- Top things to know:
- What they are
- What you might notice
- Why they happen
- Why get them checked out?
- How they’re diagnosed
- What you can do about them
- What to track
- Uterine fibroids: A common reason for irregular bleeding and pain
- The Signs and Symptoms of Uterine Fibroids
- Fibroid Zen: 8 Ways to Shrink Them
- Lingerie model’s weight problem was actually a tumor
- Hi all, is it normal to gain a lot of weight after abdominal myomectomy ?
- Can Fibroids Cause Weight Gain?
- Defining A Fibroid
- Main Symptoms Of Fibroids
- Weight Gain And Bloating
- The Weight Gain and Fibroid Cycle
- 1. Your Pelvis Feels Heavy
- 2. Your Periods Are Out Of Control
- 3. You Feel Fatigued
- 4. You’re Crazy Bloated
- 5. You Constantly Have To Pee
- 6. You Actually Can’t Pee—Or Poop
- 7. Your Pelvis, Legs, Or Back Are Killing You
- 8. You’re Feeling Pain During Sex
- 7 Signs You Might Have Uterine Fibroids
- Fibroids Signs and Symptoms
- Shrinking Fibroids with Diet: Is It Possible?
- No “best” treatment
- Hysterectomy, hold the power morcellation
- Treatment options for heavy bleeding
- Treatment options for bulk symptoms
- Which treatment is right for you?
Top things to know:
- Uterine fibroids are abnormal growths of muscle tissue that form in or on the walls of the uterus
- Symptoms include irregular bleeding between periods and pelvic pain
- Estrogen and progesterone play a role in the growth of fibroids
- You might not notice them, but if they become problematic, they are treatable
Like uterine polyps, uterine fibroids are a common cause of changes in bleeding and period pattern.
While polyps are more likely to develop around the time of menopause, fibroids most often develop during the reproductive years. Here’s how to know if you have fibroids.
What they are
Uterine fibroids are abnormal growths of muscle tissue that form in (or on) the walls of the uterus. Fibroids are benign (not harmful/life threatening), but can cause symptoms such as irregular vaginal bleeding and pelvic pain (1,2). Uterine fibroids are sometimes called myomas or leiomyomas in medical literature.
Uterine fibroids are very common. About 3 in 4 women may have them at some point in their lives (3). They are most common during the reproductive years (2,3), and are more likely to occur in people of African ancestry (4). Uterine fibroids most often cause no symptoms at all (5) and often shrink after menopause (6,7). In other cases, untreated fibroids may lead to problems such as heavy bleeding, anemia, pelvic pain or pressure, fertility changes, and complications during pregnancy (1,2,8). Symptoms depend on the size, location, and number of fibroids.
If you think you may have uterine fibroids, tracking your bleeding, pain, and any other symptoms with Clue can provide your healthcare provider with information that may help with diagnosis and in forming a treatment plan. Early treatment can reduce the risk of complications.
What you might notice
Some of the most common symptoms of uterine fibroids are:
- Periods that are heavy, long, and/or painful (1,9)
- Irregular bleeding (9)
- Pelvic pressure or pain (2,10)
- Frequent urination and difficulty emptying the bladder (1)
- Constipation (10)
- Difficulty getting pregnant or carrying to term (2)
In rare cases, uterine fibroids can become very large, twisted, or infected. These situations can create intense symptoms, and may require immediate medical treatment (11,12).
Some studies show that pregnancy may cause fibroids to grow slightly bigger in up to 1 in 3 people (2,13). This might make some symptoms more noticeable. The most common complication of uterine fibroids in pregnancy is pain, usually felt in the second and third trimesters (14,15).
Why they happen
Uterine fibroids occur when muscle cells in the uterus multiply too many times. As cells multiply, lumps of various shapes and sizes are formed. They can be numerous or few—some people might only have one. These lumps can grow on the inner and outer surfaces of the uterus, as well as within the uterine wall.
Research shows the hormones estrogen and progesterone play a role in the growth of uterine fibroids. This is probably why fibroids tend to shrink after menopause, when production of these hormones decreases (6,7).
Some people are more likely than others to develop uterine fibroids, and in fact fibroids may be inherited genetically (16). This means someone is more likely to develop fibroids if a family member has had them. People of African ancestry are significantly more likely to develop them (4). Someone is also more likely to have uterine fibroids if they have hypertension (17,18), or polycystic ovary syndrome (19). They are more common in people who have an earlier age at first menstruation (menarche) (4), and people who have not given birth, though this may be because women with fibroids may have difficulty conceiving (2). Maintaining a diet high in red meat consumption may also increase the risk of uterine fibroids (20), as may beer consumption (21).
Different types of fibroids create different symptoms. Fibroids embedded within the uterine wall (intramural fibroids) can change the shape of the uterus, which may cause changes in fertility (22). Fibroids that project into the inside of the uterus (submucosal fibroids) may also cause difficulty in becoming or staying pregnant (23).
Why get them checked out?
Uterine fibroids are generally harmless and often go away on their own. When symptoms occur, however, untreated fibroids can interfere with a person’s quality of life and may lead to complications such as anemia. Anemia is a condition when the body doesn’t have enough healthy red blood cells to function properly. This can happen when uterine fibroids cause heavy bleeding (7).
Some uterine fibroids may also interfere with the probability of becoming pregnant, and may increase the chance of miscarriage, but more research is needed here (22,23). In these cases, treatment can help people become and stay pregnant.
Rarely, uterine fibroids can become very large, twisted, or infected. These situations can create symptoms that are intense, and may require immediate medical treatment (11,12).
How they’re diagnosed
A healthcare provider will probably ask questions about symptoms, medical, and menstrual history. Some uterine fibroids are diagnosed with a physical exam. Other diagnostic methods may include:
- A pelvic ultrasound (sonogram)
- An MRI
- A sonohysterogram (an ultrasound performed after the uterus is filled with fluid) (24)
What you can do about them
You and your healthcare provider may choose to leave fibroids with mild symptoms untreated. Tracking your symptoms can then help you know if your fibroids are changing, and at what point a treatment plan might be helpful. When fibroids do become problematic, there are many different options for managing and treating them, and for preventing their future formation:
- Medications: In some cases, hormonal medications are prescribed to treat uterine fibroids. These include Selective Progesterone Receptor Modulators (SPRM) which change the effect of progesterone in the body, and Gonadotropin Releasing Hormone (GnRH) Agonists which block the body’s production of both progesterone and estrogen. These medications have been shown to lessen the size and number of uterine fibroids over time in people of reproductive age (25,26).
- Lifestyle Changes: Maintaining a healthy weight may help lessen the occurrence uterine fibroids (16,27). Getting enough exercise and eating a balanced diet may also help with this. Specifically, a diet low in red meat and high in green vegetables may help to lessen the prevalence and severity of fibroids in some people (20).
