Fibroids

Fibroids are non-cancerous abnormal growths that develop in the walls of the uterus. They can occur in bunches or alone. Fibroids can range from being very tiny or grow to the size of a cantaloupe. An estimated 70% of all women of reproductive age have uterine fibroids, with most not experiencing symptoms and are never diagnosed.  Sometimes the fibroids become enlarged causing severe abdominal pain or heavy bleeding.  The causes of fibroids are unclear but their development and growth is dependent on hormones. These fibroids are sustained by blood from the uterine artery.

• Heavy Menstrual Bleeding: heavy bleeding during or in between your menstrual cycle requiring new sanitary pads as often as every hour and may include blood clots
• Long Menstrual Period: menstruation lasting longer than seven days
• Anemia: low blood cell count from heavy bleeding causing loss of energy, headaches, dizziness, insomnia, and shortness of breath with activity
• Cramping or Abdominal Pain: discomfort from fibroids pushing against other organs in the abdomen
• Constipation: difficulty having bowel movement due to larger fibroids pressing against bowels
• Incontinence or Frequent Urination: need for frequent urination from pressure on bladder giving a feeling of constant fullness
• Back or Leg Pain: Fibroids pressing on spinal nerves can cause back or leg pain.
• Pain During Sexual Intercourse: Increased pressure on the cervix or uterine walls from Fibroids may cause either a dull or sharp pain during intercourse.
• Bloating or Distended Belly: Fibroids can grow large enough to cause a change in a woman’s shape. It is not unusual for a uterus with fibroids to reach the size of a four or five-month pregnant uterus.
• Reproductive Difficulties: Fibroids that distort the size and shape of the uterus can cause infertility, miscarriages, and premature labor.

Symptoms vary and depend on the location, number, and size of the tumors present.

• Pelvic Exam: Most fibroids are found during routine pelvic exams at your gynecologist office. Your doctor checks the size and shape of the uterus for any irregularities indicating possible fibroids.
• Ultrasound: Commonly used test to confirm fibroids by using sound waves to produce images on a screen.
• MRI: More detailed imaging test that identifies the size and location of the fibroids.

The cause of fibroids are as yet unknown, but several factors can make women more prone to developing fibroids.

• Race: Fibroids are two to five times more prevalent in African American women than any other racial group. In addition, African American women can develop fibroids at a younger age and can grow larger in size and number.
• Age: Average age of symptoms of fibroids to appear is between 35-50. 70 to 80 percent of women have fibroids by the age of 50.
• Weight: The chance of fibroids is higher in women who are heavy for their height.
• Pregnancy: Progesterone and estrogen increase during pregnancy. These are the hormones that stimulate growth of fibroids increasing risk for a woman who has given birth.
• Family History: History of fibroids in your sister, mother, or grandmother may put you at risk to develop fibroids.
• Diet: Consuming beef, red meat, and ham has been associated with the presence of uterine fibroids.

A range of treatment options are available for uterine fibroids. Fibroids themselves are not dangerous, but the symptoms caused by them can limit your daily activity and create other health concerns such as anemia. Many common treatments can relieve these symptoms but the treatments can be invasive increasing risk of complications. Fibrid, the Uterine Fibroid Embolization procedure, is the only minimally invasive treatment that does not require a hospital stay, has a quick recovery, and has been shown to provide complete symptom relief in 85% – 90% of women with symptomatic fibroids. Our doctors have performed hundreds of these procedures and our success rate has been 100%.

• Watch and Wait: We recommend that your first course of action should be to simply watch and wait. If your symptoms are mild and tolerable, there is no reason to begin treatment of the fibroids. Fibroids shrink at menopause, so women who are close to the age of menopause can often simply watch and wait until their symptoms disappear with their menses.
• Medication: If your symptoms are not tolerable, you should treat the symptoms. Over-the-counter medications can help with back pain and menstrual cramping. This may not be sufficient if the fibroids are large or in certain locations.
• Hormone Therapy: A common first line treatment for fibroids is hormone therapy. Hormone therapy provides only temporary relief from symptoms because the fibroids regrow when the hormones are halted. The hormones cannot be used on a long term basis because they lead to a loss of bone density.
• fibrid Uterine Fibroid Embolization (UFE): fibrid UFE is a minimally invasive, non-surgical treatment that blocks blood flow to fibroids causing them to shrink. Symptoms from fibroids are generally caused by the bulk of the fibroids in which shrinking them effectively reduces the symptoms. This procedure is performed by an interventional radiologist in our outpatient facility. Patients are usually able to resume work and normal activities within 7-14 days. Our doctors have performed hundreds of these procedures with 100% patient satisfaction.
• Laparoscopic Uterine Artery Ligation (LUAL): Uterine artery ligation is a new technique that mimics the effect of UFE by doing laparoscopic surgery to tie off the uterine artery, thus depriving the fibroids of their blood supply. This surgical treatment is done in a hospital requiring an overnight stay with 2-4 weeks recovery.
• Endometrial Ablation: Ablation involves the removal of the lining of the uterus (endometrium). The primary goal of ablation is to reduce the heavy bleeding associated with fibroids by destroying the lining of the uterus. For this reason, ablation is not effective for everyone. Ablation is a surgical treatment done in a hospital requiring an overnight stay with 2-4 weeks recovery.
• Myomectomy: Myomectomy is a surgical procedure in which the fibroids themselves are removed. This can be done laparoscopically or through traditional surgery. Studies have shown that fibroids can recur after myomectomy. This is a surgical treatment done in a hospital requiring an overnight stay with 2-4 weeks recovery.
• Hysterectomy: Hysterectomy is a surgical procedure in which the uterus itself is removed. This provides complete relief from fibroid symptoms, but is a major surgery with the attendant risk of complications. Hysterectomy can now be performed laparoscopically, which reduces the chance of complication, but removing the uterus has its own side effects. This should be considered only as a last resort.