What are Uterine Fibroids? How are they treated?

According to Michelle Seavey, M.D., an OB/GYN on staff at HCGH, the most common symptoms of uterine fibroids are:

  • Seven or more days of menstrual bleeding
  • Heavy menstrual bleeding or clots
  • More frequent menstrual cycles
  • Frequent urination
  • Trouble emptying your bladder
  • Pelvic pressure/pain
  • Constipation

What are Uterine Fibroids?

Uterine fibroids are typically noncancerous growths of the uterus that usually appear during your childbearing years. “They can vary greatly in size—from undetectable to the human eye to masses that enlarge your uterus. You can have just one or many, and they can grow quickly, slowly or stay the same size,” explains Melinda Afzal, D.O., an OB/GYN on staff at HCGH. “They also can enlarge during pregnancy and then shrink after pregnancy as your uterus returns to its normal size.”

What are the Symptoms?

“At least 60 to 70 percent of women will get fibroids at some point, however most women are unaware they have fibroids because they have no symptoms,” states Dr. Afzal. “Typically, fibroids are found incidentally during a routine pelvic exam. If your doctor feels irregularities in your uterus’ shape, he or she may suggest a pelvic ultrasound—the gold standard for diagnosis.”

How are They Treated?

“When most women find out they have fibroids, they are concerned and think the fibroids need to be removed. If you have a small fibroid and are not experiencing any symptoms, we will follow it at your annual visits. If you have a larger fibroid, we may monitor you every six months to see size change,” states Dr. Seavey. “Fibroids are not associated with an increased risk of uterine cancer. However, there are many options for treating uterine fibroids, and treatment recommendations depend on the severity of symptoms and the size and number of fibroids. If you have symptoms, talk with your doctor to determine which option is best for you.”

Medications. An injection that blocks the production of estrogen and progesterone, creating a temporary postmenopausal state that lasts three to six months, can shrink the fibroid’s size. “Hormone therapy, in the form of oral contraceptives, can help control menstrual bleeding but will not reduce fibroid size,” notes Dr. Seavey.

Minimally Invasive Procedures. “Uterine artery embolization uses a small device that is placed in the major blood vessel that supplies the uterus with blood to reduce the blood supply to the fibroid, causing it to shrink,” says Dr. Seavey. “This technique can be used depending on the size and location of the fibroid.”

Hysterectomy (the surgical removal of the uterus). “Depending on fibroid size, a hysterectomy can be performed laparoscopically with three to four small abdominal incisions and typically a one-day recovery in the hospital,” explains Dr. Afzal. “Patients who require an open hysterectomy typically have a three-day hospital stay and another four to six weeks for recovery after the procedure.” While a hysterectomy is not an option for those still wanting to bear children, it remains the only proven permanent solution for fibroids.

 

Howard County General Hospital is hosting a discussion called, “Understanding Fibroids” on Thursday, June 19, 7-8:30 p.m. at the HCGH Wellness Center. Presented by Phyllis Campbell, M.D., the presentation will include the symptoms, when treatment is appropriate and what treatments are available. For information, click here.

 


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