- Non-surgical procedures: Some symptomatic uterine fibroids may be destroyed through non-invasive procedures like uterine artery embolization and radiofrequency myolysis. These procedures cut off blood supply to fibroids. MRI-guided focused ultrasound surgery (FUS) is an example of a newer technique that uses soundwaves to destroy fibroids (25).
- Surgery: Uterine fibroids are sometimes treated with minimally invasive surgical procedures, via the abdomen or pelvis. Some cases of fibroids may be treated with a procedure called an abdominal myomectomy, in which problematic fibroids are surgically removed (25). In severe cases, a hysterectomy, or a removal of the uterus, may be performed (25).
What to track
Essential to track
- bleeding patterns
Helpful to track
- blood volume
- sex (if trying to get pregnant)
Uterine fibroids: A common reason for irregular bleeding and pain
Like uterine polyps, uterine fibroids are a common cause of changes in bleeding and period pattern. While polyps are more likely to develop around the time of menopause, fibroids most often develop during the reproductive years. Here’s how to know if you have fibroids.
- Uterine fibroids are abnormal growths of muscle tissue that form in or on the walls of the uterus.
- Symptoms include irregular bleeding between periods and pelvic pain.
- Estrogen and progesterone play a role in the growth of fibroids.
- You might not notice them, but if they become problematic, they are treatable.
The Signs and Symptoms of Uterine Fibroids
Toya Wright (who you might know as Lil Wayne’s ex-wife, a TV personality, or author of In My Own Words) walks around every day feeling like she’s five months pregnant. Despite sticking to a healthy diet and busting her butt in the gym, that belly won’t go away-because it’s caused by uterine fibroids. Not only do they give her the feeling of being pregnant, but they also serve up severe bleeding and cramping every month when she gets her period.
And she’s far from alone. A whopping 50 percent of women will have uterine fibroids, says Yvonne Bohn, M.D., ob-gyn at Los Angeles Obstetricians and Gynecologists and Cystex spokesperson. The Office on Women’s Health even estimates that between 20 and 80 percent of women will develop fibroids by age 50. Despite the fact that this issue affects such a huge chunk of the female population, many women don’t know the first thing about fibroids. (And, no, it’s not the same as endometriosis, which stars like Lena Dunham and Julianne Hough have spoken out about.)
“I didn’t know anything about fibroids at the time,” says Wright. “It was so foreign to me. But once I was diagnosed with them, I started talking about it to different friends and family members and reading up about it, and I realized that it was really very common.” (Seriously-even supermodels get them.)
What Are Uterine Fibroids?
Uterine fibroids are growths that develop from the muscle tissue of the uterus, according to the American Congress of Obstetricians and Gynecologists (ACOG). They can grow inside the uterine cavity (where a fetus grows), within the uterine wall, on the outside edge of the uterine wall, or even outside the uterus and attached by a stem-like structure. While they are often called tumors, it’s super important to know that almost all of them are benign (non-cancerous), says Dr. Bohn.
“On very rare occasions they can become cancerous, and that’s called a leiomyosarcoma,” she says. In that case, it’s usually extremely fast growing, and the only way to know if it’s cancerous or not is to get it removed. But, really, it’s super rare; only an estimated one in 1,000 fibroids is cancerous, according to the Office on Women’s Health. And having fibroids does not increase the risk of developing a cancerous fibroid or of getting other forms of cancer in the uterus.
Right now, we don’t know what causes fibroids-although estrogen does make them grow, says Dr. Bohn. For that reason, fibroids can grow a lot during pregnancy and usually stop growing or shrink during menopause. Because they’re so common, it’s weird to consider them a hereditary thing, says Dr. Bohn. But having family members with fibroids does increase your risk, according to the Office on Women’s Health. In fact, if your mother had fibroids, your risk of having them is about three times higher than average. African-American women are also more likely to develop fibroids, as are women who are obese.
Uterine Fibroid Symptoms
Women can have multiple large fibroids and have zero symptoms, or they can have one tiny fibroid and have horrible symptoms-it all depends where the fibroid is, says Dr. Bohn.
The number-one symptom is abnormal and heavy bleeding, she says, which is usually accompanied by severe cramping and passing blood clots. Wright says this was the first sign that something was wrong; she’d never had cramps before in her life, but suddenly she was experiencing sharp pains and extremely heavy cycles: “I was running through pads and tampons-it was really bad,” she says.
If you have a fibroid in the uterine cavity, bleeding can become super intense, because that’s where the uterine lining builds up and sheds during your period each month, says Dr. Bohn. “Even if the fibroid is small, if it’s in that wrong spot, you can hemorrhage to the point of having anemia and requiring blood transfusion,” she says.
Larger fibroids can also cause pain during sex as well as back pain. They can put pressure on the bladder or rectum, resulting in constipation, or frequent or difficult urination, says Dr. Bohn. Many women get frustrated that they can’t lose weight in their stomach-but it’s actually fibroids. It’s not uncommon for large fibroids to create a super-bloated feeling, like Wright experienced.
“I was able to feel them through my skin, and kind of see them and move them around,” she says. “My doctor told me my uterus is the size of a five-months-pregnant woman.” And this is no exaggeration; while rare, Dr. Bohn says that fibroids can grow to the size of a watermelon. (Don’t believe it? Just read the personal story of a woman who had a melon-sized fibroid removed from her uterus.)
Can You Get Rid of Uterine Fibroids?
First things first: If you have fibroids that are small, aren’t causing any life-altering symptoms, or aren’t in any problematic positions, you may not even need treatment, according to ACOG. But, unfortunately, fibroids never go away on their own, and won’t disappear no matter how many urban legend remedies you try or how many pounds of kale you eat, says Dr. Bohn.
Decades ago, the go-to fibroid treatment was a hysterectomy-the removal of your uterus, says Dr. Bohn. Luckily, that’s no longer the case. Many women without super-severe symptoms live with their fibroids, and successfully get pregnant and have kids without any issues, she says. But this all depends on where your fibroids are located and how severe they are. In some cases, fibroids can block a fallopian tube, prevent implantation, or block the path of a natural birth, says Dr. Bohn. It all depends on the individual situation. (Here’s everything you need to know about fertility.)
Today, most women with fibroids go on low-dose birth control pills or get a hormonal IUD-both of which thin the uterine lining, limiting menstrual bleeding and symptoms, says Dr. Bohn. (BC also decreases your risk of ovarian cancer-yay!) There are some drugs that can temporarily shrink fibroids, but because they reduce bone marrow density (basically making your bones weak), they’re only ever used for a short period of time and usually to prep for surgery.
There are three different surgical approaches to dealing with fibroids, says Dr. Bohn. The first is a hysterectomy, or removal of the entire uterus (in women who aren’t having children). The second is a myomectomy, or removal of the fibroid tumors from the uterus, either by opening the abdomen or laparoscopically (where they go through a small incision and break the fibroid into smaller pieces to remove it from the body). The third surgical option is a hysteroscopic myomectomy, where they can remove small fibroids in the uterine cavity by going into the uterus vaginally. Another treatment option is a procedure called embolization, where doctors go through a vessel in the groin and track the blood supply to the fibroid. They kill off the blood supply to the tumor, shrinking it by about one-third, says Dr. Bohn.
