Uterine Fibroids - What are they and how are they treated?

Diagnosis and Symptoms of Uterine Fibroids

Fibroids are benign (not cancerous) growths of the muscular layer of the uterus. They are very common in women of reproductive age. They can be as small as a marble or may grow to be very large, similar to the size of a softball. Often, women will have multiple fibroids.

Small fibroids may not cause symptoms. The most common symptoms women have from fibroids are heavy or prolonged periods. If you are passing clots with your periods, you should see your OBGYN doctor as this may be due to fibroids. They can also cause symptoms of pressure on your bladder and GI tract. In other cases, fibroids can make it more difficult to become pregnant. This is especially true of fibroids close to the lining of your uterus, which is where an embryo implants. Sometimes fibroids are the cause of recurrent pregnancy loss. Large fibroids can cause other complications in pregnancy, which you can discuss with your OBGYN doctor.

There are multiple risk factors for fibroids. These can include African American race, early age at time of your first period, obesity, and a family history of fibroids. Protective factors include multiple pregnancies and some forms of birth control.

Fibroids are best diagnosed on ultrasound. Occasionally, they can be incidentally diagnosed if you are getting a CT scan or MRI scan for other reasons.

Fibroid Treatment

There are multiple treatments for fibroids. The biggest factor when deciding on a treatment option for fibroids, is if you want to have more children. If you plan to have more children, symptoms can be treated with short term hormonal treatments like an intrauterine device (IUD) or regular birth control pills. If you are having difficulty becoming pregnant due to your fibroids, you may also wish to undergo a surgery to remove just the fibroid, called a myomectomy or hysteroscopy.

If you are finished having children, there are many options to manage fibroids. You can also try hormonal treatments like an IUD or regular birth control pills. If you are having isolated symptoms from heavy bleeding, you can use a medication called tranexamic acid which helps with bleeding during your period. There are other newer medications that your doctor can offer, if the above treatments do not work well for you. 

Surgical Management of Fibroids

There are various surgical options to manage fibroids. If your only symptoms are heavy periods, you may be able to undergo an in-office procedure called an endometrial ablation. The definitive management for heavy periods from fibroids is a hysterectomy. With a hysterectomy, the recovery time is longer. Our goal at Nurture Women’s Health is to use the least invasive surgical route possible. These include a total laparoscopic hysterectomy or total vaginal hysterectomy.

Another option to decrease the size of fibroids is a uterine artery embolization. This is a minimally invasive procedure which is performed by an interventional radiologist doctor. This is typically a same day surgery. Sometimes uterine artery embolization is used in preparation for a hysterectomy, to decrease the size of fibroids, prior to surgery.

If you have any of the above symptoms, please schedule a visit with one of our OBGYN physicians at Nurture Women’s Health.