Uterine Fibroids

“My periods are so much heavier and frequent now. My cramping is unbearable, the back pain is getting worse and now I am having pain with intercourse! I have been diagnosed with uterine fibroids.”

Uterine fibroids are benign (not cancer) growths in the uterus. They are the most common type of growth found in a woman’s pelvis. In some women, fibroids remain small and do not cause symptoms or problems. However, in some women fibroids can cause problems because of their size, number, and location.

For those women who experience minor symptoms, have small fibroids, or occur in a woman who is nearing menopause fibroids often do not require treatment. Certain signs and symptoms may signal the need for treatment:

  • Heavy or painful menstrual cycles
  • Bleeding between periods
  • Rapid increase in growth of the fibroid
  • Pelvic pain
  • Chronic constipation and or rectal pain
  • Difficulty urinating or frequent urination

Available treatments for Uterine fibroids

Oral Contraceptives are often used to decrease menstrual flow and associated cramping is often seen among women with uterine fibroids. However, these medications do not shrink the fibroids.

Progesterone releasing IUD (Mirena, Lileta) can also help with painful and excessive vaginal bleeding caused by uterine fibroids.

Gonadotropin-releasing hormone (GnRH) agonist (Leupron) is a medication that shuts off the menstrual cycle and shrinks uterine fibroids. Since shrinkage is not permanent, the use of this medication is to correct anemia prior to surgery and or to reduce the risk of hemorrhage during surgery. After a woman stops taking GnRH agonist, her fibroids usually return to their previous size.

Uterine artery embolization is another alternative to surgery.
An interventional radiologist uses x-ray technology to target the blood vessels of the uterus. These tiny particles can be injected into these vessels and block blood flow to the fibroids. Thus, causing shrinkage, and improvement in menstrual bleeding.

Myomectomy is a surgical procedure for the removal of fibroids for those women wishing to preserve their uterus for childbearing. Depending on size, shape, number, and location of the fibroids this can be accomplished either by laparoscopy, laparotomy (a small incision similar to a c-section scar) or hysteroscopy.

Hysterectomy is the removal of the uterus. This procedure can be performed vaginally, laparoscopically, or abdominally depending on the size, shape, number, and location of the uterine fibroids. This option is for women no longer bearing children who want to definitively resolve fibroid problems by removing the entire uterus.

Treatment for uterine fibroids and their symptoms is an individual decision. My recommendation is to work with your healthcare provider to determine the best treatment for you.