Uterine fibroids are growths that thrive in the uterus. These growths, however, are benign and not cancerous. In some women, uterine fibroids remain so small that they do not cause any problems or symptoms. In some women though, due to the location, number and size, they cause problems. Some of these uterine fibroids grow inside the uterus; while others grow on the outer surface of the uterus, within its wall or attached to it by a stem-like structure. A Houston Gynecologist can be a valuable resource to help you diagnose and manage the symptoms and complications associated with uterine fibroids.
Uterine fibroids are commonly found in women aged between 30-40 years old. However, fibroids can occur at any given age. To date, it is not clear what causes fibroids. Studies suggest that the two hormones of women, estrogen and progesterone, play a role in the fibroids growth. Throughout the lifespan of a woman, the levels of these two hormones fluctuate. This hormonal fluctuation is evident during menopause. During this time, estrogen is significantly decreased. Studies have shown as well that uterine fibroids shrink during the time when a woman enters menopause.
The following problems may be experienced by a woman with uterine fibroids:
Changes in menstruation: Menstruation becomes heavy, more frequent and longer. During menstruation, as well, the affected woman may experience pain or cramps, vaginal bleeding other than menstruation and anemia due to the blood loss.
Pain: This pain – usually sharp, dull, aching and heavy – can be felt particularly in the lower back and the abdomen. Women can also have pain during sex.
Others: Fibroids also cause difficulty with urination and frequent urination, rectal pain, difficultly in bowel movements, constipation, abdominal cramps, infertility, miscarriages, enlargement of the abdomen and uterus.
These symptoms are also signs of other medical problems. As such, there is a need to consult your Houston Gynecologist once you notice these symptoms. Other fibroids do not exhibit any signs and symptoms. Because of the lack of symptoms, these uterine fibroids are discovered only during a routine pelvic exam and during other medical tests.
Uterine fibroids that are very small, those that do not cause symptoms and those that occur in women who will soon experience menopause do not need treatment. The following symptoms may, however, call for treatment:
- Painful and abnormal vaginal bleeding that already disrupt normal activities and cause anemia
- Bleeding between periods
- Unclear diagnosis of a fibroid versus a cancerous tumor
- Rapid growth of the fibroid
- pelvic pain
Drug therapy is one option of some women with fibroids. Medications may minimize the painful menstruation and heavy bleeding caused by fibroids. Drug therapy may not stop the growth of fibroids though.
This is a surgical procedure that removes the fibroids. This procedure, however, leaves the uterus in place. Because the uterus is still in place, the affected woman may still have children. In some cases, if after the myomectomy procedure, the woman becomes pregnant, the baby may be delivered via cesarean birth. In other cases, the procedure causes internal scarring resulting in infertility. After this procedure, the original fibroids will not grow back. However, new fibroids may grow and this may require another surgery.
The endometrial ablation procedure is used to treat women who have heavy menstrual periods. In addition to treating heavy menstrual flow, this procedure can treat women with small fibroids, specifically those that are less than three centimeters.
Bleeding and infection are some of the risks associated with endometrial ablation. Although this rarely happens, the device used in this procedure may pass through the bowel or uterine wall.
Uterine Artery Embolization
Another option for women with fibroids is the procedure called uterine artery embolization (UAE). This particular treatment blocks the blood vessels to the uterus. By blocking the blood flow, the growth of the fibroid is stopped.
Infection and uterine injury are the known complications of this procedure. Shortly after the procedure, many women will resume their normal menstrual periods. About 40% of the women above 50 years old who have undergone UAE do not have a return of their menstruation. As to the effect of this procedure to future pregnancies, this is not clear. Women who have undergone UAE may also be at greater risk for placenta problems during pregnancy. This procedure is not advisable to women who may still want to have children
This procedure removes the uterus, though the ovaries may not be removed. With this procedure, a woman cannot anymore become pregnant. These situations call for hysterectomy:
- Pain and unusual bleeding persists
- The size of the fibroid is extremely large
- Other procedures and treatment are not possible
Magnetic Resonance Imaging-Guided Ultrasound Surgery
This new procedure utilizes ultrasound. The ultrasound is used to destroy the fibroids. The long-term relief of the innovation or new approach is currently being looked into or studied.
If you have fibroids, you should see your Houston Gynecologist on a regular basis. Some changes can occur that may require treatment and your doctor can help you monitor for any changes.