Question

I am 35 years old and have been trying to get pregnant for three years. Four months ago I was diagnosed with a uterine fibroid. Up until three months ago, I was having regular periods approximately every 28-30 days - 7 days length.

I have had numerous tests run including the dye through my fallopian tubes and catheter in my uterus. All tests conclude that the fibroid is not blocking - as it sits on the outside not the inside.

I am hypothyroid taking Levoxyl. My doctor increased my dosage about four months ago but just this week determined it was too high and altered it slightly. My problem is that in the last three months I have my period almost every day. In the last 33 days I have bled for 27 of them. Is this a result of the fibroid or the change in the dose for my thyroid? Can it be fixed? What would make me bleed so heavily and for such a long period of time? This has never happened before - I have always been regular.

Advice 1

The bleeding is most likely related to the imbalance of thyroid replacement therapy. Once this is cleared up, you'll probably resume your normal cycles. The real problem is that you've not gotten pregnant after three years of trying. That's about two years too long to wait. You need to see a fertility specialist. Don't waste any more time, at 35 your time is running short.

Advice 2

Abnormal bleeding can be caused by a very wide range of problems, fibroids and thyroid abnormalities just being two of them. If the fibroid itself is altering the general shape of the uterine cavity (the inside) of the uterus, it can indeed cause problems not only with bleeding, but with fertility as well. The normal processes that make the menses (period) a cyclic process can be altered by the chemicals made inside of the fibroid. Abnormal thyroid levels, whether they are high or low, can cause a disruption of the normal hormonal support of the lining of the uterus. When this lining is altered in this way, it can fall off irregularly, which you see as vaginal spotting. I am also concerned about your age. At this age, there are concerns about the quality of eggs that you have remaining.

If you have any doubts about any of these considerations, I would strongly recommend seeing a Reproductive Endocrinologist. This is the OB/GYN who has done an additional fellowship of three years of training specifically in the treatment of hormonal problems and infertility.

Advice 3

A small fibroid tumor on the outer surface will not usually affect conception. The tubal study and hysterosalpingogram indicate the reproductive tract is intact and patent. Therefore, if you are ovulating and if your husband¡¯s semen count is normal, you should be able to conceive. The recent change in menstrual bleeding suggests ovulatory skipping which results in hormonal imbalance. This can easily be ascertained by your Gynecologist with simple blood tests or occasionally by biopsying the uterine lining in the office. It is common in the thirties and usually temporary. Your thyroid status needs to be regulated, but is probably not the reason for the abnormal bleeding. Once your thyroid state is normalized, you should be on your way. Good luck.