The fact that women can get their fibroids removed while keeping their uterus (and preserving their ability to have children) is a huge deal-which is why it’s important for women to know their treatment options.
“A lot of women I talked to have made the mistake of getting fibroids removed with a hysterectomy,” says Wright. “It kind of ruined their lives, because now they’re not able to have kids anymore. That was the only way they thought they could remove them.”
There’s one big downside to removing the fibroids but leaving the uterus in place, though: the fibroids may reappear. “If we do a myomectomy, unfortunately, until the woman gets into menopause, there’s a chance that the fibroids can come back,” says Dr. Bohn.
Your Uterine Fibroid Game Plan
“If you’re having these weird symptoms, the first thing is to let your gynecologist know,” says Dr. Bohn. “Changes in your menstrual cycle, clots in your period, severe cramping, that’s a sign that something isn’t right.” From there, your doc will determine whether the causes is structural (like a fibroid) or hormonal. While docs can feel some fibroids during a standard pelvic exam, you’ll most likely get a pelvic ultrasound-the best imaging tool for looking at the uterus and ovaries, says Dr. Bohn.
While you can’t totally control the growth of fibroids, living a healthy lifestyle can help minimize your risk; red meat might be linked to a higher fibroid risk, while leafy greens might be linked to lower risk, according to a study published in the journal Obsetrics and Gynecology. While there’s still limited research on lifestyle risk factors and uterine fibroids, consuming more fruits and vegetables, exercising regularly, minimizing stress, and being at a healthy weight were all linked to lower incidence of fibroids, according to a review published in the International Journal of Fertility and Sterility.
And if you do get diagnosed with fibroids, don’t freak out.
“The bottom line is that they’re very common,” says Dr. Bohn. “Just because you have one doesn’t mean it’s awful or that you have to be rushed to surgery. Just be aware of the signs and symptoms so you can seek attention if you have any of these abnormal feelings.”
- By Lauren Mazzo @lauren_mazzo
Fibroid Zen: 8 Ways to Shrink Them
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By Devin Namaky MD
TriHealth Advanced Gynecologic Surgery
Your clothes don’t fit like they used to. Your belly may even start to look a little lumpy, not to mention that constant urge to urinate. Getting asked “how far along are you?” might be the last straw.
How do you deal with your fibroids? Because let’s face it. You can’t exactly head down to your local evil villain supply shop and get your hands on a shrink ray and we don’t have a time machine to reverse the growth of fibroids. There are things you just can’t change. There’s always the option of a hysterectomy, but what if you don’t want to have a hysterectomy just yet?
Here are eight ways you may be able to shrink those fibroids, potentially avoiding hysterectomy.
1. Do nothing (Watchful Waiting)
We’re traditionally taught that fibroids shrink around menopause, although that’s not always the case. If your symptoms aren’t making you an anxious mess, or if they aren’t life threatening, this may be a reasonable option.
What about those of you who aren’t approaching menopause? You might be thinking “If I was interested in doing nothing I wouldn’t be reading this article in the first place!” But did you know about seven percent of fibroids seem to shrink on their own?
Now for the reality check: In the same women the overall growth rate was a nine percent increase in size. Even though some fibroids shrink, most women using watchful waiting actually get worse.
You may especially want to consider other options if you are young and nowhere near menopause.
2. Have a baby
There are many factors you consider before having children (e.g. the presence of a stable loving relationship, parenting skills, financial means, etc.)
Then there are the minor details of wanting and managing to get pregnant and making it through nine months of potential misery as fibroids tend to temporarily grow during pregnancy. You also have to consider the challenges of the postpartum period as well as raising a child.
All of that said, pregnancy can improve fibroids. Some will shrink or even disappear postpartum, so if you were already considering having a child, a reasonable option might be to go ahead and have one.
Mifepristone has been shown to reduce the size of fibroids, and decrease fibroid symptoms. It may be hard to get the right dose. For some, having a pharmacy compound Mifepristone is an option.
Ulipristal decreases fibroid size by about 20 percent and controls bleeding. Typically, small doses are used. Unfortunately, in the United States only larger doses are available, which limits its use.
Leuprolide is sometimes used before fibroid surgery, decreasing fibroid size and symptoms.
A drawback is that myomectomy (i.e. fibroid removal) may be more difficult. Its main pre-operative use is to make hysterectomy easier and enable a minimally invasive procedure.
Side effects of leuprolide can be significant. Essentially, you’re put in an induced menopause. Symptoms of menopause are common on this medication, and if taken long-term your bone health can also be affected.
Myolysis is an outpatient laparoscopic approach to destroy (not remove) fibroids. Various technologies can be used to perform myolysis, the most promising of which is radiofrequency (RFA). Recent information on RFA myolysis shows size reductions of up to 45 percent.
There is still a lack of information on myolysis. It isn’t well known how it affects future pregnancies. It hasn’t been compared to many other treatments, and there is little information on how often you might need another surgery. Myolysis is still considered investigational.
7. Uterine artery embolization (UAE)
Uterine artery embolization has been around for more than 10 years. A Cochrane review showed a 30 to 45 percent reduction in fibroid size for UAE, the main benefit being faster recovery than major surgery.
UAE is not without its drawbacks, however, and readmission is sometimes required. Some fibroids are not amenable to treatment with UAE, and UAE may have a detrimental effect on future pregnancies. Many patients will still need an invasive procedure.
8. Focused ultrasound (FUS)
FUS is used to heat fibroids. Only certain sizes and numbers of fibroids are treatable with FUS, and many centers restrict who they are willing to treat. It requires spending quite a bit of time laying in an MRI machine.
Further complicating things, FUS was compared with placebo (i.e. they essentially faked FUS on some patients for comparison) and the results were disappointing. Regarding fibroid symptoms, women who received FUS fared no better than women who received the fake treatment.
FUS is probably not ready for regular use.
What doesn’t shrink fibroids?
Diet, “natural”, and non-prescription therapies don’t shrink fibroids. Some reduce the risk of developing fibroids, but there is no information to suggest diet or herbal therapies shrink fibroids or are effective treatments for fibroids.
Even when you feel desperate, overcome with anxiety, fed up with bloating, pain or bleeding, don’t fall victim to “natural” or “herbal” remedies. They are not regulated for safety and are not tested for efficacy (i.e. they aren’t tested to see if they work). Don’t hurt yourself, or prolong your own suffering with the false sense of hope they provide.
Take care of your body. Stay informed. Ask your doctor.
Tags Women’s Health
Last Updated: March 15, 2018
Lingerie model’s weight problem was actually a tumor
Beware the food baby — it could actually kill you.
