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Q. Will I still pass fibroid tissue after six months of UFE?

Answered by
Dr. R Balakrishnan Menon
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Aug 21, 2020 and last reviewed on: Sep 23, 2020

Hi there, Presently, I am a very anxious lady, who has just turned 50 years in perimenopause. I have a severe phobia of menstrual blood loss and dread having heavy loss, in fact most things about periods upset me, where I just wish to avoid them.

Last year, I had UFE for one intramural fibroid, and overall, much improved. Previous to this procedure, I was on Norethisterone long term, due to the fibroid and anxiety of blood loss, while waiting for my UFE. I then had to be very brave, I had to discontinue on advice from the IR, I do so in good faith and the bleed was very light but constant. After, my UFE, I had no periods for 9 weeks and then they started back, and were again light but increased to an acceptable level. Fast forward to three months back, and on day 3 of a period, I had pain around the fibroid area and then bled on and off for around 24 hours. I expelled what I believe to be fibroid pieces, very grey and rubbery, not like anything I had had before and also like white stringy tissue. It then stopped and end of. I tried to speak to my IR, but she refused and so I contacted my GP.

At this appointment, I broke down because my last period was heavier but not overly so, as in the past, but it was unexpected and really scared me. For emotional support, as I really broke down, I have been put back on Northeristone to help me and to lighten any periods. I have taken 1 10 day course and only had 1 heavier flow once and then stopped after 5 days, as oppose to 12. I have now completed my 2nd course, day 5 to 26 and i am waiting, feeling very sick for my period's arrival. I have had a breakdown in confidence since my UFE and a melt down in front of my GP.

I have a lovely family and friends who all care for me and support me, but i take a great deal of convincing. My fear is despite my UFE and on Northeristone for my cycle, I will bleed very badly and die. I am not sure as to all that is entailed in a withdrawal bleed and i am now concerned I have harmed myself and caused my womb lining to be so thick, hence pain and bleeding. I really wind myself up and think about this fear 24/7. It is such a horrid, consuming phobia. During, my last period, I had no pain from the fibroid area but during the month, I still get the odd twinge, like wind, is this normal. I am now 6 months post UFE?

Will I still pass fibroid tissue at this stage and I was told than when you do it is painful and comes with blood? I guess I was not expecting this three months back. I really feel, I have been left to find my own way and in the dark, which is difficult for someone like me. Do fibroids continue to shrink after 6 months? Overall, I am very unsure, very scared to have this bleed and feel like hiding.' Will the UFE have helped and will Northeristone keep things light? Thank you

Dr. R Balakrishnan Menon

Infertility Obstetrics And Gynaecology
#

Hi, How are you doing?

You have having the right treatment for fibroid but I don't think you have been fully explained about the procedure and what to expect. Let me give you few facts.

First of all, you are absolutely healthy and will lead a normal life. You are 49 yrs old & will be entering menopause in a few years ( approx age of menopause of your sisters or mother, if you want to know when). It is this estrogen hormone from ovaries which is making the fibroids grow, once they stop, no periods & fibroids. This sense of negativism you are experiencing is one of the side effects of the waning estrogen hormone levels, which actually gives a sense of well-being.

Norethisterone is progestogen hormone which is released from your body every month in second half of periods. This hormone increases the thickness of uterine lining & stops bleeding. If you rewind back to many years back, you would have had this feeling of bloated, negative feelings just before periods. So this hormone also making you feel bad. After having taken this medication for long & stopping it, the thickened endometrial lining falls out as a fleshy mass ( almost the size & shape of uterus) along with lots of white thick discharge. So I think that symptom is a side effect of the hormone & not fibroid.

UFE, is a process where the blood flow to fibroid are blocked, so without nutrition they tend to shrink. They just shrink like a leaf & stay in the lining of uterus, they don't fall off as you are feeling. Pain may be due to the shrinking of fibroids. I would advise you to have some painkillers for some time SOS & lot of patience and your further life will be surely healthy and blood free!!! No-one has ever died of fibroids or bleeding due to that. All you need is to wait. You are normal. Hope I have clarified your query,do write back if any more queries and for your feedback All the best


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Thank you for replying. I understand the UFE procedure better now and do feel relief at what you have written.
I guess I would rather not have bleeding at all as it scares me so. Hence the Northeristone.
I am waiting for this period to start, as a withdrawal bleed. Is it likely that this period will be heavy. I have taken it as prescribed 5 to 22 days. I am now concerned my bleed will be heavy as you stated it increases the lining and comes out as a fleshy mass. I did not know this and do not think I could cope with that. I believed Northeristone kept the lining thinner and less bleeding, please could you clarify? Though I am so anxious I was hoping this bleed as a withdrawal bleed would be OK? If meds are taken as planned are withdrawal bleeds lighter as I take it they are not a real bleed? Thank you

Dr. R Balakrishnan Menon

Infertility Obstetrics And Gynaecology
# Hi again,
Nice to hear that I could be of some help to you.
Norethisterone is progestogen, the same hormone which is released in second half of periods & also during pregnancy, when the inner lining of uterus thickens. You will have a thick,dark clots like bleeding as withdrawal.
From your history I understand that you want to completely avoid bleeding. But till 50-52 yrs, you will have some bleeding.
If I may advice,
So why don't you ask your doctor to give you Tab.Ormeloxifene 60 mg weekly twice ( Centchromen) - this will fully reduce intrauterine thickness, no side effects. Can have it for any number of years,max i have given is for 5-7 yrs. By then your periods will stop naturally. Another option is Mirena ( LNG -IUS). effective for 5 yrs. Also injection of Injection. Lupreolide 3.75 mg monthly once for 5-6 months. These methods will fully reduce the uterine lining & periods will never trouble you.
Hope this was helpful, do write back if any more queries
All the best

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