DEAR DR. DONOHUE: I am 37, have two children and also have fibroids. My periods are quite heavy. My doctor says that removal of the uterus is the best way to end my problem. My husband and I would like to have more children. What other options do I have? —P.S.
ANSWER: The uterus is a large, hollow muscle with an internal layer that grows every month in preparation for the reception of a fertilized egg. Fibroids are noncancerous growths of the uterine muscle. They’re common, and for most women they cause few, if any, symptoms. Large fibroids can compress the bladder and provoke frequent urination. Or they can press on the colon and bring on constipation. They sometimes reduce the chances of pregnancy. They can be responsible for heavy menstrual bleeding.
Their cause hasn’t been discovered, but female hormones must be involved in their appearance, because they tend to regress with menopause.
If they’re not producing symptoms, they can be ignored. If they are kicking up a fuss, hysterectomy — removal of the uterus — is one solution, but not the only one. Options depend on what the woman wants.
For a woman approaching menopause, the medicine Lupron is a good choice. It suppresses estrogen production, which shrinks fibroids. Since this has a time limit on use, women who will soon be menopausal are the ones who can take advantage of it.
Danazol (a synthetic male hormone), birth-control pills and Depo-Provera control excessive menstrual bleeding due to fibroids.
Sometimes doctors can remove a fibroid with a scope that enters the uterus through the vagina without any external cutting.
Uterine artery embolization is a procedure where the doctor threads a soft tube (a catheter) to the artery feeding the fibroid. When the right position is reached, the doctor releases particles that obstruct the artery and cut off blood supply to the fibroid. It falls off.
MRgFUS, magnetic resonance guided focused ultrasound, is a new technique employing sound waves to heat the fibroid and shrink it. It can interfere with subsequent pregnancies, however.
The booklet on fibroids explains these growths in detail. To order a copy, write: Dr. Donohue — No. 1106W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: Will you please tell me what causes hand-foot-and-mouth disease? What can be done to prevent kids from getting it? — A worried grandmother of four grandchildren
ANSWER: Hand-foot-andmouth disease is a viral illness most often occurring in children younger than 10. The virus’s name is coxsackie virus, from the name of the New York city where it was first found. It causes tiny blisters on the tongue, in the throat and on the palate, gums and lips. The blisters break to form shallow sores. The hands, fingers, feet and groin can also break out. The illness peaks in summer or early fall. It’s usually a mild illness that’s over in one week. There is no prevention for it, and there is no medicine for it.
©2008 North America Synd.