As lingerie model Shorntay Allen discovered in September 2014, her bloated belly was actually a fibroid tumor the size of a four-month pregnancy.
“It was a big shock when the doctor talked about the impact the tumor could have and it scared me,” the 31-year-old London native told Mercury News. “When I was told of the tumor, I literally just said ‘OK.’ I didn’t show how I really felt to anyone. When I was on my own I was really upset but I didn’t want to worry my family.”
While Allen originally believed her expanded stomach was the result of filling meals over the course of three months, she soon noticed swelling after lying down at home. After consulting with her doctor, she was given a heavy dose of reality.
Allen believed her bloated belly was the result of a large lunch.Caters News Agency
“I was worried at the fact they were using the word hysterectomy. I was only 29 at the time and I thought I was way too young. I want kids — I was really worried whether I would be OK or not,” Allen said.
Though the hysterectomy procedure came with several risks, including fertility issues and early menopause, Allen underwent an open myomectomy based on the large size and placement of the tumor lining her womb.
“I was generally fit and healthy, and I had never had any kind of surgery before, I wasn’t sure what was ahead and it made me very anxious,” she shared.
Despite the grueling, two-month recovery, Allen is back on her feet.
Caters News Agency
“Recovering was really tough. Tthe pain was horrible — it had felt like I had been stabbed repeatedly in my stomach. I’d never felt anything like it,” Allen said.
As for her dreams of becoming a mother of five, Allen is grateful they’re still within reach.
“If the worst had happened and I couldn’t have had children, saying I would have been devastated is an understatement. I would have been crushed and it would have been the end of a dream,” she said. “I think I would have been seriously depressed. I didn’t know if I would wake up from the operation with my womb gone or not. I just hoped it would still be there.
“It was one of the first things I asked when I woke up. I would have had a full-on breakdown. I’m a massive family person and I treat my nieces and nephews like they’re my own children. My family means the world to me,” she continued. “When I was told the good news, I thought, ‘Thank God.’ I was so happy that I could still be a mother. I was over the moon.”
While raising a family is Allen’s ultimate goal, breaking into the final 10 of the lingerie model competition Curvy Kate is an accomplishment she can check off her list.
“I’m quite self-conscious after my surgery with my scar, and I’ve found it quite difficult being intimate with someone, but I try to act confident,” Allen noted.
Though winning the title would mean something to Allen, her grand prize is being able to inspire others.
“I’m hoping that by . . . sharing my story, it will help and reassure other women who are going through it too,” she said.
Caters News Agency
Hi all, is it normal to gain a lot of weight after abdominal myomectomy ?
I’ve gained a little over 15 pounds since my myomectomy last July, which removed one fibroid the size of a baseball that had punched through one side of the uterus and was growing out of the other side, and a second fibroid on top of the uterus, about the size of a golf ball. I also have endometriosis and my doctor removed ovarian cysts as well.
I’m 37 yrs old and I’ve always been quite healthy and (on average) about 125 lbs. I’m at 140 now, have hyperthyroidism as of last month, high cholesterol, etc. and my body is going crazy. My skin is as dry as it gets in winter 24/7, no matter how much water I drink. My food cravings are different now, they’ve elevated, and my moods are all over the place. My depression and anxiety are through the roof. My hair is thinning on the front part too.
I told my OBGYN about all my new health problems and she said they’re not related in any way to the fibroid surgery, but I don’t believe that. It cannot be coincidence. My endocrine system is out of whack now. I went to my Primary Care doctor and she is the one who said my thyroid was messed up, but I am not going through perimenopause (thank goodness). There’s also a new body odor now that I’ve noticed. It’s not a bad odor like BO, but I smell different if that makes any sense. Almost like a sweet perfume-like smell.
Also, my stomach is SO bloated now, even seven months post-surgery. I basically can only manage to comfortably wear maternity pants and work slacks with thick elastic bands. Jeans are awful.
The only good thing I got out of this was 6 day periods as light as day one. They’re amazing. No longer do I go through an entire box of SuperPlus AND half a box of heavy overnight pads in what used to be 10 days of hell. There’s no more clotting. I rarely even take pain killers when I have cramps. It’s blissful. But I want my body back. Ya know?
Can Fibroids Cause Weight Gain?
Category: fibroids Posted by CareNet Medical Group April 24, 2018
Fibroids affect women mostly during their thirties and forties, and yes, unfortunately fibroids can cause weight gain. One might call it a “double whammy” for women.
Let’s look at what fibroids are, their symptoms, and how they can cause weight gain.
Defining A Fibroid
Women who haven’t experienced any symptoms of a fibroid may not know what they are, so a brief definition may be in order. A fibroid is a benign tumor usually found in the tissue of the uterus. They may be so small that they can only be detected by an examination, and can remain painless. There are also larger ones, but in all cases, they are not cancerous.
Pregnancy and hormone swings during menstrual cycles produce a surge in estrogen, feeding the fibroid and causing it to grow. Women taking postmenopausal hormone replacement therapy, or HRT, along with African American women are also at higher risk to develop fibroids.
Main Symptoms Of Fibroids
If you have not been diagnosed with fibroids, be aware of the following common symptoms.
If you experience frequent pelvic pain, feel the urge to urinate more often, are constipated, or are bothered by backache and leg pain, it’s possibly the result of fibroids. Long menstrual bleeding and pain can be another sign, as well as painful intercourse.
Weight Gain And Bloating
Fibroids cause weight gain and bloating due to a hormonal imbalance or the size of the fibroid. Larger fibroids may cause a woman to gain weight in the abdomen.
Simply put, the more a fibroid grows, the heavier it will become. Consequently, weight gain and discomfort will follow as some fibroids weigh as much as 20-40 pounds. This swelling and bloating can even make a woman look pregnant.
The Weight Gain and Fibroid Cycle
A woman with fibroids may have long menstrual cycles with excessive bleeding. Losing an inordinate amount of blood can trigger anemia, resulting in fatigue from the iron deficiency.
The excess weight, combined with anxiety, discomfort, and fatigue may cause a woman to begin a cycle of:
- Overeating and craving foods with higher calorie content
- Reducing the amount of exercise she normally performs
- This combination can turn into even more pounds without the woman even realizing what is happening.
If you are experiencing unexpected weight gain, maybe it is due to fibroids. Consider whether you have any of the normal symptoms of fibroids, and then evaluate if you have changed what you eat or how much, and if you are being consistent with your exercise routine.
If you discover your weight gain is unexpected and unexplained, maybe it’s time to consult with your OBGYN at CareNet Medical Group.
Request an Appointment
Tags: fibroids menopause weight gain
You’re bloated like never before and your period has been acting CRAZY for the past few months. Probably just PMS gone wild, right? Not so much. Those are both symptoms of uterine fibroids, which you definitely shouldn’t just ignore.
