I am 42 years old and for the past three years have been having very
heavy periods with clotting.  I have numerous fibroid tumors.  A year
ago I had the large tumors removed in hopes that it would stop the
heavy bleeding.  The tumors have reappeared and the procedure did not
make any difference at all.  My ob-gyn now suggest that I have a
hysterectomy, leaving in my ovaries.  I am looking for other options.

Hello,

I have found some interesting information on ObGyn.net, a web site
which claims to be “designed by Obstetricians and Gynecologists... …
and continuously monitored by an advisory board of qualified
physicians.”  There is a whole section on fibroids at:
http://www.obgyn.net/ah/articles/fibroids/fibroids.htm
It says that “The trend is moving away from treating fibroids with
hysterectomies, but fibroids remain the number one reason for
performing hysterectomies in the U.S.”  and “Unfortunately, because
there have been so many advances in a short period of time, not every
doctor is knowledgeable about or qualified to perform the latest, less
invasive alternatives to the hysterectomy. You really have to do your
homework and learn what your options are. Remember, fibroids are not
cancerous and you don’t have to rush into anything.”  This page has
links to other features including a quiz, “Questions For My Doctor”
and a summary of treatment options.

Going into the treatment options section at
http://www.obgyn.net/displayarticle.asp?page=/ah/articles/fibroids/page_5
I found the following list of therapies in addition to removal of
fibroids and hysterectomy: (a) synthetic hormones to decrease the size
of the uterus and the fibroid; (b) endometrial ablation, which is said
to be helpful for excessive bleeding. This involves destroying the
inner lining of the uterus.  It is not as drastic as hysterectomy, but
it does make it impossible to have a baby afterwards.  (c) uterine
artery embolization – this is also used to treat heavy bleeding due to
fibroids. It works by blocking the supply of blood to the fibroids
causing them to shrink and die.

In its Expert Interview section, the site publishes an interview with
Francis L. Hutchins, M.D., who has pioneered the use of uterine artery
embolization to treat women with severe bleeding due to fibroids.  He
is Clinical Associate Professor of Obstetrics and Gynecology at
Allegheny University of the Health Sciences and Thomas Jefferson
University, and he has a web site at http://www.fibroidcorner.com/ 
His view is “Most women with fibroids do not need to have a
hysterectomy. And I believe that we are going to see the numbers of
hysterectomies performed to treat fibroid symptoms decline, as more
doctors and women become aware of other effective, less-invasive
treatment options. A hysterectomy to treat fibroids should be reserved
for the woman who says, I’ve been burned. I’ve tried everything and I
don’t want to ever have to think about my fibroids again.”

An article on uterine artery embolization is available at Health Scout
http://www.healthscout.com/template.asp?page=newsdetail&ap=1&id=506645
 It gives details about the success rates of this procedure as
reported at the annual meeting of the Society of Cardiovascular and
Interventional Radiology in Baltimore in April 2002.

The FDA web site also has information on alternatives to hysterectomy
at http://www.fda.gov/fdac/features/2001/601_tech.html and an
illustrated description of the embolization technique at
http://www.fda.gov/fdac/features/2001/chrtfibroid.html

Another page on alternative treatments,
http://www.scvir.org/fibroid/treatments.htm on the web site of the
Society for Interventional Radiology states: “Studies show that 78 to
94 percent of women who have the [embolization] procedure experience
significant or total relief of heavy bleeding, pain and other
symptoms. The procedure also is effective for multiple fibroids.
Recurrence of treated fibroids is very rare. In one study in which
patients were followed for six years, no fibroid that had been
embolized regrew.”

The ObGyn site urges women to examine all options fully, seeking
second and third opinions if necessary.  It does admit that in some
cases hysterectomy will be the only option, but only after all other
possibilities have been tried.
Please note that I am not a medical practitioner, and cannot provide
you with definitive medical advice.  I hope that some of the links I
have provided will enable you to explore your therapeutic options in
order to be able to discuss them more fully with the people you
entrust with your treatment.