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Suggest Treatment For Mood Swings And Depression

Posted on Mon, 3 Aug 2015

Question: I have to have a resection of fibroid and have been told I am to have zoladex injections first. I am in a weepy state after a break up and am worried about the side effects, particularly the mood swings and depression. How common are these side effects. My pain can generally be controlled by tranexemic acide and ponstan although I do have a large fibroid in my uterus that is about the size of a golf ball. I am 51 and just not sure whether to leave it and not go through the awful side effects I am reading below. Thank you so much for listening

Answered by Dr. Nidhi Setia (36 minutes later)

Brief Answer:
depression is an infrequent side effect.

Detailed Answer:
Hello,

Welcome to HCM,

I can understand your concerns,

First,I suggest that you should not go for fibroid resection as you are 51years old and near to menopause. Menopause will naturally decreases the size of fibroid.

You can take medicine to reduce the size of fibroid like Mefipristone (prescription drug) if your symptoms are tolerable and till you will not get menopause.

If you have heavy bleeding, pressure symptoms,then i should advise you to go for hysterectomy rather than fibroid resection (assuming you have completed your family) .because at this age fibroid resection is not advisable as there are chances of recurrence.

Injection zoladex has side effects like recurrence of depression (infrequent side effect), weight gain but if it is used for more than six months.

Discuss these issues with your Gynecologist.

Hope this helps

Feel free to ask further.

Thanks

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Nidhi Setia (10 minutes later)

also I have heard reports of hair loss and acne with zoladex. Could you please advise how common these side effects are as well? Thank you.

Could I please also ask that as I have now stopped the HRT which was 1mg Climagest, is it likely that the fibroid will shrink a bit anyway. Thank you.

Answered by Dr. Nidhi Setia (19 hours later)

Brief Answer:
acne is a common side effects.

Detailed Answer:
Hi again.
Sorry for the late response.

Acne is fairly common with Zoladex. Hair loss is an infrequent side effect.
Some other common side effects are flushing, hot flashes, diarrhea.

In my opinion, stopping Climagest will not have any significant effect on the size of fibroid because the amount of hormone in the HRT is less than that in natural cycles.

Hope this answers your query satisfactorily.

I wish you well.
Take care.
Thanks.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Nidhi Setia (2 hours later)

Thank you for all of these most helpful responses. I am considering seeking a second opinion from another gynaecologist because last time I saw a specialist nurse rather than a doctor and it was she who prescribed the zoladex. In your medical opinion, would you recommend zoladex to someone in my situation?
Kindest regards
XXXX

Answered by Dr. Nidhi Setia (8 hours later)

Brief Answer:
zoladex would not be the first choice.

Detailed Answer:
Dear XXXXXXX
You are most welcome.

As I mentioned earlier, mifepristone can be used to reduce the size.
I would prefer this over zoladex, considering side effects and cost of treatment.

Anyhow, Gonadotropin-releasing hormone analogue (GnRH-a) therapy (like zoladex) can shrink the fibroid. But Fibroids grow back after GnRH-a therapy is stopped.

If the fibroid is large, drugs can be used shrink the fibroid. This will make the surgical process easier to conduct. The decision of your treating Gynecologist would be final. You can discuss this with your doctor.

Hope this helps.
Take care.
Thanks.

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Above answer was peer-reviewed by : Dr. Prasad