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Re: Lupron: pro or con?

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I have had hysteroscopic resection twice. The first time I had fibroids

and they were only able to get one out. Three years later I went back to

get the 2nd out and this time I did take Lupron 3 months before the

procedure. Fortunately, I had no side effects from the Lupron (except to

stop my constant bleeding, which was a wonderful side-effect). But

unfortunately, I also had no shrinkage of my fibroids. I have a suspicion

that I suffered no hot flashes, etc, because my diet is high in soy foods

(tofu, soybeans, and soy milk). I also suspect this may be why I got no

shrinkage.

I think hysteroscopic resection is a wonderful procedure if you are a

candidate for it. Unfortunately, both times I suffered complications (this

last time, pretty serious). I would do it all over again but wanted to

mention this to you for 2 reasons. One, just as a reminder that any

surgery has its risks and the second because you mentioned that your doctor

was very negative about UAE citing examples of negative cases, (which I'm

not really sure are true to begin with) and also, giving you the impression

that the procedure is very risky. I'll bet the complications from

hysteroscopy which I had are far more common than the risks mentioned below

of UAE. (Specifically, my complications were first fluid overload of

saline, and 2nd perforation of the uterus). I'm not suggesting this

procedure is dangerous, as I said I would do it over again. I'm suggesting

that perhaps he is overstating the risks of UAE and understating the risks

of hysteroscopic removal.

One last point, I would say that the biggest reasons not to have UAE would

be 1) your desire to maintain the possibility of fertility--UAE is a bit of

an unknown here, and 2) for submucosal fibroids, there is some danger that

when the fibroid degenerates from UAE, it can cause infection, so you

really need a supportive GYN to be on top of this possibility.

I am also 37 (although I have no desire to maintain fertility). I opted

for the hysteroscopy because, when all goes well, the recovery is shorter

(days rather than weeks) and it was an outpatient procedure (rather than a

hospital night stay), and the associated pain is minimal (not true for UAE).

There have been so many successful hysteroscopic resections on this board,

I'm sure yours will go great (and you will be in the majority).

Good luck.

Sydney

At 07:03 PM 6/22/01 +0000, you wrote:

>Hi all!

>Thanks so much for all of your input thus far. It has been very

>helpful.

>

>Since I last posted, I saw the doctor again, and got a saline

>ultrasound, which identified the exact position and size of my

>fibroid. The doctor now feels that he can perform a

>hysteroscopy, but because of the large size of the fibroid, he

>would like me to take lupron injections for 3 to 4 months to

>shrink the fibroid first. He recommends this procedure, because

>I'm 37, and not 100% certain that I don't want children. He

>doesn't recommend embolization, because he cites 2 cases

>where the patients died, one where a woman became paralyzed

>in her leg and another where a patient lost control of her bladder.

>In addition, he stated that in some cases, embolization can

>cause early menopause.

>

>I am aware, however, that the fibroid can grow back after a

>hysteroscopy, and in addition, that lupron will induce all the

>symptoms of menopause, including hot flashes, mood swings,

>and possible dryness. Has anyone else taken the same route I

>am considering taking? I would really appreciate any input. My

>e-mail address is: wellred@.... Thanks in advance!

>

>

>

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> I am aware, however, that the fibroid can grow back after a

> hysteroscopy, and in addition, that lupron will induce all the

> symptoms of menopause, including hot flashes, mood swings,

> and possible dryness.

My doctor that performed an abdominal myo warned me about Lupron and

told me that he would never use Lupron to reduce the size of the

fibroid because it makes the surgery more difficult. He said that it

changes the consistency of the fibroid from that of a rubber ball to

that of jelly. When it is of jelly-like consistency it is tougher to

get all of it out and tougher to tell the difference between the

fibroid and the uterine tissue. I don't know if the same

complications are true for hysteroscopy, but it's worth a question to

your doctor.

Good Luck!

Giselle

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> I am aware, however, that the fibroid can grow back after a

> hysteroscopy, and in addition, that lupron will induce all the

> symptoms of menopause, including hot flashes, mood swings,

> and possible dryness.

My doctor that performed an abdominal myo warned me about Lupron and

told me that he would never use Lupron to reduce the size of the

fibroid because it makes the surgery more difficult. He said that it

changes the consistency of the fibroid from that of a rubber ball to

that of jelly. When it is of jelly-like consistency it is tougher to

get all of it out and tougher to tell the difference between the

fibroid and the uterine tissue. I don't know if the same

complications are true for hysteroscopy, but it's worth a question to

your doctor.

