I saw the gynaecologist this morning. The summary is I am on a three month waiting list for surgery to fix part of the problem, then we'll see how I go before taking further steps. I'll go into more detail now, mainly for my own records while I still remember, so if you find women's issues TMI don't read on!
We decided a hysterectomy was a bit drastic while there were other options available, even though it would solve both problems at once. Instead we are starting with fibroid removal with newish MyoSure technology, like a tiny vaccum cleaner on a stick that goes in through the cervix, under general anaesthetic in day surgery. I have one small intramural (inside the tissues) fibroid tucked away that isn't causing any problems, which won't be touched, and a larger submucosal one sticking into my uterus (looks a bit like a grape but it has lots of blood vessels) which they will remove. It has tripled in size lately and probably causing most of the heavy bleeding and pain.
The second problem is my adenomyosis, I though I had one or the other but apparently I have both. Adenomyosis is where the uterus lining grows where it shouldn't, into the muscle wall. My muscle there is all riddled with pockets of this lining stuff. It's quite common (so are fibroids) but in my case it is probably causing some of the pain/bleeding etc. It's a bit hard to tell which issue is causing what problem! In a nine month period between ultrasounds my uterus has enlarged from 84 x 50 x 30 mm to 106 x 82 x 45 mm. The gyno can't do anything about the adenomyosis (except hysterectomy) until the fibroid is removed because the treatment is insertion of a "Mirena" hormone delivery system which releases hormones directly into the uterus. She can't put one in with the fibroid taking up all the space. So I have to wait.
The gyno came up with a third possible issue which had not been considered. The pattern of my pelvic pain does not quite match either of these diagnoses and she is sending me for a bone scan of my pelvis to see if I have an infection there. She did not say so, but this might be supported by the unexplained raised lymphocytes (white blood cells) in my last three blood tests. I have booked that in for Monday, it looks like it takes a few hours altogether, they give you an injection then do the actual scan a couple of hours later. I'll have to remember to take a book.
One funny/not funny thing today... My foot was hurting really badly today and the long drive made it worse so I was limping badly, you might say hobbling. It probably looked like my gynaecologist had been a bit rough with me!