Fibroids are abnormal uterine muscle tissue growths. They can occur inside the uterine cavity, within the uterine wall, on the outside edge of the uterine wall, or even outside of the uterus, and they strike roughly 70 percent of women at some point in their lives, according to Taraneh Shirazian, M.D., a gynecologist at NYU Langone Health specializing in minimally invasive gynecologic surgery.
So why isn’t anyone talking about them? Probably because the majority of women who have them never even know they’re there, says Shirazian. “Uterine fibroids symptoms vary depending on how many you have, where they’re located, and how large they are,” she says. So if they’re small and few enough, chances are, you’ll never feel anything. But in some women, they can be very serious—and if they’re large or painful enough, they may have to be removed via medical or surgical methods.
“Typically, when women come in with fibroids, it’s because they’re experiencing pelvic pressure or abnormal bleeding,” she says. But there are other symptoms of fibroids you can look out for—and if you’re experiencing one or two of the issues below, you should get to your ob-gyn for a full workup ASAP.
1. Your Pelvis Feels Heavy
This is probably the most common symptom of fibroids. “We call this a mass-effect symptom—an effect of having some sort of growth in your body,” says Uchenna Acholonu Jr., M.D., obstetrician-gynecologist at Weill Cornell Medicine and New York-Presbyterian in New York. Women with larger fibroids tend to feel a sensation of something pushing down on the pelvis—because there is something pushing down on the pelvis.
The exact feeling is hard to describe because, unless you’ve had a bun in the oven, you have probably never felt this sort of pressure before. But, when you feel it, you know it, he says.
2. Your Periods Are Out Of Control
There are a lot of things that can cause changes to your menstrual cycle, and fibroids are a super-common culprit. “If you have what we call a submucosal fibroid, a fibroid within the uterine cavity, you’ll bleed much more than typical,” says Shirazian. “That means your period would be longer, heavier, or you might bleed in between periods.”
We’re not talking an extra day or a little spotting here—the bleeding would be significantly greater than or different from your norm.
RELATED: 7 PICTURES OF YOUR CERVIX YOU NEED TO SEE
3. You Feel Fatigued
Some fibroids can actually lead to anemia, a lack of red blood cells, or iron deficiency. The reason comes down to those heavy periods. “Usually with submucosal fibroids, women bleed quite extensively, even to the point of requiring blood or iron transfusions,” says Shirazian.
Symptoms of anemia include fatigue, shortness of breath, lightheadedness, dizziness, or an overactive heartbeat. Your doctor can also perform a simple blood test to diagnose anemia.
4. You’re Crazy Bloated
“Women will come to me and say, ‘people are saying that I look pregnant, but I’m clearly not.’ That’s usually the result of a fibroid,” says Shirazian. For the most part, fibroids just make you look or feel bloated, but they can even grow to a size where they can cause difficulty breathing or kidney failure, says Shirazian.
“If your abdomen is expanding in size, don’t just write it off as weight gain if you’re not gaining weight elsewhere,” she says.
RELATED: ‘MY IBS SYMPTOMS TURNED OUT TO BE OVARIAN CANCER’
5. You Constantly Have To Pee
If you’ve noticed that you’re peeing more frequently, or just feel the urge to pee more frequently, it might be the result of a fibroid. “Because the uterus is located right next to the bladder, a mass growing on the left side of your uterus could very well cause urinary pressure or frequency,” says Shirazian.
6. You Actually Can’t Pee—Or Poop
On the flip side, a fibroid can actually make it harder to use the bathroom, too. “If you’re accommodating urinary frequency and your body gets used to that, after a while, your anatomy changes so much that the urethra, the tube that leads from the bladder out, becomes so kinked or bent you have difficulty urinating,” says Acholonu. “Some people will actually have to lift up on the fibroid or lift up on their uterus to straighten out the urethra enough to allow themselves to void.”
It’s the same effect with constipation—if the fibroid is in the back of the uterus, it going to push on your rectum, which can limit bowel movements, says Shirazian.
Constipation happens to everyone from time to time, but if it doesn’t clear up in a couple of days or you are experiencing difficulty urinating, you need to talk to your doctor about your symptoms.
RELATED: 8 THINGS YOUR POOPING HABITS SAY ABOUT YOU
7. Your Pelvis, Legs, Or Back Are Killing You
Pain is less common with fibroids than it is with, say, endometriosis or other gynecological issues, but you may experience it—although it’s difficult to define. “Pain for some people is just a light ache, for other people it’s a stabbing, hard pain they can’t walk or talk through. And you can have the full range with fibroids,” says Acholonu. “It really depends on location. If you have a fibroid within the uterus, that may cause more central pelvic pain; if you have fibroids that are really pushing against your back bones, you can have lower back pain or pain all the way down your leg.”
8. You’re Feeling Pain During Sex
This isn’t a fibroid symptom that ob-gyns are going to hang their hats on, but it can occur along with other fibroid symptoms. “You could have a fibroid that protrudes or bulges down into the vagina,” says Acholonu, which could cause pain during penetration, “or, because a fibroid is generally attached to the uterus, it could be jostled during intercourse and hit another part of the anatomy, which can result in pain.”
Painful sex can result from several other down-there issues, ranging from cervical cancer to vaginal dryness. Pain is nothing to shrug off, but talk to your gyno before sounding any alarms.
Ashley Mateo Ashley Mateo is a writer, editor, and UESCA-certified running coach who has contributed to Runner’s World, Bicycling, Women’s Health, Health, Shape, Self, and more.
7 Signs You Might Have Uterine Fibroids
Uterine fibroids sound either disgusting or dangerous, depending on your perspective on “things that grow on your uterus without asking”. The good news, however, is that they’re generally viewed as less of a problem than they sound like; a whopping 70 to 80 percent of women will have uterine fibroids before the age of 50, though there are differences in expectation about when they may turn up, based on your age and racial background. But there are certain symptoms that can definitely point to a benign growth making a big fuss on a bit of your reproductive system. How rude.
The key thing to realize here, though, is that many woman actually don’t know they have uterine fibroids because they’re asymptomatic (i.e. none of the following list applies to them at all). Only about a third of all women with fibroids will get an array of these symptoms, and what combination they get is heavily individual. This huge variation is because of the big range of fibroids that can turn up, and their range of locations; the Mayo Clinic lists submucosal (in the inner part of the uterus), subserosal (projecting out of the uterus onto the bladder) and intramural (in the wall of the uterus) fibroids as the most common, but others exist, including a variety of the subserosal variety called pedunculated fibroids, which are fibroids that have developed a “stem”.
Fibroids aren’t as big a problem as they may sound. They can often be easily diagnosed during a routine pelvic exam, or with an ultrasound or X-ray; more complicated ones may require a laparoscopy, a keyhole surgical procedure to check their location on your abdomen. Fibroids are benign and are usually left alone if they’re not causing any symptoms, but treatment for more problematic ones can include pain relief, hormonal medication to shrink them, or even a fascinating non-invasive new surgery called focused ultrasound surgery (FUS) that involves sound waves being directed at your fibroids to destroy them. (How cool is that.)