Good Luck!

Giselle

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> I am aware, however, that the fibroid can grow back after a

> hysteroscopy, and in addition, that lupron will induce all the

> symptoms of menopause, including hot flashes, mood swings,

> and possible dryness.

My doctor that performed an abdominal myo warned me about Lupron and

told me that he would never use Lupron to reduce the size of the

fibroid because it makes the surgery more difficult. He said that it

changes the consistency of the fibroid from that of a rubber ball to

that of jelly. When it is of jelly-like consistency it is tougher to

get all of it out and tougher to tell the difference between the

fibroid and the uterine tissue. I don't know if the same

complications are true for hysteroscopy, but it's worth a question to

your doctor.

Good Luck!

Giselle

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" wellread " wrote:

>Since I last posted, I saw the doctor again, and got a saline

>ultrasound, which identified the exact position and size of my

>fibroid. The doctor now feels that he can perform a

>hysteroscopy, but because of the large size of the fibroid, he

>would like me to take lupron injections for 3 to 4 months to

>shrink the fibroid first. He recommends this procedure, because

>I'm 37, and not 100% certain that I don't want children. He

>doesn't recommend embolization, because he cites 2 cases

>where the patients died, one where a woman became paralyzed

>in her leg and another where a patient lost control of her bladder.

>In addition, he stated that in some cases, embolization can

>cause early menopause.

All surgeries have risks. I read of a woman who died from hysteroscopy and

another who had a perforated bowel. The deaths after embolisation are a tiny %

out of several thousand UAEs performed worldwide. It appears to be a very safe

procedure, though of course if you decide to have embolisation be sure you go to

an experienced reputable radiologist. Yes, embolisation might affect fertility

and I think about 1% of women under 45 stop having periods after UAE. The % is

a lot higher for women over 45, but we don't know how may of these women would

have stopped menstruating around the same time anyway if they hadn't had UAE. I

don't know what risk there is of periods not resuming after a few months

treatment with Lupron.

It is generally agreed, however, that if you can safely and effectively be

treated by hysteroscopy that it is the preferable procedure. I had UAE, but my

fibroids are numerous intramural and subserosal. I think in your shoes I would

opt for the short-term effects of Lupron rather than the permanent effects of

UAE and the unknown consequences of low radiation exposure. (perhaps you can

take synarel, which is given in shorter-term doses, so you can stop it sooner if

the side effects are too severe?)

If you experience symptomatic growth of fibroids again some time after

treatment, you could possibly have another hysteroscopic resection or opt for

UAE at that time.

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" wellread " wrote:

>Since I last posted, I saw the doctor again, and got a saline

>ultrasound, which identified the exact position and size of my

>fibroid. The doctor now feels that he can perform a

>hysteroscopy, but because of the large size of the fibroid, he

>would like me to take lupron injections for 3 to 4 months to

>shrink the fibroid first. He recommends this procedure, because

>I'm 37, and not 100% certain that I don't want children. He

>doesn't recommend embolization, because he cites 2 cases

>where the patients died, one where a woman became paralyzed

>in her leg and another where a patient lost control of her bladder.

>In addition, he stated that in some cases, embolization can

>cause early menopause.

All surgeries have risks. I read of a woman who died from hysteroscopy and

another who had a perforated bowel. The deaths after embolisation are a tiny %

out of several thousand UAEs performed worldwide. It appears to be a very safe

procedure, though of course if you decide to have embolisation be sure you go to

an experienced reputable radiologist. Yes, embolisation might affect fertility

and I think about 1% of women under 45 stop having periods after UAE. The % is

a lot higher for women over 45, but we don't know how may of these women would

have stopped menstruating around the same time anyway if they hadn't had UAE. I

don't know what risk there is of periods not resuming after a few months

treatment with Lupron.

It is generally agreed, however, that if you can safely and effectively be

treated by hysteroscopy that it is the preferable procedure. I had UAE, but my

fibroids are numerous intramural and subserosal. I think in your shoes I would

opt for the short-term effects of Lupron rather than the permanent effects of

UAE and the unknown consequences of low radiation exposure. (perhaps you can

take synarel, which is given in shorter-term doses, so you can stop it sooner if

the side effects are too severe?)

If you experience symptomatic growth of fibroids again some time after

treatment, you could possibly have another hysteroscopic resection or opt for

UAE at that time.

