Unsure if symptoms are from fibroids

[tlee59]

I am 49 with a 4 inch uterine fibroid.  My Dr. keeps trying to talk me into other options besides surgery (birth control pills, an IUD, etc...).  I have had a problem with spotting (anywhere from barely noticeable to seeming like the beginning of my period that just stops after one day) at least once or twice a week for months now.  My periods are irregular, every two to six weeks, and I have what would seem like normal cramping before my period begins several times a month.  Something new that I'm not sure is from the fibroid is a problem with some incontinence (some small leakage, when I have to go I can't put it off for any length of time as was normal) and more vaginal discharge than normal.  Although I did have a yeast infection following a large dose of antibiotics after an unrelated surgery, the yeast infection has been cleared up.  
Could the incontinence be related to the fibroid?  I have told my Dr. I am uncomfortable with any type of HRT, including birth control pills.  What is the best next course of action?

[John Kim, M.D.]

Yes, incontinence could be related if the fibroid is putting pressure on your bladder. Your doctor can check this.
I cannot tell you the best course of action but your options are numerous. You can do uterine artery embolization. You can take a short course of Lupron since you may be close to menopause. You can take Depo-Provera to stop your ovulation and control bleeding. You can get a Mirena IUD placed to control bleeding. You can have myomectomy surgery to just remove the fibroid. You can get a hysterectomy to remove the uterus altogether. There are other options too. You should discuss all this with your gynecologist to determine what is the best for you and for your specific condition.

[tlee59]

Thank you  for your quick response and also for a list of possible options to discuss with my Dr.  It helps to understand and be more prepared.