If you’re experiencing heavy menstrual bleeding or more frequent periods, chances are you have uterine fibroids. These are unwanted growths in or out of the uterus. They are noncancerous growths which don’t cause any symptoms. But sometimes they can cause troublesome symptoms that need to be treated. Luckily, many treatment options are available. Learn about uterine fibroids symptoms and treatment options in this article. Visit Doral Health and Wellness – Women’s Health Center and consult with the best Women’s health specialist in New York.
Understanding Uterine Fibroids: Symptoms
Usually, uterine fibroids don’t cause any symptoms because they are tiny. If they do, it is affected by the location, size, and number of fibroids. It includes:
- Heavy menstrual bleeding or pain during your periods.
- Longer or more frequent periods.
- Pelvic pressure or pain.
- Frequent urination and difficulty urinating.
- Constipation or feeling pressure on your rectum.
- Growing stomach/abdominal area.
- Pain during sex.
- Low back pain.
These symptoms can get better or go away after you have gone through menopause because hormone levels decline within your body.
Diagnosis
Usually, uterine fibroids are often discovered during a routine pelvic exam. Your doctor may feel the irregularity in the uterus shape and may detect the presence of fibroids. To confirm fibroids, the doctor may recommend several tests to determine their size and location. These tests include:
- Ultrasound:
This test uses soundwaves to create a picture of the uterus on the monitor to see the fibroids, their location, and size. In this test, the doctor uses a transducer over the stomach area to see images. It is called transabdominal ultrasound. In case the device is placed inside the vagina is to get images of your uterus, that is called a transvaginal ultrasound.
- Lab tests:
If you have irregular menstrual bleeding, then the doctor may take your blood samples to test it. It might include a complete blood count to check anemia due to ongoing blood loss. Other blood tests might be needed to look for bleeding disorders or thyroid problems.
- Magnetic resonance imaging (MRI):
This test is used to get more detailed images of the fibroids’ location and size by using magnets and radio waves.
- Hysterosonography:
In this test, the doctor uses sterile salt water (saline) to expand the space inside the uterus (the uterine cavity). This makes it easier to get clear images of submucosal fibroids and the lining of the uterus if you’re trying to get pregnant or if you have heavy menstrual bleeding.
- Hysterosalpingography:
In this test, the doctor uses a dye to highlight the uterine cavity and fallopian tubes on X-ray images. It is recommended if infertility is a concern. It also helps to find if your fallopian tubes are open or blocked, and it shows some submucosal fibroids.
- Hysteroscopy:
In this exam, your doctor will use a small telescope that has a camera attached to it, which is called a hysteroscope, inserted through your cervix into your uterus. Then, saline is injected into the uterus, which expands the uterine cavity and lets your doctor check the walls of your uterus and the openings of your fallopian tubes.
- Computed tomography (CT) scan:
A CT scan uses X-ray images to make detailed images of your internal organs from several angles.
Treatment
Uterine fibroids treatment depends on the size, number, and location of the fibroids and what causes your symptoms. If you aren’t experiencing any symptoms, then you may not need any treatment. Then, the doctor chooses a watchful waiting strategy where they just monitor the fibroids and wait for them to shrink after menopause. Small fibroids don’t impact pregnancy nor are they cancerous. So, they are left alone unless you experience moderate symptoms.
If you’re experiencing symptoms from your fibroids such as anemia from excess bleeding, moderate to severe pain, or urinary tract and bowel problems, then you need treatment. Your treatment plan can be a combination of many treatment options, including:
- Medications:
Medications target hormones that control the menstrual cycle to manage the symptoms. They don’t get rid of fibroids but may help shrink them. Medicines include:
- Gonadotropin-releasing hormone (GnRH) agonists: These medications block the body from making the hormones estrogen and progesterone. It creates a temporary menopause-like state, which makes fibroids shrink and anemia get better. It includes leuprolide, goserelin, and triptorelin. Many people experience hot flashes while using this medicine. That’s why it is not prescribed for more than 6 months. Its long-term use can even cause loss of bone density(osteopenia). Sometimes, this medicine is used with low-dose estrogen or progestin as an add-back therapy. This can ease side effects and can be taken for 12 months. This medicine can be prescribed to shrink the size of your fibroids before the planned surgery or help transition you into menopause.