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>Has anyone else taken the same route I

> am considering taking?

I did the same thing you are doing. I ended up taking only 2 months of

Lupron as it shrunk it enough to do the surgery without a 3rd shot. The

symptoms we intense at times but worth it as far as the fibroid. Within 6

weeks of the Lupron-related surgery I was back in having it again withouth

Lupron. Neither worked but I would recommend hysteroscopy before going to a

more major surgery.

good luck!

Alison

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>Has anyone else taken the same route I

> am considering taking?

I did the same thing you are doing. I ended up taking only 2 months of

Lupron as it shrunk it enough to do the surgery without a 3rd shot. The

symptoms we intense at times but worth it as far as the fibroid. Within 6

weeks of the Lupron-related surgery I was back in having it again withouth

Lupron. Neither worked but I would recommend hysteroscopy before going to a

more major surgery.

good luck!

Alison

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on 6/22/01 12:03 PM, wellred@... at wellred@... wrote:

The doctor now feels that he can perform a

hysteroscopy, but because of the large size of the fibroid, he

would like me to take lupron injections for 3 to 4 months to

shrink the fibroid first.

I just got done doing some research on Lupon after one doctor suggested that

I take it before I have a UAE. I won't go into what a jerk he was (my

regular doctor wasn't in) and he suggested it without even looking at my

history!

Anyway you should check out this site: http://www.lupronvictims.com

Just a few of the side effects I learned of: bone mineral loss, significant

cholesteral, lipid and liver funtion changes, possible loss of blood flow to

the frontal lobes of the brain and that the insert to the prescription has

265 adverse reactions listed!

Other articles I read stated that the drug actually made the fibroids harder

to find.

I've decided not to take it, but then my other doctor who is running the

clinical study may not wnat me to anyway. I'll find out when I go in on

Monday to sign consent forms and schedule my surgery.

Pam

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on 6/22/01 12:03 PM, wellred@... at wellred@... wrote:

The doctor now feels that he can perform a

hysteroscopy, but because of the large size of the fibroid, he

would like me to take lupron injections for 3 to 4 months to

shrink the fibroid first.

I just got done doing some research on Lupon after one doctor suggested that

I take it before I have a UAE. I won't go into what a jerk he was (my

regular doctor wasn't in) and he suggested it without even looking at my

history!

Anyway you should check out this site: http://www.lupronvictims.com

Just a few of the side effects I learned of: bone mineral loss, significant

cholesteral, lipid and liver funtion changes, possible loss of blood flow to

the frontal lobes of the brain and that the insert to the prescription has

265 adverse reactions listed!

Other articles I read stated that the drug actually made the fibroids harder

to find.

I've decided not to take it, but then my other doctor who is running the

clinical study may not wnat me to anyway. I'll find out when I go in on

Monday to sign consent forms and schedule my surgery.

Pam

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on 6/22/01 12:03 PM, wellred@... at wellred@... wrote:

The doctor now feels that he can perform a

hysteroscopy, but because of the large size of the fibroid, he

would like me to take lupron injections for 3 to 4 months to

shrink the fibroid first.

I just got done doing some research on Lupon after one doctor suggested that

I take it before I have a UAE. I won't go into what a jerk he was (my

regular doctor wasn't in) and he suggested it without even looking at my

history!

Anyway you should check out this site: http://www.lupronvictims.com

Just a few of the side effects I learned of: bone mineral loss, significant

cholesteral, lipid and liver funtion changes, possible loss of blood flow to

the frontal lobes of the brain and that the insert to the prescription has

265 adverse reactions listed!

Other articles I read stated that the drug actually made the fibroids harder

to find.

I've decided not to take it, but then my other doctor who is running the

clinical study may not wnat me to anyway. I'll find out when I go in on

Monday to sign consent forms and schedule my surgery.

Pam

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Hi, just to let you know that I am going to have a myomectomy

performed to remove my huge fibroid. I have to use Lupron for 3

months before the surgery. The surgery does not really scare me that

much but what does scare me is the Lupron. I have check out the

lupronvictim web site and lot of that stuff I read on it scares me to

much, but for me to maintain my fertility I am willing to take that

risk because if I don't I would have to have a hysterectomy performed

instead or even UAE but that procedure is very risky to me since I am

allergic to the x-ray dye they use for that procedure. I have given

it a lot of thought to what I would have decide to have done if I had

my family already.

I with you on the Lupron.

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