Finding Relief from Uterine Fibroids
Uterine fibroids are noncancerous growths in the uterus that are made from the muscle that is naturally found in the uterus.
What are uterine fibroids?
Uterine fibroids are noncancerous growths in the uterus that primarily occur during childbearing years and usually regress in menopause. Uterine fibroids are more common in African American women. They are also called “myoma” or “leiomyoma.” They are made from the muscle that is naturally found in the uterus. They can vary in shape and size, ranging from a seed to a small watermelon, and they can grow quickly or slowly over time. A woman may only have one fibroid or can have several at any given time.
What are symptoms of fibroids?
Many women having fibroids do not display any symptoms. Fibroid symptoms can include:
- longer and/or heavier periods
- increased menstrual cramps
- vaginal bleeding at times other than menstruation
- abdominal and/or lower back pain
- difficulty with or frequent urination
- painful sex
- enlarged abdomen
- other issues
Pregnant patients who have fibroids usually do fine but can have preterm contractions, preterm labor and malpresentation (baby failed to turn downward).
How are fibroids diagnosed?
Uterine fibroids can be detected during a routine pelvic exam. Various tests can provide more information about them. Ultrasound, the most commonly used imaging test, uses sound waves to capture pictures of the uterus and other pelvic organs. Hysteroscopy, sonohysterography, CT scan, MRI and laparoscopy can also help in diagnosing fibroids. A hysteroscopy is a small scope with a camera that is inserted up through the vagina into the uterus to examine a woman’s uterine cavity for presence of fibroid. A sonohysterography uses ultrasound along with fluid that is placed inside the uterus to get a better picture of the uterine lining. CT scan and MRI are advanced imaging techniques often used to diagnose fibroids. Laparoscopy, which involves making a small cut near the belly button and placing a scope in through the cut, is good for visualizing any fibroids on the outside of the uterus.
How are fibroids treated?
Fibroids that are asymptomatic do not require treatment. If you are having symptoms, treatment options include birth control pills, DEPO shots, or a progestin releasing intrauterine device (IUD). An IUD is a small progestin releasing device that is inserted and left in the uterus. For patients who would like to get pregnant in the future, myomectomy is the surgery which only removes the fibroid and leaves the uterus. For women who failed medical management and have completed childbearing, hysterectomy that removes the uterus is also an option. It is important to remember with this procedure that you can no longer have children. Gonadotropin releasing hormone agonists are a class of drugs that temporarily stop periods and can temporarily shrink uterine fibroids. Many times, these drugs are used prior to surgery to reduce blood loss during surgery. Other treatment options include hysteroscopy, uterine artery embolization and magnetic resonance (MRI) guided ultrasound surgery.