Common Questions About Uterine Fibroids

Who Gets Uterine Fibroids?

Anyone with a uterus can develop uterine fibroids. They are common in approximately 1/3 of women in the reproductive group. According to WebMD, an estimated 40% to 60% of women have fibroids by age 35. Up to 80% of women have them by age 50. 

For a comprehensive diagnosis, consider a visit to the Supreme Vascular and Interventional clinic and read about our treatment option for Uterine Fibroids.

Symptoms of Uterine Fibroids 

Small fibroids may cause no symptoms. The most common symptom of fibroids is very heavy menstrual bleeding, accompanied by cramping and pain. Many women who experience this symptom attribute it to perimenopause, but it is not. This is a classical sign of fibroids that women should not ignore.

Other symptoms may include:

• Vaginal bleeding between menstrual periods
• Dull or cramping pain in the abdomen, pelvis, or lower back
• Pain during sex
• Difficulty urinating or frequent urination
• Constipation or difficulty with bowel movements
• Enlarged uterus and abdomen
• Miscarriage

Causes of Uterine Fibroids

Hormones drive the growth of uterine fibroids. However, what causes them to develop in the first place is unclear. They tend to run in families.

Diagnosis of Uterine Fibroids

Women with symptoms must undergo a manual pelvic exam and/or ultrasound, which is usually sufficient to diagnose the condition. If necessary, a doctor may also conduct other specialized tests such as an MRI scan.

Uterine Fibroids vs. Adenomyosis

Adenomyosis is a condition in which endometrial tissue invades the muscle tissue of the uterus. It causes symptoms similar to fibroids, especially very heavy menstrual bleeding. Bleeding is more symptomatic and is harder to control. Traditional treatments used to be Adenomyosis. As a less invasive option, embolization can be offered and as effective is 3/4 patients with that condition.

Uterine Fibroids and Pregnancy

Uterine fibroids usually do not affect the ability to get pregnant. However, fibroids double the risk of having a miscarriage during the first trimester, and this rate goes up for women with large fibroids. Women with fibroids may also experience bleeding and pain during the first trimester. In the second trimester, fibroids may cause pain. In the third trimester, fibroids may cause placental abruption, a life-threatening condition for both the woman and the fetus that usually requires an emergency cesarean section and sometimes an emergency hysterectomy to stop the bleeding. Women with fibroids are also at an increased risk of preterm and cesarean delivery.

Uterine Fibroids and Menopause

Menopause causes uterine fibroids to shrink. Most women experience complete relief from fibroid symptoms after menopause.

Management of Fibroids 

Fibroids do not need treatment unless they are causing symptoms such as excessive blood loss resulting in anemia, painful and heavy menstrual periods, bleeding between periods, pain, and/or miscarriages. Sometimes, doctors suggest removing extremely large fibroids, rapidly growing fibroids, and fibroids with an abnormal appearance because they might be cancerous growths.

Treatment Options for Fibroids

Medication

Currently, no medications can shrink or destroy fibroids. Medications can treat some of the symptoms of fibroids, especially heavy and painful periods. These medications include hormones as well as gonadotropin-releasing agonists.

Uterine Artery Embolization

In uterine artery embolization, tiny particles are injected into the blood vessel feeding the fibroid. The particles block blood flow to the fibroid, causing it to shrink and sometimes detach and become expelled from the body through the vagina. This procedure is minimally invasive and involves threading a catheter to the uterus from a tiny incision made on the inner thigh. In fact, recovery only takes a few hours. Three out of four women also report relief from their fibroid symptoms after this procedure.

Targeted Ablation Procedures

Radiofrequency ablation is a minimally invasive procedure. This starts by inserting a tiny camera threaded through a small incision to locate the fibroids. Then, thin needles are inserted into the fibroids, and radiofrequency energy is used to destroy the fibroids.

MRI-guided ultrasound is a non-invasive procedure where MRI is used to locate the fibroids, and then strong ultrasound energy is sent through the skin and tissues to the fibroids, destroying them. This procedure may require multiple treatments and is considered somewhat experimental.

Myomectomy

Myomectomy involves surgical removal of the fibroids. New fibroids can grow after a myomectomy procedure, and it may need to be repeated periodically. Women who get pregnant after a myomectomy usually need to deliver by cesarian section.

Hysterectomy

Hysterectomy is the surgical removal of the uterus. It is the definitive treatment for fibroids. However, it causes infertility.

When to Consider a Uterine Fibroid Specialist Assessment in Singapore 

Uterine fibroids are common and often manageable, but specialist assessment can help determine whether symptoms require treatment and which options are appropriate.

Consider seeking specialist assessment if you:

• Have been diagnosed with uterine fibroids.
• Experience heavy or prolonged menstrual bleeding.
• Have symptoms of anaemia such as fatigue or dizziness.
• Experience pelvic pressure, pain or abdominal fullness.
• Have frequent urination caused by pressure from fibroids.
• Have fibroids that are increasing in size.
• Want to explore treatment options beyond surgery.
• Are considering uterine artery embolisation (UAE).
• Want a second opinion about fibroid treatment options.

At the Supreme Vascular and Interventional Clinic, uterine fibroid assessment focuses on understanding fibroid size, location and blood supply through appropriate imaging. Your specialist will discuss personalised treatment options, including minimally invasive approaches such as uterine artery embolisation where suitable.

Seek medical assessment promptly if you experience unusually heavy bleeding, severe pelvic pain, dizziness from possible blood loss or symptoms that significantly affect daily activities.