- Gonadotropin-releasing hormone (GnRH) antagonists: These medicines are used to manage heavy menstrual bleeding in people with uterine fibroids who haven’t reached menopause. However, they don’t shrink fibroids. You can take this medicine for up to 2 years. This can also be used along with add-back therapy with fewer side effects such as hot flashes and bone loss. Sometimes, low-dose estrogen or progestin is also involved in these medicines. It includes Elagolix and Relugolix.
- Progestin-releasing intrauterine device (IUD): This can relieve heavy bleeding caused by fibroids. But they don’t shrink fibroids or make them go away. It also helps to prevent pregnancy.
- Tranexamic acid: This non-hormonal medicine can ease heavy menstrual periods. You can take it only on heavy bleeding days.
- Other medicines: Sometimes doctors may recommend other medicines like low-dose birth control pills to manage menstrual bleeding. However, it won’t decrease the fibroid size. Medicines like nonsteroidal anti-inflammatory drugs (NSAIDs) may help relieve pain tied to fibroids but don’t lower bleeding caused by fibroids because they are not hormonal medicines. Examples include ibuprofen and naproxen sodium. Your doctor may suggest taking vitamins and iron if you have heavy menstrual bleeding and anemia.
- Minimally invasive procedures:
These procedures use small cuts. This ensures a faster recovery with fewer complications compared to traditional open surgery. It includes:
- Uterine artery embolization: In this procedure, small particles called embolic agents are injected into the arteries that supply blood to the uterus. These particles cut off blood flow to fibroids, making them shrink and die. While it helps to shrink fibroids, sometimes complications may occur if the blood supply to your ovaries or other organs gets reduced.
- Radiofrequency ablation: In this procedure, heat from radiofrequency energy is used to destroy uterine fibroids and shrink the blood vessels that feed them. To perform this, the doctor makes small cuts in the stomach area (which is called a laparoscopic incision). A small tool with a camera at the tip is placed through the cuts. Using the camera and an ultrasound tool, your doctor finds fibroids and uses a device to send small needles into the fibroid to destroy them. During the next 3 to 12 months, the fibroid continues to shrink, and your symptoms get better. The procedure can also be done through the vagina (it’s called a transvaginal procedure), or through the cervix (called a transcervical procedure).
- Laparoscopic or robotic myomectomy: In this procedure, your surgeon removes the fibroids and leaves the uterus in place. This is used when you have a few fibroids. A slender instrument is placed through small cuts in the abdomen to remove the fibroids from the uterus. Sometimes, a robotic system is used to perform this procedure. Your doctor monitors the stomach area using a small camera attached to one side of the instrument. This gives your surgeon a magnified, 3D views of the uterus which makes the procedure more precise. Larger fibroids can also be removed through smaller cuts by breaking them into pieces with a device that cuts tissue, called morcellation.
- Hysteroscopic myomectomy: It is an option if the fibroids are inside the uterus (also known as submucosal fibroids). To remove the fibroids doctors place tools through the vagina and cervix into the uterus.
- Endometrial ablation: This procedure can lower heavy menstrual flow by inserting a device into the uterus to give off heat/microwave energy/hot water/cold temperature/electric current. This destroys the tissue inside the uterus lining. However, you can’t get pregnant after endometrial ablation. So, you may need to take birth control to prevent a fertilized egg from forming in a fallopian tube, called an ectopic pregnancy. Without birth control, the fertilization can cause life-threatening bleeding.
If you don’t remove the uterus, there’s always a risk that new fibroids could grow and cause symptoms. Traditional surgeries are not often recommended now due to the risk of complications and longer recovery times.
Uterine fibroids are a very common condition that affects many women during their lives. Most of the time, they are tiny and don’t cause any symptoms at all. Other times, depending on their size and location, it can cause challenging symptoms. Fortunately, many treatments for uterine fibroid are available. So, if you notice their symptoms, talk with your healthcare provider to discuss what combination of treatments is best for you to treat your fibroids symptoms.
Need help with uterine fibroids, visit our gynecology clinic in Brooklyn to get professional medical help. Call us to book your appointment now!!!! Log on to www.doralhw.org or visit us at 1797 Pitkin Avenue, Brooklyn, NY 11212 to book an appointment. At Doral Health and Wellness – Women’s Health Center, we have the best GYN doctor in Brooklyn, and we provide women with quality health care services. You can also visit our website at https://doralhw.org/department/gynecology/
