Definition and Types of Uterine Fibroids

Uterine fibroids are common tumors among women of reproductive age. They develop on the uterine wall and vary significantly from microscopic to huge masses large enough to make someone look pregnant. 

Uterine fibroids are classified based on their location. The three main types include:

• Subserosal fibroids: Develop near serosa (outer layer) of the uterus and grow outwards. Larger subserosal fibroids can cause menorrhagia, while smaller ones may be asymptomatic. 
• Submucosal fibroids: Develop near the mucosa (internal layer) of the uterus. They protrude inward toward the uterine cavity and may cause infertility, menorrhagia, and anemia even when small in size.
• Intramural fibroids: Develop in the muscular wall of the uterus, causing enlargement of the uterus. They may be asymptomatic when smaller and cause severe symptoms such as menorrhagia as they grow larger.

Subserosal and submucosal fibroids also have a variation called pedunculated fibroids. These often grow on a stalk of the uterus, either outside or inside the uterus. Pedunculated subserosal fibroids’ symptoms vary in severity, depending on their size, while pedunculated submucosal fibroids have severe symptoms.  

Menorrhagia

Menorrhagia is a menstrual disorder often characterized by abnormally heavy and longer periods. It can be caused by various factors, including non-cancerous growths such as fibroids, polyps, or adenomyosis. Other common causes of menorrhagia include hormonal imbalance, STI infection, cancer (uterine or cervical), pregnancy complications (ectopic pregnancy or miscarriage), or other medical conditions such as liver, kidney, pelvic inflammatory, or Von Willebrand diseases.

Common symptoms of menorrhagia include: 

• Longer periods lasting more than seven days
• Heavy flow requiring a change of pad or tampon every 1 to 2 hours
• Having to change pad or tampon at night
• Large blood clots (size of a quarter or larger)
• Spotting or bleeding between periods
• Exhaustion and lack of energy
• Intense menstrual cramps

Menorrhagia can affect your quality of life in terms of general health (risk of anemia and mental health), pain, and social and emotional functioning. However, note that symptoms of menorrhagia may also be due to other medical conditions such as cancer or kidney disease; hence it’s crucial to seek medical attention for a proper diagnosis. 

Diagnosing Uterine Fibroid Menorrhagia

Uterine fibroid menorrhagia diagnosis involves clinical assessment and imaging techniques. Common diagnoses include:

• Blood tests
• Pelvic exam
• Ultrasound

After the primary tests, secondary tests may be recommended, such as:

• Hysteroscopy
• Dilation and curettage (D&C)
• Sonohysterogram
• Magnetic resonance imaging (MRI)
• Hysterosonography
• Hysterosalpingography 

Treatment Approaches

Various treatment approaches may be taken (including medical management, interventional procedures, and surgery) depending on the diagnosis. Common treatments include:

• Medicines: (gonadotropin-releasing hormone (GnRH) agonists, GnRH antagonists, progestin-releasing intrauterine device (IUD), tranexamic acid, and low-dose birth control pills.
• Noninvasive procedures: Focused ultrasound surgery.
• Surgery: Radiofrequency ablation, uterine artery embolization, myomectomy, and hysterectomy.

Lifestyle Strategies

Positive lifestyle changes are also essential in the management of uterine fibroid menorrhagia, such as:

• Exercise: Talk to your doctor for a recommendation of uterine fibroid menorrhagia-appropriate exercises such as stretching, running, and jogging.
• Diet: Consume a healthy diet rich in iron and vitamin C, and drink plenty of water. Especially, fruits, vegetables, and herbs are highly recommended.
• Other self-care tips: Watch your blood pressure, learn stress-relieving techniques, get enough rest, and avoid smoking.

Supreme Vascular and Interventional Clinic Provides World-Class Menorrhagia Care in Singapore

If you’re experiencing menorrhagia-related symptoms, seeking medical attention is essential for a proper diagnosis of the underlying issue. Heavy menstrual bleeding may be caused by uterine fibroids or another health condition, hence an accurate diagnosis is always recommended. And with appropriate treatment and lifestyle changes, menorrhagia can be managed, allowing you to lead a quality life. 

In case you’re looking for a specialized menorrhagia clinic in Singapore, we welcome you to visit us at Supreme Vascular and Interventional Clinic. Dr. Manish Taneja is vascular and interventional treatment specialist in Singapore, ready to walk you through your menorrhagia treatment journey. Contact us to arrange your appointment.

Other Vascular Treatments

Peripheral Vascular Malformations

The Supreme Vascular and Interventional Clinic is your “go-to” facility for various vascular conditions and treatments. To arrange an appointment with Dr. Manish Taneja, our vascular specialist, contact us. You can also call us at (+65) 6904 8084 for a consultation.