after almost a year post procedure

at which point i thought i would be feeling better...did you have a D & C due

to bleeding problems? thanks in advance for more details on your case and

recent findings on broken off fibroid...were they able to remove this piece??

hope you are feeling better....Joan in new york

February 23, 2001

Is it common to be " thrown into menapause " after UAE? I am only 43 so that

scares me!

<JoansieP@... wrote: >

> Janet - i have a very similar situation to yours i believe...i had a UAE

on

> 4/6/00 with a rather large uterus and little shrinkage at my 3 month post

> sonogram...i'm very close to your age and was thrown into a full menopause

as

> a side effect of UAE which made me very happy in the hopes of additional

> shrinkage and the relief of no more anemia...i recently have been

experincing

> spotting as well and have been feeling lots of my original bladder

pressure

> symptoms...i'm interested in hearing more details about the part of the

> fibroid that broke off in your uterus???...i'm due for another trans

vaginal

> sonogram on 3/1/01 to see what's going on after almost a year post

procedure

> at which point i thought i would be feeling better...did you have a D & C

due

> to bleeding problems? thanks in advance for more details on your case and

> recent findings on broken off fibroid...were they able to remove this

piece??

> hope you are feeling better....Joan in new york

>

February 23, 2001

Diane - i was perimenopausal at the time and was 51 years old so that little

push over the edge was welcomed...i was told about this before UAE but did

come home from hospital with a period and then had one more period after

weeks of what i called " drainage " and that was the total end of periods for

me...had the fsh test and i was indeed in full menopause...only now almost a

year later am i spotting and somewhat concerned especially after reading

about Janet's broken off piece of fibroid, i've never heard of that one

before so i'm having another sonogram...i was not, on the other hand, told

about the " secondary blood vessels feeding into the uterus " until i had

absolutely no shrinkage in one of my large fibroids...good luck...Joan

February 24, 2001

wrote:

" Is it common to be " thrown into menopause " after UAE? I am only 43 so that

scares me! "

I can't remember the statistics. It isn't common in younger women, but not

unknown. More common over 45 years, thought to be mostly women who were already

perimenopausal. UAE can cause cessation of periods through damage to ovaries

and/or through lessening overall blood supply to the uterus. Older ovaries are

more susceptible to damage.

Dr Kirsh wrote of women who ceased having periods but didn't experience

menopausal symptoms. He wrote last Sept., in response to a question about post

UAE ovarian failure: " In my patient population, I am aware of only 2 patients

out of >500 who have ceased to have periods since UAE and are under 45. As a

matter of fact, neither of these women is showing other evidence of ovarian

dysfunction,only of uterine cessation. " Not every menopausal woman experiences

symptoms such as hot flushes, but were the women cited above hormonally

menopausal or did they just stop having periods the way women do after ablation?

More research has to be done to find out what is happening and whether anything

can be done to lessen the chances of being " thrown into " menopause prematurely

by UAE.

=====PS ===== Statistics and website quotations:

" About 1 percent to 2 percent of women go into premature menopause following the

procedure, said Goodwin, chief of cardiovascular radiology at University

of California, Los Angeles Medical Center and the first doctor to do fibroid

embolization in the United States. " Source: Gilbert; New York Times

Service

" There were no cases of procedure-induced menopause " in an Oxford, England

clinical trial of 50 patients, ages not cited.

" Ovarian failure is a complication of uterine artery embolisation as it is of

hysterectomy with conservation of the ovaries. In our series [of over 270

patients] however this has not been a serious problem. Only one of our patients

under 45 years developed permanent ovarian failure. Three other patients

developed transient amenorrhoea but reverted to a normal hormone profile within

nine months of the procedure. " report from Dr , Royal Surrey Hospital,

England.

" 2 patients had menopause precipitated by the procedure (ages 54 and 55). A

third patient in her mid-forties developed temporary amenorrhea that resolved

after three months. " Dr Spies, town U, reviewing Royal Surrey 1998

results of series of 109 patients.

" The effect on ovarian function has been a question, given the sporadic reports

of amenorrhea after treatment. It is not known whether ovarian infarction

occasionally occurs to affect function or whether merely decreasing uterine flow

is sufficient to affect ovarian function. Further, it is not clear whether

ovarian function is affected in only a few patients or whether it is more common

and just not apparent clinically. " from the Literature Review by Dr Spies cited

above

" Another unresolved question is the effect, if any, of this procedure on the

menstrual cycle. The overwhelming majority of women who have had embolization of

fibroids have had decreased bleeding with normal menstrual cycles. There have

been a few women (most of whom are near the age when menopause would be

expected) who have lost their menstrual periods after uterine embolization. It

is uncertain whether these cases are a result of decreased ovarian function from

the procedure. This question will require further study. Based on this limited

information, it appears that this procedure may result in loss of menstrual

cycles (premature menopause) in a very small number of patients. We are

currently studying the effect of this procedure on ovarian function and hope to

resolve this question in the next year. " Uterine Fibroid Embolization Procedure

articel at town U Medical Centre website. Written more than a year ago. I

understand that the clinical trials at town include hormone testing.

