Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Non-surgical techniques are usually hormonal in nature and include the use of drugs that turn off the production of estrogen from the ovaries (GnRH analogs). These medications are given for three to six months and induce a hypoestrogenic (low estrogen) state. When successful, they can shrink the fibroids by as much as 50%. Side effects of these drugs are similar to the symptoms of the perimenopause and can include hot flashes,
sleep disturbance, vaginal dryness, and mood changes. Bone loss leading to osteoporosis after long-term (12+ months) use is the most serious complication. These drugs may also be used as preoperative treatment prior to undergoing surgical treatment of leiomyoma.
Mifepristone (RU-486) is an antiprogestin drug that can shrink fibroids to an
extent comparable to treatment with the GnRH analogs. This drug, sometimes known
as the "morning-after pill" is also used to terminate early pregnancy. Treatment
with mifepristone also reduced the bleeding associated with fibroids, but this
treatment can be associated with adverse side effects such as overgrowth
(hyperplasia) of the endometrium (uterine lining). Mifepristone is not approved
by the US Food and Drug Administration (FDA) for the treatment of uterine
leiomyomas, and the required dosages (different from those used for termination
of early pregnancy) have not been determined.
Danazol (Danocrine) is an androgenic steroid hormone that has been used to reduce
bleeding in women with fibroids, since this drug causes
menstruation to cease.
However, danazol does not appear to shrink the size of fibroids. Danazol is also associated with significant side effects, including weight gain, muscle cramps, decreased breast size, acne, hirsutism (inappropriate hair growth), oily skin, mood changes, depression, decreased high density lipoprotein (HDL or
'good cholesterol') levels, and increased liver enzyme levels.
The administration of raloxifene
(Evista) (a drug used to prevent
and treat osteoporosis in postmenopausal women) has been shown to decrease the
size of fibroids in postmenopausal women, but results with this therapy in premenopausal
women have been conflicting.
Low dose formulations of oral contraceptives are also sometimes given to
treat the abnormal bleeding associated with fibroids, but these do not shrink
the fibroids themselves. Use of oral contraceptive pills has been associated
with a decreased risk of developing fibroids, so some women may benefit from
their use for this purpose.
Uterine Fibroids (Benign Tumors Of The Uterus) - Describe Your ExperienceQuestion: Please describe your experience with uterine fibroids (benign tumors of the uterus).
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Anemia is the condition of having less than the normal number of red blood cells or less than the normal quantity of hemoglobin in the blood. The oxygen-carrying capacity of the blood is, therefore, decreased.
An ectopic pregnancy is a pregnancy located outside the inner lining of the uterus. The majority of ectopic pregnancies occur in the Fallopian tube. Symptoms include abdominal pain, amenorrhea, and vaginal bleeding. Treatment options include observation, medication, or surgery.
Though uterine cancer's cause is unknown, there are many factors that will put a woman at risk, including: over age 50, endometrial hyperplasia, using hormone replacement therapy, obesity, using tamoxifen, being Caucasian, having colorectal cancer. Symptoms of cancer of the uterus (endometrial cancer) include abnormal vaginal bleeding, painful urination, painful intercourse, and pelvic pain. Treatment depends on staging and may include radiation therapy or hormone therapy.
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the “change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.
Normal vaginal bleeding (menorrhea) occurs through the process of menstruation. Abnormal vaginal bleeding in women who are ovulating regularly most commonly involves excessive, frequent, irregular, or decreased bleeding. Causes of abnormal may arise from a variety of conditions.
A miscarriage is any pregnancy that ends spontaneously before the fetus can survive. Miscarriage usually occurs before the 13th week of pregnancy. The cause of a miscarriage cannot always be determined. The most common causes of a miscarriage in the first trimester are collagen vascular disease (lupus), hormonal problems, diabetes, chromosomal abnormalities, and congenital abnormalities of the uterus.
Benign uterine growths are tissue enlargements of the female womb (uterus). Three types of benign uterine growths are uterine fibroids, adenomyosis, and uterine polyps. Symptoms include: abdominal pressure, pelvic pain, and pain during intercourse. Diagnosis and treatment of benign uterine growths depends upon the type of growth.
Menstruation (menstrual cycle) is also referred to as a "period." When a woman menstruates, the lining of the uterus is shed. This shedding of the uterine linking is the menstrual blood flow. The average menstrual cycle is 28 days. There can be problems with a woman's period, including heavy bleeding, pain, or skipped periods. Causes of these problems may be amenorrhea (lack fo a period), menstrual cramps (dysmenorrhea), or abnormal vaginal or uterine bleeding. There are a variety of situations in which a girl or woman should see a doctor about her menstrual cycle.
Trying to get conceive, or become pregnant can be challenging, frustrating, and an emotional rollercoaster for some couples. There are things you can do to chart progress, which may ultimately lead to a successful healthy pregnancy, or, when necessary, lead to discussions with a fertility specialist. Being aware of your menstrual cycle, charting your fertility pattern, knowing the reasons for infertility, and treating infertility are key points to discuss with your partner and physician.
Women's health is an important topic area to guide a woman through the stages of her life, as well as knowing the conditions and diseases that may occur. Educating yourself so that the transitions into different phases of life is key to a healthy, happy, and productive life.
Placenta previa is a condition during pregnancy when the placenta lies low in the uterus either partly or completely blocking the uterus. Women with placenta previa generally deliver their baby via cesarean delivery. There are several types of placenta previa: 1) a low-lying placenta, 2) a partial placenta previa, and 3) a total placenta previa, which covers and blocks the cervical opening. Women who are at risk of placenta previa are women who have delivered a previous baby by cesarean section, and are also at risk of placenta accreta, placenta, increta, or placenta precreta.
Surgical menopause happens when a premenopausal woman has her ovaries removed in a surgical procedure called a bilateral oophorectomy. An abrupt menopause follows, with women often experiencing more severe menopausal symptoms than if they were to go through natural menopause. Chemotherapy and pelvic radiation therapy may also cause menopause by damaging the ovaries.
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