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Update: A 41-year-old woman with menorrhagia, anemia, and fibroids: review of treatment of uterine fibroids.

Update: A 41-Year-Old Woman With Menorrhagia, Anemia, and Fibroids Review of Treatment of Uterine Fibroids IN A CLINICAL CROSSROADS ARTICLE PUBLISHED IN JANUary 2009, Bradley Van Voorhis, MD, discussed the epidemiology, management, and treatment of uterine fibroids. The patient, Ms P, was a 41-year-old woman with recurrent uterine fibroids, menorrhagia, anemia, and fatigue since age 30 years. Because of intractable symptoms, at age 35 years she underwent a myomectomy. Two years later, Ms P’s fatigue returned, as did her heavy periods. Repeat ultrasound at that time showed multiple large fibroids, which continued to grow during the subsequent 2 years. Given her persistent symptoms, Ms P wished to consider treatment but expressed an interest in options that would allow her to retain her uterus. Dr Van Voorhis recommended that Ms P’s thyroidstimulating hormone be measured. He also suggested an evaluation of her endometrial cavity by either saline infusion sonography or hysteroscopy to determine if she might have an intracavitary fibroid or polyp that would be easy to remove. He acknowledged that Ms P’s fertility was waning, not only because of her age but also because her previous surgery might have scarred her fallopian tubes. He offered that if Ms P decided that she wanted to retain her uterus she should consider a repeat myomectomy. If not, he recommended definitive therapy with a hysterectomy.