So while only some women with fibroids will experience symptoms, there are some signs you can watch out for that indicate you might have uterine fibroids — but don’t freak out about it if this all sounds like you. Just head to the doctor for an ultrasound.
1. Your Periods Are A Vampire’s Delight
This is one of the first signs that a fibroid may be developing somewhere, specifically the inside of the uterus. Both fibroids inside the uterus itself and those lodged in its wall can cause seriously heavy bleeding; any obstruction or thickening may be behind heavier periods, plus fibroids in the wall of the uterus may actually change its shape. It seems that the hormones that have a vital role in the menstrual cycle, specifically estrogen, have a role in the production of fibroids; in pregnant women, the first trimester, with its flood of hormones, tends to cause fibroids to expand, which obviously can cause some serious issues. Medication to reduce period flow can help these kinds of fibroids cause less of an issue.
2. You Seem To Pee A Lot
This particular difficulty is associated with the kinds of fibroids that grow on the outside of the uterus, projecting out into the abdomen. Fibroids can vary vastly in size, from microscopic to weighing several pounds, but if you get a big one on the exterior of your uterus and it happens to be positioned so that it presses on or contacts the bladder, it’s a recipe for abnormal peeing behavior.
3. Your Abdomen Feels And Looks Weirdly Stuffed
Because of the significant size of some fibroids, they may actually become physically obvious as a feeling of pressure or roundness in your abdominal cavity. It’s actually possible for some women with very large fibroids to look slightly pregnant, because they tend to show up in the lower abdomen where a baby would normally be growin’. Obviously, if there’s any kind of fullness or lumpiness that can’t be explained by a significant dinner, you need to get to a doctor immediately, whether you think it’s fibroids or not.
4. You Get Pain During Sex
There are two possible ways in which fibroids can make sex painful: pressure on the uterus, whether inside or out, or growths in or near the cervix that come into contact with anything inserted — none of which sounds particularly pleasant. The cervical ones can also cause bleeding during sex, according to the Fibroid Treatment Collective, and obviously any unexplained blood from intercourse needs to be investigated, so book into a GP or gynecologist if this is one of your symptoms.
5. Your Periods Last Forever
The other side of the menstruation coin when it comes to fibroids is that they can also last longer; we’re not sure why, but it’s possibly to do with hormonal problems related to fibroid growth. The main issue with prolonged periods, of course, is anaemia; if you find yourself weak, dizzy, and short of breath after a prolonged menstrual period, seek medical attention.
6. You’re Massively Constipated
Remember the potential issues that came with the fibroids that pushed on the bladder? This particular issue is the result of fibroids positioned in such a way that they push against the rectum, interfering with the waste disposal of your body; they may prevent proper poos and back you up considerably. This does depend on the fibroids being a very specific size and position, so they shouldn’t be the first thought that pops into your mind if you’re having a tricky time on the toilet.
7. You Get Lower Back Pain
This is another potential problem stemming from subserosal fibroids, but this one’s to do with positioning against the back, specifically the spine. If they’re large enough, they may cause enough pressure to create muscular or spinal pain, and will have to be diagnosed via MRI along with other scans to see whether they’re the cause of the issue. This is one of those cases where treatment, whether via medication to shrink them (like gonadotropin releasing hormone analogues or ulipristal acetate) or a surgical procedure, might be seen as a pretty good idea.
Remember, a lot of these symptoms could be signs of other things, so if this sounds like you, head to the doctor to get an ultrasound and get things sorted out for sure.
Want more women’s health coverage? Check out Bustle’s new podcast, Honestly Though, which tackles all the questions you’re afraid to ask.
Images: Pexels, Giphy
Signs and Symptoms
Symptoms of fibroids may include:
- Heavy Vaginal Bleeding Excessively heavy or prolonged menstrual bleeding is a common symptom. Women describe soaking through sanitary protection in less than an hour, passing blood clots and being unable to leave the house during the heaviest day of flow. As a result, some women develop anemia, also known as a low blood count. Anemia can cause fatigue, headaches and lightheadedness. If heavy bleeding interferes with your everyday activities or if you develop anemia, you should see your doctor to discuss fibroid treatment options.
- Pelvic Discomfort Women with large fibroids may feel heaviness or pressure in their lower abdomen or pelvis. Often this is described as a vague discomfort rather than a sharp pain. Sometimes, the enlarged uterus makes it difficult to lie face down, bend over or exercise without discomfort.
- Pelvic Pain A less common symptom is acute, severe pain. This occurs when a fibroid goes through a process called degeneration. Usually, the pain is localized to a specific spot and improves on its own within two to four weeks. Using a pain reliever, such as ibuprofen, can decrease the pain significantly. However, chronic pelvic pain can also occur. This type of pain is usually mild but persistent and confined to a specific area.
- Bladder Problems The most common bladder symptom is needing to urinate frequently. A woman may wake up several times during the night to empty her bladder. Occasionally, women are unable to urinate despite a full bladder. These symptoms are caused by fibroids pressing against the bladder, reducing its capacity for holding urine or blocking the outflow of urine. Treatment for bladder problems can provide great relief.
- Low Back Pain Rarely, fibroids press against the muscles and nerves of the lower back and cause back pain. A large fibroid on the back surface of the uterus is more likely to cause back pain than a small fibroid within the uterine wall. Because back pain is so common, it is important to look for other causes of the pain before attributing it to fibroids.
- Rectal Pressure Fibroids also can press against the rectum and cause a sensation of rectal fullness, difficulty having a bowel movement or pain with bowel movements. Sometimes, fibroids can lead to the development of a hemorrhoid.
- Discomfort or Pain With Sexual Intercourse Fibroids can make sexual intercourse painful or uncomfortable. The pain may occur only in specific positions or during certain times of the menstrual cycle. Discomfort during intercourse is a significant issue. If your doctor doesn’t ask you about this symptom, make sure you mention it.
Shrinking Fibroids with Diet: Is It Possible?
There are a number of changes you can make that might help reduce your risk for fibroids.
Follow a Mediterranean diet
Add plenty of fresh and cooked green vegetables, fresh fruit, legumes, and fish to your plate. A Mediterranean diet is one way to do this. Research shows that eating these foods regularly may help lower your risk for fibroids. On the other hand, eating beef, ham, lamb, and other red meat may raise your risk.
Check out a beginner’s guide to the Mediterranean diet for tips and a meal plan.
Cut back on alcohol
Drinking any type of alcohol may increase your risk for fibroids. This can happen because alcohol raises the level of hormones needed for fibroids to grow. Alcohol may also trigger inflammation.
One study found that women who drank one or more beers a day increased their risk by more than 50 percent. Avoid or limit alcohol to help reduce your risk.
Estrogen is a hormone important for healthy fertility in both women and men. However, too much estrogen can increase your risk for fibroids or make them worse.
