Uterine Fibroids the Diagnosis and Treatment
Uterine fibroids are benign tumors found in the womb or uterus. They are composed of dense fibrous tissue and can cause a variety of symptoms including excessive menstrual bleeding, pain, abdominal swelling and infertility. Fortunately, there is a wide range of effective treatments for fibroids.
The medical term for uterine fibroids is leiomyoma. A rare cancer of the uterus is called a leiomyosarcoma, but having fibroids does not lead to this tumor or increase the risk of it. However, fibroids can have serious impact on a woman’s health.
No one knows for sure what causes fibroids but there are risk factors that make them more common, obesity being one of them. They are also more common in women in their 30’s and 40’s although they often shrink after menopause. African American women are more likely to have fibroids and so are women with a family history of the condition. While the causes of fibroids are not known, the risk can be decreased by avoiding obesity and the consumption of a healthy diet rich in vegetables.
From 20% to 80% of women will develop fibroids in a lifetime. It is known that diet can have an influence on the development of fibroids with the consumption of lots of vegetables and fruits being protective while large quantities of red meat seem to encourage fibroid growth.
Some fibroids cause no symptoms at all, even when sizeable. Common symptoms of fibroids are heavy menstrual periods, heaviness in the lower abdomen and pelvis, urinary symptoms and painful sexual intercourse. Fibroids can complicate pregnancy and greatly increase the chances of requiring a cesarean delivery.
Fibroids are classified by where in the uterine wall they occur. Submucosal fibroids grow into the uterine cavity while intramural fibroids are contained inside the muscle wall and subserosal fibroids grow on the outside of the womb. Pedunculated fibroids grow on a thin stalk and look something like a mushroom.
There are many different means of treating fibroids when they require treatment at all. Asymptomatic fibroids only require watching for problems and are common. When symptoms cause a great deal of pain or anemia from heavy bleeding, there are surgical and nonsurgical options. Size and location of the fibroids may dictate the types of therapy available.
For women who do not wish to preserve childbearing, hysterectomy or removal of the uterus is a direct solution. It is also often possible to remove just the troublesome fibroids by a procedure called myomectomy. Conception may be possible after that option. Another option is uterine lining ablation which is done with a variety of techniques. After ablation, conception is not possible.
Medical control of fibroids may be as simple as the use of NSAIDs or acetaminophen for discomfort or may use hormones and anti-hormonal drugs to control symptoms. Low dose birth control pills may work for some women while others require hormone suppressing drugs such as Lupron or mifespristone. The problem with these drugs is that the fibroids may grow again when the medication stops.
Women with fibroids may not even know they are present or may have significant symptoms, but modern treatments make this diagnosis one that should not be terrifying. Diagnosis can usually be made by imaging with X-ray, ultrasound or MRI but occasionally is done by inserting a special scope into the uterus through the vagina (hysteroscopy) or through the abdominal wall (laparoscopy.) Biopsies can be taken to confirm the diagnosis in this way.
Frequently Asked Questions
Can someone who had Endometrial ablation please share her experience?
My doctor recommended this procedure because I have a uterine fibroid!!
And..with this procedure I will not need any extra form of birth control method?
I had an ablation about 7 years ago due to extremely heavy periods. The procedure was simple and short. I was in recovery for about 30 minutes and was up and moving that evening. The procedure worked; no more heavy periods. I realize you are contemplating the surgery for a different reason, but I definitely recommend it.
Ablation or Hysterectomy????
I am 25, and I suffer from heavy bleeding, and severe pain in my left side. I recently was diagnosed with a uterine fibroid and an enlarged uterus. The doctor told me I could have an ablation, which there is an 85% chance it would work, or I could have a hysterectomy which would offer me a 100% result. I am needing advice on both of the surgeries. I have 3 kids, so I am done with that part. I just need advice as to the best choice to make. The doctor did tell me that if I had the ablation I would still need the hysterectomy eventually. Thanks!!!
Did the doc mention a myomectomy (removal of the fibroid itself)? Or why that wasn’t possible in your particular case? Any suggestion of drug therapy to shrink or ? Ablation’s a bit of a nonstandard therapy for fibroids.
In general, I’d be hesitant to go for a hysterectomy at such a young age. It tends to produce premature menopause (even if you keep the ovaries) and up your risks of cardiovascular disease and osteoporosis. While the increased risks can certainly be worth it, I incline to the conservative approach in situations like this. Then, too, the EA has a shorter recovery time than even a laparoscopic or vaginal hysterectomy.
Not knowing your case history I’d call up your doctor and ask to chat about your options and why they would suggest a given line of treatment. And maybe seek a second opinion, too.
Has any one had an Endometrial Ablation Procedure Done at Kaiser Permanente? Please share your experience!!?
I will get one done because of a uterine fibroid..I want to know your experience on side effects…
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