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Featured Article
Fibroids: What Are They and How Are They Treated?

You have been told by your doctor that you have "fibroids." After you have gotten over the shock and fear of not knowing what to expect next, you have a few questions of your own. The one question you want an answer to is simple. What are "fibroids," how did I get them, and where do I go from here? These are typical questions to ask and of course you deserve to know exactly what is going on inside of you. Whether you are attempting to get pregnant, have already completed your family or just curious about your health, you need to follow up with your gynecologist.

What Are Fibroids?

Fibroids are small or large tumors that grows inside or outside of the uterus. There are several types of fibroids, which are often identified by their location.
  • Intramural fibroids are located inside the muscle part of the uterus wall
  • Subserosal fibroids normally grow on the outside of the uterus
  • Submucosal fibroids grow inside the wall of the muscle, and continue to grow into the cavity of the uterine.
Although, this sounds very frightening, fibroids are typically quite harmless. Most fibroids are "benign" or non-cancerous. They can stay small in size, or they can increase in size. This depends on which type of fibroids you have, and their location. Most fibroids do not cause symptoms at all, however, some, particularly as they get larger, can cause the following:
  • Heavy bleeding during menstruation. This is the most common sign of all. Although, not all painful and heavy bleeding indicate or point to signs of fibroids.
  • Pressure or pain on the bladder. If the tumor is large enough, it may cause discomfort in your abdomen and in your lower back. As the tumor grows, the pain and pressure increases. This can cause symptoms of urinary urgency or frequency.
  • Painful sexual intercourse is a symptom that can be caused by fibroids
Why Do I Have Fibroids?

No one knows what causes some women to develop fibroids. They can be hereditary and are more prevalent in African American patients when compared to Caucasian patients.

Can I Conceive If I Have "Fibroids"?

If you are diagnosed with fibroids, it does not mean that you can not get pregnant or that you can not successfully carry a pregnancy. Many patients with fibroids do not know that they have them until having an ultrasound during their pregnancy. Occasionally, fibroids can cause issues with conception and fertility, however.

Intramural (within the muscle wall) and subserosal (on outer wall of uterus), may not cause any issues with conception or pregnancy unless quite large. On the other hand, submucosal tumors are different from both subserosal and intramural fibroids. Their growth can interfere with pregnancy and may increase your risk of miscarriage.

What Treatment Options Do You Recommend If I Want to Be Able to Have Children?

Hysterectomies were the only treatment available to women with fibroids many years ago. Today women have more choices, because doctors are better educated on how to deal with the different types of fibroids. If your doctor feels your fibroids are causing issues with you being able to conceive or carry a pregnancy, or if you have large fibroids or anemia caused by heavy bleeding from fibroids, a procedure called a "Myomectomy" may be suggested. This procedure removes the fibroids, but leaves the uterus in place. This procedure requires making an incision in the abdomen, and is often recommended to women of the childbearing age.

A myomectomy was generally done as an open procedure in the past, with a fairly large abdominal incision much like the one used with a cesarean section. Now, sometimes less invasive techniques can be used. For instance, hysteroscopic myomectomy involves a telescopic tube being placed inside the uterus and then the fibroids can be extracted, through the opening of the cervix and the vagina. Women who have this procedure go home the same day, and usually resume their normal activities within 24 hours. This type of surgery does not leave any scars behind, which makes your recovery easier and less painful.

A Laparoscopic myomectomy procedure entails a camera being inserted into the abdominal cavity through a small incision in the navel. Usually two other small incisions are made as well, and this allows the fibroids to removed with special instruments through these small holes rather than a larger one. This allows for a shorter recovery time. With the proper diagnosis and treatment, a patient with fibroids should be able conceive, and experience the joy of being pregnant and giving birth to a full-term baby.

What Treatment Options Do You Recommend if I No Longer Plan to Have Children?

"Expectant management": Having NO treatment is an option if your fibroids are not causing significant bleeding or pain.

Medicines: Many medications used for birth control can be used to decrease heavy menstrual bleeding (birth control pills, shots, implants, etc.). The Mirena Intrauterine Device (IUD) contains progesterone (a hormone) that can decrease menstrual flow as well. Therefore, if heavy bleeding from fibroids is your main issue, these medications or devices may be an option for you.

Surgery: As noted above, hysteroscopic or laparoscopic myomectomy may be an option for you, just as it is in a patient who still plans to have children. However, with those procedures, it is possible for new fibroids to grow. Therefore, if you don't plan to have more children, it may be wise for you to have a hysterectomy. These can also be done with "minimally invasive" techniques, like vaginal, laparoscopic or DaVinci (robotic) hysterectomy. Endometrial ablation (treatment to destroy the lining of the uterus) is an outpatient procedure with quick recovery and no incisions that may be an option in certain patients with heavy bleeding and fibroids, but it depends on their size and location.

Uterine artery embolization: This is a treatment performed by radiologists which is used to cut off blood supply to your fibroids. A catheter is inserted into an artery in the leg and it can be guided to the arteries feeding your uterus and your fibroids. A special material is then placed in these arteries to block the blood flow to the fibroids, thus helping them shrink.
What is HPV?

Human papilloma virus is a very common infection that can be transmitted from person to person. The type of HPV that we worry about is the kind that is sexually transmitted. There are many strains of the virus that are sexually transmitted. Some cause genital warts and some cause abnormal pap smears and even cervical cancer. Studies show that at least 3 out of 4 sexually active people will contract HPV at some time in their lives. The Pap smear is a test used to screen for cervical cancer and any lesions that could someday lead to cervical cancer.

For more answers, click here to visit our frequently asked questions page.
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Northwest Women's Consultants, SC
1630 W. Central Road
Arlington Heights, Illinois 60005
(847) 394-3553

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Disclaimer: The information contained in this newsletter is for educational purposes only. It should not be used as a substitute for medical care and advice of your physician. The dispensing of this information should in no way be construed as establishing a doctor-patient relationship.