Fibroids are often multiple of varying sizes in different locations within the uterus. There are multiple management options for fibroids.
Uterine Artery Embolization is a nonsurgical vascular procedure for treatment of fibroids. This procedure is also effective in many patients with adenomyosis of uterus.
Everything You Need to Know: Uterine Fibroids from Pregnancy to Menopause
Uterine fibroids are benign growths that arise from the muscular layer of the uterus. They are sometimes called leiomyomas or myomas. These fibroids can form inside the cavity of the uterus, within the wall of the uterus, or on the surface of the uterus. In fact, they can be as small as peas or five to six inches in diameter. They can also grow rapidly, grow slowly, or remain the same size for years.
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.
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
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
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 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 is the surgical removal of the uterus. It is the definitive treatment for fibroids. However, it causes infertility.
If you suspect you have fibroids and would prefer a minimally invasive treatment such as uterine artery embolization, reach out to our clinic. Watch our video guide and learn what uterine fibroids are, their causes, and how to manage the condition.
The Supreme Vascular and Interventional Clinic, is your “go-to” facility for various vascular conditions and pain management as well as the premiere clinic in Singapore for uterine fibroid treatments. Our state-of-the-art facilities and dedication to patient satisfaction ensure we help you best with a positive outcome. To learn more about how to deal with the issue, contact us to arrange an appointment on our website with our vascular specialist, Dr. Manish Taneja, or call us at +65 6904 8084.