" A few women who have had UAE have had no period since their procedure. None of

these patients have experienced the hot flashes, mood swings, or other symptoms

of ovarian failure which are associated with menopause. Also, all of these womrn

were in their late 40s or early 50s - at the time when menopause would be

expected. "

Fibroid Corner website FAQs

February 24, 2001

Thank you!

> wrote: > " Is it common to be " thrown into menopause " after UAE? I

am only 43 so that

> scares me! "

cailleach responded: > I can't remember the

statistics. It isn't common in younger women, but not unknown. More common

over 45 years, thought to be mostly women who were already perimenopausal.

UAE can cause cessation of periods through damage to ovaries and/or through

lessening overall blood supply to the uterus. Older ovaries are more

susceptible to damage.

>

> Dr Kirsh wrote of women who ceased having periods but didn't experience

menopausal symptoms. He wrote last Sept., in response to a question about

post UAE ovarian failure: " In my patient population, I am aware of only 2

patients out of >500 who have ceased to have periods since UAE and are

under 45. As a matter of fact, neither of these women is showing other

evidence of ovarian dysfunction,only of uterine cessation. " Not every

menopausal woman experiences symptoms such as hot flushes, but were the

women cited above hormonally menopausal or did they just stop having periods

the way women do after ablation?

>

> More research has to be done to find out what is happening and whether

anything can be done to lessen the chances of being " thrown into " menopause

prematurely by UAE.

>

> =====PS ===== Statistics and website quotations:

>

> " About 1 percent to 2 percent of women go into premature menopause

following the procedure, said Goodwin, chief of cardiovascular

radiology at University of California, Los Angeles Medical Center and the

first doctor to do fibroid embolization in the United States. " Source:

Gilbert; New York Times Service

>

> " There were no cases of procedure-induced menopause " in an Oxford, England

clinical trial of 50 patients, ages not cited.

>

> " Ovarian failure is a complication of uterine artery embolisation as it is

of hysterectomy with conservation of the ovaries. In our series [of over 270

patients] however this has not been a serious problem. Only one of our

patients under 45 years developed permanent ovarian failure. Three other

patients developed transient amenorrhoea but reverted to a normal hormone

profile within nine months of the procedure. " report from Dr , Royal

Surrey Hospital, England.

>

> " 2 patients had menopause precipitated by the procedure (ages 54 and 55).

A third patient in her mid-forties developed temporary amenorrhea that

resolved after three months. " Dr Spies, town U, reviewing Royal

Surrey 1998 results of series of 109 patients.

>

> " The effect on ovarian function has been a question, given the sporadic

reports of amenorrhea after treatment. It is not known whether ovarian

infarction occasionally occurs to affect function or whether merely

decreasing uterine flow is sufficient to affect ovarian function. Further,

it is not clear whether ovarian function is affected in only a few patients

or whether it is more common and just not apparent clinically. " from the

Literature Review by Dr Spies cited above

>

> " Another unresolved question is the effect, if any, of this procedure on

the menstrual cycle. The overwhelming majority of women who have had

embolization of fibroids have had decreased bleeding with normal menstrual

cycles. There have been a few women (most of whom are near the age when

menopause would be expected) who have lost their menstrual periods after

uterine embolization. It is uncertain whether these cases are a result of

decreased ovarian function from the procedure. This question will require

further study. Based on this limited information, it appears that this

procedure may result in loss of menstrual cycles (premature menopause) in a

very small number of patients. We are currently studying the effect of this

procedure on ovarian function and hope to resolve this question in the next

year. " Uterine Fibroid Embolization Procedure articel at town U

Medical Centre website. Written more than a year ago. I understand that the

clinical trials at town include hormone testing.

>

> " A few women who have had UAE have had no period since their procedure.

None of these patients have experienced the hot flashes, mood swings, or

other symptoms of ovarian failure which are associated with menopause. Also,

all of these womrn were in their late 40s or early 50s - at the time when

menopause would be expected. "

> Fibroid Corner website FAQs

>

February 24, 2001