Many treatments for fibroids work by lowering estrogen levels. Other ways to balance estrogen levels include:
Losing weight. Obesity and excess weight increase the risk for fibroids. Fat cells make more estrogen, so losing weight may help prevent or slow the growth of fibroids.
Avoiding hormone-disrupting chemicals. Natural and synthetic chemicals can throw off your endocrine balance, raising estrogen levels. These chemicals can leach into your body through skin and food. Avoid or limit coming into contact with chemicals found in:
- plastics such as BPA
- nonstick coatings on cookware
- fire retardants
- some personal care products
Lower blood pressure
Research shows that a high number of women with severe fibroids also have high blood pressure. More research is needed to find out if there’s a link.
Balancing blood pressure is vital for your overall health. Try these tips:
- Avoid added salt. Flavor food with herbs and other spices instead.
- Limit high-sodium processed and packaged foods.
- Check your blood pressure daily with a home monitor.
- Exercise regularly.
- Lose weight, especially around the waist.
- Avoid or limit alcohol.
- Increase potassium by eating a majority of plants at each meal.
- Quit smoking and avoid secondhand smoke.
- If you have high blood pressure, take medication as prescribed.
- See your doctor for regular checkups.
Get enough vitamin D
Vitamin D may help reduce your risk of fibroids by almost 32 percent. Your body makes this “sunshine vitamin” naturally when your skin’s exposed to sunlight. If you have darker skin or live in cooler climates, you’re more likely to be deficient.
Supplements can help raise your levels, along with foods such as:
- egg yolks
- fortified milk, cheese, and dairy products
- fortified cereals
- fortified orange juice
- fatty fish such as salmon, tuna, and mackerel
- cod liver oil
A note about smoking and diet
Eating brightly colored fruits and vegetables is good for your general health. Consuming a variety of red, yellow, and orange foods will provide rich antioxidants. Dark greens are also nutrient dense and will provide healthful benefits. These nutrients may help protect you from disease, including some cancers.
However, a study found that beta carotene found in red, yellow and orange foods didn’t lower the risk for fibroids. In smokers, beta carotene may even increase risk. Further research is needed on why this might happen. In any case, smoking is harmful to your health and may increase your risk of fibroids.
The other night, I sat in a restaurant with a group of girlfriends. We shared laughter, good conversation and some great wine. As I looked around, I realized that we were likely to share something else: uterine fibroids. Of the ten women sitting at the table, there was a good chance that seven of us would have uterine fibroids at some point in our lives.
Fibroids are noncancerous tumors that grow in the uterus. They may be smaller than a seed or bigger than a grapefruit. A woman may have only one fibroid or she may have many. Depending on their size, number, and location, fibroids can cause heavy bleeding and long menstrual periods (which can, in turn, cause anemia), pelvic pain, frequent urination, or constipation. Fibroids can also cause infertility and repeated miscarriages.
No “best” treatment
Given how common uterine fibroids are, you’d think there would be a lot of research comparing treatment options. In fact, there are only a few randomized trials to guide treatment. In a clinical practice article in today’s New England Journal of Medicine, Dr. Elizabeth A. Stewart, professor of obstetrics and gynecology at the Mayo Clinic, lays out the options and discusses the factors that women and their doctors should consider when making treatment decisions.
First, are the fibroids causing symptoms? If not — which is often the case — no treatment is needed.
Next, what are the symptoms? These can be broadly divided into two categories: heavy menstrual bleeding and “bulk” symptoms. Bulk symptoms, like pelvic pain and frequent urination, are caused by the presence of large fibroids in the abdomen.
“I consider the severity of symptoms and the impact of those symptoms on a woman’s quality of life to be the foundation of treatment decision making,” says Dr. Aaron Styer, an obstetrician-gynecologist at Harvard-affiliated Massachusetts General Hospital. “For example, is the woman missing work, requiring frequent hospitalizations, or missing out on normal, daily life? If so, that information will guide the treatment I recommend.”
Whether a woman would like to have children, her age, and how close she is to menopause can also ninfluence the treatment decision. Once a woman enters menopause, fibroids often shrink or even disappear. But until menopause, they may continue to form or reappear after they are removed.
Hysterectomy, hold the power morcellation
Removal of the uterus (hysterectomy) is a popular option for women who are done having children. With the uterus gone, new fibroids can’t form. But traditional hysterectomy, in which a surgeon makes a large incision in the abdomen, is major surgery.
In laparascopic hysterectomy, the surgeon removes the uterus through three or four small incisions in the wall of the abdomen. Recovery is quicker and there are usually fewer complications than with a traditional hysterectomy.
Laparascopic hysterectomy has historically been accompanied by a procedure called power morcellation. It uses a device to cut the uterus into fragments so it can be removed through the small incisions. But the FDA recently recommended limiting the use of power morcellation because of the small chance that a woman having surgery to remove fibroids may have undiagnosed uterine cancer. If power morcellation is performed in these women, there is a risk that the procedure will spread the cancer throughout the abdomen and pelvis. This is precisely what happened in the much-publicized case of Dr. Amy Reed, an anesthesiologist at Boston’s Brigham and Women’s Hospital.
Treatment options for heavy bleeding
Women with heavy bleeding who do not want to have a hysterectomy can turn to both medical and surgical options. Some medications reduce heavy bleeding by helping blood clot. Hormonal birth control works by thinning the endometrium. This is the nutrient-rich lining of the uterus that is shed during a woman’s period. Medications can relieve symptoms, but they don’t treat the underlying problem.
A surgical option to treat heavy bleeding is hysteroscopic myomectomy. In this procedure, a thin tube called an endoscope is passed through the cervix and into the uterus. The fibroid is shaved and removed, but the uterus is left intact. If a woman does not want to have children, she can opt for endometrial ablation. In this procedure, the endometrium is destroyed, often with heat or cold.
Treatment options for bulk symptoms
When fibroids cause pelvic pain or frequent urination, the goal of treatment is to reduce the size of the fibroids. Medications called GnRH agonists effectively shrink fibroids. However, fibroids grow back once the treatment is stopped, and these drugs are not intended for long-term use.
Myomectomy — this time done through a larger incision in the abdomen — can reduce the size of the fibroids while preserving a woman’s ability to have children. However, fibroids can recur after myomectomy. Another option is uterine artery embolization. This procedure blocks the blood supply to fibroids, causing them to shrink and die. Women are significantly more likely to have a successful pregnancy and delivery after myomectomy than after embolization.
A treatment option that is increasingly being used to treat uterine fibroids is MRI-guided ultrasound surgery. It uses ultrasound waves to shrink fibroids and reduce heavy menstrual bleeding.
Which treatment is right for you?
While there are many treatment options for uterine fibroids, there is no clear winner. That means you and your doctor can choose a treatment based on your preferences and reproductive plans along with other medical considerations.
As you decide, ask your doctor:
- Which treatment gives me the best chances of having a healthy pregnancy?
