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Doctors' Answers to "Frequently Asked Questions" - Uterine Problems


These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An indi vidual patient is always advised to consult their own physician.

[posted 06/13/2000]
Question: About 7 years ago my doctor told me I had an "erosion" of the cervix (he explained that my cervix wall was soft) and asked if I was experiencing pain during sex and pap pears but I wasn't. A couple of months ago (three years after the break up of my marriage and my last smear) I went for a routine smear and it was very painful. This new doctor told me it was not an eroded cervix but cervical polyps. They have all been vague (confusing) in their explanations and treatments although the original doctor suggested I have that part of my cervix frozen after the birth of my first child. Two children later and no treatment they are now suggesting another follow up smear. I am scared because of the pain. What are they looking for and what are the remedies. My periods have changed considerably - much more painful and heavy (although of shorter duration). Please your help would be most appreciated.

Answer: Several things can cause cervical erosions. The first question is is it infectious? If so, what is the cause of the infection? A biopsy may be necessary(looking for Human Papilloma Virus) may be necessary. If it is not infectious, then other causes should be looked for(Bechets syndrome etc.) Are these ob/gyns? Because they are confusing you about a fairly straightforward problem.

[posted 04/16/2000]
Question: I am a yr old female with a septate uterus. It was discovered about 5 yrs ago when I had an AB. The DR or technician saw it on the ultrasound and explained it somewhat then. It went in one ear and out the other- I recently heard it can affect my fertility or more likely my ability to carry a child. I think they told me that it usually doesn't cause problems- were they wrong? What are my chances of having children?

Answer: Some women can experience difficulties with pregnancy with a septate uterus depending on the degree and your inherent fertility. A septate uterus makes implantation of the fertilized embryo more difficult(not impossible). Also, occasionally as the fetus enlarges the uterus may not tolerate it anatomically. This depends on where the embryo implants and the degree of the uterus. In general, with normal fertility a normal pregnancy is possible. But, there is a higher degree of spontaneous abortion. You need to discuss this with your gyn to understand the degree of the anatomic variation. In severe cases(which doesn't sound like you) it is a minor risk.

[posted 11/29/1999]
Question: MY MOTHER HAS RECENTLY BEEN PUT ON PREMPRO AND ON THE COMERCIAL I SAW ON TV ABOUT IT SAID THAT DRUG WAS NOT TO BE USED BY WOMEN THAT HAVE HAD A HISTERECTIMY(SP?) OR UTERIAN CANCER AND MY MOM HAD HAD BOTH AND I WAS WONDERING IF IT IS SAFE FOR HER TO BE ON THIS PARTICULAR DRUG.

Answer: Women who have had a hysterectomy do not usually get treated with progesterone, only estrogen. This is due to the fact that progesterone is used to minimize the risk of uterine cancer with unopposed estrogen and this is not a problem if the uterus is absent. As to the cancer risk, there are currently studies ongoing to see if estrogen replacement is safe in the setting of uterine cancer. Most would say that it is safe if the cancer is in the early stages, but not if there is any indication of spread out of the uterus. But, this is not clearly known. Consequently, it would depend on her other risk factors as to the estrogen. That is, family cardiac risk, osteoporosis risk etc. weighted against the risk of the uterine cancer.

[posted 11/24/1999]
Question: My doctor prescribed glucophage 500mg to reduce the size of fibroid tumors of the uterous. I am told this is a faily new method, do you have more information on this topic? What are some of the side effect possible from taking this drug? I also have thyroid disease, can the combination of these two conditions combined contribute to weight gain?

Answer: This has been used recently by ob/gyn, I haven't had any experience with this usage. Probably of little risk to try and should be no interaction at all with your thyroid.

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