DEAR DR. DONOHUE: My menstrual periods last two weeks, sometimes longer. I bleed so much that I am anemic and have to take iron pills. My doctor suggests I have my uterus removed because fibroids are causing this. I’m not eager for surgery. I am only 35, and my husband and I would like more children. What are other ways for treating fibroids? — S.M

ANSWER: The uterus’s wall is muscle. Fibroids are noncancerous growths of the uterine muscle that project into the uterine cavity. They can be silent, producing no symptoms. Or they can cause lengthy periods with excessive bleeding, pelvic pain and troubles with adjacent organs like the bladder (due to pressing on those structures), and they might interfere with fertility.

How best to treat fibroids depends on their size, their number, the woman’s age and the woman’s desire to have more children. It’s a joint decision made by the woman and her doctor.

Myomectomy is a procedure in which only the fibroid is removed. The uterus remains intact. Often, this is done with the assistance of a scope. In some places, robotic-assisted laparoscopic techniques are employed.

Uterine artery embolization entails filling the artery that provides the fibroid’s blood supply with small particles that stop the flow of blood in that artery. The fibroid shrivels and is sloughed off.

Ablative procedures, in which the uterine lining and fibroid are removed in a number of ways, are techniques that preserve the uterus. Heat, freezing, electric current and microwaves are some of the methods used.

A new approach is called magnetic resonance-guided focused ultrasound, which targets the fibroid with sound waves. It’s not available in all localities.

I hope this provides you with some ideas you can discuss with your doctor to see which applies best to your wishes.

The booklet on fibroids discusses this all-too-common female problem. To obtain a copy, write: Dr. Donohue — No. 1106, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: How does a person know what his or her ideal body weight should be? I am 26, 5 feet 5 inches tall and weigh 120 pounds. My sister says I’m too fat. I am quite satisfied. — L.B.

ANSWER: Formulas for predicting ideal body weight are, at best, approximations, and at worst, misleading. I can give you one that is commonly used. A woman is allowed 100 pounds for 5 feet of height and then five pounds more for every inch over 5 feet. By this formula, your ideal body weight is 125 pounds. You’re 5 pounds under your ideal weight. Your sister is wrong.

For men, it’s 110 pounds for 5 feet and then 5 pounds for every inch over 5 feet.

Don’t take this rule too seriously.

DEAR DR. DONOHUE: I have a fast heartbeat and have had it for a number of years. I can feel it beating even when I sit. What are the implications of this? — W.M.

ANSWER: The normal resting pulse (heartbeat) ranges from 60 to 100 beats a minute. Most people have a resting heartbeat in the 70s or 80s. Trained athletes have slower heartbeats, often in the 40s. Their hearts pump more blood with each beat, so they need fewer beats.

Have you actually counted your heartbeat (pulse)? Without a number, it is not possible to make any meaningful comments. If you just feel your heart beating in your chest, it might not be of any consequence. Very thin people can be aware that their hearts are contracting. They feel it doing so.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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