- Which treatment is most likely to offer permanent removal of fibroids?
- What are my personal risks and benefits of medical versus surgical treatment options?
Let your doctor know:
- whether you plan to have more children
- if you’d prefer to keep your uterus, even if your childbearing days are over
- which symptoms you find most bothersome and how they affect your quality of life.
There may be no “best” treatment for uterine fibroids. But there is a best treatment for you.
There’s no single best approach to uterine fibroid treatment — many treatment options exist. If you have symptoms, talk with your doctor about options for symptom relief.
Many women with uterine fibroids experience no signs or symptoms, or only mildly annoying signs and symptoms that they can live with. If that’s the case for you, watchful waiting could be the best option.
Fibroids aren’t cancerous. They rarely interfere with pregnancy. They usually grow slowly — or not at all — and tend to shrink after menopause, when levels of reproductive hormones drop.
Medications for uterine fibroids target hormones that regulate your menstrual cycle, treating symptoms such as heavy menstrual bleeding and pelvic pressure. They don’t eliminate fibroids, but may shrink them. Medications include:
- Gonadotropin-releasing hormone (Gn-RH) agonists. Medications called Gn-RH agonists (Lupron, Synarel, others) treat fibroids by blocking the production of estrogen and progesterone, putting you into a temporary postmenopausal state. As a result, menstruation stops, fibroids shrink and anemia often improves. Your doctor may prescribe a Gn-RH agonist to shrink the size of your fibroids before a planned surgery.Many women have significant hot flashes while using Gn-RH agonists. Gn-RH agonists typically are used for no more than three to six months because symptoms return when the medication is stopped and long-term use can cause loss of bone.
- Progestin-releasing intrauterine device (IUD). A progestin-releasing IUD can relieve heavy bleeding caused by fibroids. A progestin-releasing IUD provides symptom relief only and doesn’t shrink fibroids or make them disappear. It also prevents pregnancy.
- Tranexamic acid (Lysteda). This nonhormonal medication is taken to ease heavy menstrual periods. It’s taken only on heavy bleeding days.
- Other medications. Your doctor might recommend other medications. For example, oral contraceptives or progestins can help control menstrual bleeding, but they don’t reduce fibroid size.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), which are not hormonal medications, may be effective in relieving pain related to fibroids, but they don’t reduce bleeding caused by fibroids. Your doctor may also suggest that you take vitamins and iron if you have heavy menstrual bleeding and anemia.
MRI-guided focused ultrasound surgery (FUS) is:
A noninvasive treatment option for uterine fibroids that preserves your uterus, requires no incision and is done on an outpatient basis.
Performed while you’re inside an MRI scannerequipped with a high-energy ultrasound transducer for treatment. The images give your doctor the precise location of the uterine fibroids. When the location of the fibroid is targeted, the ultrasound transducer focuses sound waves (sonications) into the fibroid to heat and destroy small areas of fibroid tissue.
Newer technology, so researchers are learning more about the long-term safety and effectiveness. But so far data collected show that FUS for uterine fibroids is safe and effective.
Minimally invasive procedures
Certain procedures can destroy uterine fibroids without actually removing them through surgery. They include:
- Uterine artery embolization. Small particles (embolic agents) are injected into the arteries supplying the uterus, cutting off blood flow to fibroids, causing them to shrink and die. This technique can be effective in shrinking fibroids and relieving the symptoms they cause. Complications may occur if the blood supply to your ovaries or other organs is compromised.
- Myolysis. In this laparoscopic procedure, radiofrequency energy, an electric current or laser destroys the fibroids and shrinks the blood vessels that feed them. A similar procedure called cryomyolysis freezes the fibroids.
- Laparoscopic or robotic myomectomy. In a myomectomy, your surgeon removes the fibroids, leaving the uterus in place. If the fibroids are few in number, you and your doctor may opt for a laparoscopic or robotic procedure, which uses slender instruments inserted through small incisions in your abdomen to remove the fibroids from your uterus. The fibroids can be removed through those same small incisions by breaking them into smaller pieces, a process called morcellation, or one incision can be extended to remove whole fibroids.
Your doctor views your abdominal area on a monitor using a small camera attached to one of the instruments. Robotic myomectomy gives your surgeon a magnified, 3-D view of your uterus, offering more precision, flexibility and dexterity than is possible using some other techniques.
- Hysteroscopic myomectomy. This procedure may be an option if the fibroids are contained inside the uterus (submucosal). Your surgeon accesses and removes fibroids using instruments inserted through your vagina and cervix into your uterus.
- Endometrial ablation. This treatment, performed with a specialized instrument inserted into your uterus, uses heat, microwave energy, hot water or electric current to destroy the lining of your uterus, either ending menstruation or reducing your menstrual flow.
Typically, endometrial ablation is effective in stopping abnormal bleeding. Submucosal fibroids can be removed at the time of hysteroscopy for endometrial ablation, but this doesn’t affect fibroids outside the interior lining of the uterus.
Traditional surgical procedures
Options for traditional surgical procedures include:
- Abdominal myomectomy. If you have multiple fibroids, very large fibroids or very deep fibroids, your doctor may use an open abdominal surgical procedure to remove the fibroids. Many women who are told that hysterectomy is their only option can have an abdominal myomectomy instead. However, scarring after surgery can affect future fertility.
- Hysterectomy. This surgery — the removal of the uterus — remains the only proven permanent solution for uterine fibroids. But hysterectomy is major surgery.
Hysterectomy ends your ability to bear children. If you also elect to have your ovaries removed, the surgery brings on menopause and the question of whether you’ll take hormone replacement therapy. Most women with uterine fibroids may be able to choose to keep their ovaries.
You may also face an increased long-term risk of heart and blood vessel (cardiovascular) diseases and certain metabolic conditions after a hysterectomy, especially if you have the surgery before age 35, according to recent research. Talk with your doctor about treatment options for your condition, to see if there are any alternatives that you might consider.
Morcellation during fibroid removal
Morcellation — a process of breaking fibroids into smaller pieces — may increase the risk of spreading cancer if a previously undiagnosed cancerous mass undergoes morcellation during myomectomy. There are several ways to reduce that risk, such as evaluating risk factors before surgery, morcellating the fibroid in a bag or expanding an incision to avoid morcellation.
All myomectomies carry the risk of cutting into an undiagnosed cancer, but premenopausal women generally have a lower risk of undiagnosed cancer than do older women. Also, complications during open surgery are more common than the chance of spreading an undiagnosed cancer in a fibroid during a minimally invasive procedure. If your doctor is planning to use morcellation, discuss your individual risks before treatment.
The Food and Drug Administration (FDA) advises against morcellation for most women. In particular, the FDA recommends that women who are peri- or postmenopausal avoid morcellation. Older women in or entering menopause may have a higher cancer risk, and women who are no longer concerned about preserving their fertility have additional treatment options for fibroids.