Peri + fibroids + fibroadenoma + HRT?

[gofibrogofibrogo]

I'm 46 and have had peri symptoms for about 18 months. None are debhilitating or constant (I have good months and some awful months) but it's getting worse and I've been considering HRT.

I have a large 9cm fibroid which is growing 2cm/year just on its own. I've had multiple opinions from gynae and GP specialists on whether HRT will make it worse/grow more, no one can say for sure.

My local meno clinic suggested I try low dose HRT and that they would scan me again in 6 months to check how much it was feeding the beast, which seemed like a plan.

But then literally a week later I found a lump in my breast which was (thankfully) eventually diagnosed as fibroadenoma, aka another oestrogen-hungry growth. The breast doc said they thought HRT would definitely make the fibroadenoma grow, or trigger more of them to appear and (having waited two very stressful months for my biopsy results) I don't think my anxiety could handle going through that regularly.

My last fibroid appt re possible surgery was cancelled with two days notice last summer and I'm still waiting for a new one. The bigger it gets, the more invasive the surgery becomes.

I suspect my peri symptoms are caused by low progesterone, which might explain why the fibroid and fibroadenoma have grown/appeared, because I've naturally got an excess of oestrogen? So I sometimes wonder if HRT would help balance me out?

I feel like I have a choice between improving some of the peri stuff but ending up with anxiety around multiple breast lumps plus an enormous fibroid that needs big surgery. Or putting up with the peri symptoms to reduce the risk of more fibro lumps appearing. Or hitting it lucky and finding that HRT relieves the peri AND rebalances my hormones and slows the growths!

I know the one-off blood tests are meant to be useless but is there anywhere privately that might test me at key points in my cycle to give me an idea what my levels are and which scenario is most likely before I choose? The NHS breast doc said that might be next step but that she couldn't advise further.

Thanks if you made it this far!

Periodic blood tests will def help I’d have thought. You can have a baseline & some kind of pattern even if imperfect. See a private GP.

I'm considerably older than you but I suffered for years with fibroids and dreadful bleeding which nothing seemed to help. In the end, despite being very scared of hospital procedures, I had an embolization. I should have done it years before. It made a huge difference, far less bleeding, although not ended altogether, but it made life bearable. I still have a small fibroid but am on HRT which I'm happy with. I don't have the fibroadenoma tho'. Has an embolization been suggested to you? It transformed things for me.

I had a 10 cm fibroid that started to bother me quite a bit a few years ago (pressure, problems bending over, not being able to lay on my front). I had the embolisation procedure, which didn’t shrink it at all, but really improved the symptoms. Then I started HRT - which caused the fibroid to grow to 17 cm and brought all the symptoms back, with the addition of non-stop very heavy bleeding. I’ve had to stop HRT and now had a hysterectomy a couple of weeks ago and look forward to getting my quality of life back (which includes re-starting HRT).

Can you be referred to a gynae consultant to discuss the options?

Luckily I don't have any bleeding issues with the fibroid - and it's right on the top of my uterus so doesn't cause too many pressure symptoms yet (hard to tell if the occasional twitchy bladder is peri related or from the fibroid sitting on it) but it is increasingly getting in the way of bending, lying on my front etc and I think it's causing my occasional coccyx pain too. You can't really see if from outside either so it must be squashing something in there somewhere! I can't risk it getting much bigger or it really will start causing more problems.

I first saw a gynae consultant about two years ago (NHS). They said none of the less invasive treatment options like embolisation would help with the size of it, at best they'd reduce it by a third and it would likely grow back. The only way to really reduce it is a myomectomy or hysterectomy which I'm happy to consider but they cancelled my last review due to an 'admin error' last July and I'm still waiting for them to rebook it (despite me complaining to PALS!).

Plus even if I get it taken out, but the breast lumps might still scupper HRT so I'd be going through invasive surgery for no real change.

I'm happy to consider paying to speak to a private gynae consultant, but I'm not sure they'd be able to tell me anything different as every variety of NHS doc (either gynae, breast or HRT) has had such different opinions so far. Unless I have more intel on what's causing the fibroid and fibroadenoma before I even start HRT, which is why I thought blood tests might be next best step?