All About Fibroids

If you ever heard the word ‘Fibroid’ and thought, “what the heck is that?” you aren’t alone. Typically, they aren’t discussed unless you are diagnosed. This is a massive problem as they are incredibly common! Up to 70% of women will develop them in their lifetime, most during their reproductive years. That means the overwhelming majority of adult women have/had a fibroid or are at risk for developing a uterine fibroid. This is why it is essential to open a discussion about fibroids- what they are, where they come from, and treatment options.

What is a Uterine Fibroid?

A uterine fibroid is a growth that develops in the uterus, typically during reproductive or ‘childbearing’ years. Most of the time (estimated 99%), these growths are noncancerous. These growths can be outside the uterus, inside the uterine cavity, or within the muscle. Now, this may sound similar to a uterine polyp. However, there is a distinct difference. Uterine fibroids are dense fibrous connective tissue (hence the name), while uterine polyps are made from endometrial tissue. Another critical difference is that while the majority of uterine fibroids are noncancerous, uterine polyps have the potential to develop into cancer. Uterine Fibroids are often diagnosed during a routine pelvic exam. After taking a medical history and inventory of symptoms, your doctor may evaluate your uterus for any irregularities. To confirm the presence of fibroids, your doctor may utilize ultrasound. This can be used to map and measure how many fibroids you have and how large they are. Your doctor may also rule out any other potential causes with blood tests.

Uterine Fibroid Symptoms

When it comes to fibroids, everyone experiences them differently. Some individuals have no symptoms and are unaware of the presence of fibroids until their annual exam. Others experience symptoms ranging from mild to severe. As a good majority of the signs concern menstruation, many mistakenly attribute the symptoms to normal period pain. However, there may be an underlying cause. The symptomatology of uterine fibroids can include heavy and/or irregular menstruation, fertility issues, painful intercourse, anemia, and even insomnia, just to name a few. While there is some speculation that uterine fibroids can also be related to mental health concerns such as anxiety and depression, it is more likely that the symptoms may cause stress and depressive symptoms. For example, If my uterine fibroids cause a heavy period, I may be anxious that I will bleed through my pants. Other symptoms include lower back pain, stiffness, muscle spasms, leg numbness, frequent urination, and even infertility..

Uterine Fibroid Treatment

In terms of treatment for uterine fibroids, much of the decision depends on the severity and type of symptoms. For many individuals, uterine fibroids are present with minor annoyance of symptoms or no symptoms at all. Due to this, many individuals monitor their signs and the growth of fibroids for any increase in symptoms or decrease in functioning. However, if your symptoms interfere with your day-to-day life and sexual functioning or are causing excruciating pain, you may decide to investigate further treatments.

Medications

There are a few medication options that help to alleviate and/or regulate symptoms. These are often hormone-targeting medications that help with menstruation or pelvic pain. It is important to note that these medications do not shrink or remove the fibroids; they only alleviate the symptoms. The most common of these medications are Gonadotropin-releasing hormones. These work by blocking the creation of estrogen and progesterone in the body and mimics the effects of menopause. These medications are often used within a 6-month time frame or less because long-term effects include bone density loss and fertility complications. This route is often used when preparing for surgery to remove fibroids. Another option is progestin-releasing IUDs. This IUD device is inserted to help alleviate heavy bleeding from menstruation while also preventing unwanted pregnancies. This is a practical two bird, one stone option for effective birth control.

Procedures

The procedures for the treatment of uterine fibroids range from noninvasive to invasive. The route you take depends on the fibroid’s size, location, and how many are present. It is essential to discuss with your provider the severity of symptoms and what procedure will be the most effective to help you alleviate the symptoms. One option for a noninvasive treatment is MRI-guided focused ultrasound surgery. This procedure is a noninvasive surgery that helps protect the uterus and has no known long-term fertility side effects. This procedure is completed inside an MRI machine that allows the providers to locate the fibroids. The machine then focuses intense sound waves on the fibroid to break up and destroy the fibroid. In terms of minimally invasive procedures, the most common treatment includes embolization. This is when small particles are injected into the arteries supplying blood supply to the uterus via a catheter. This cuts off the fibroids’ blood flow, causing them to shrink and absolve. There are risks to such a procedure, including complications to reproductive organs if the blood supply is compromised. However, this procedure is completed at an outpatient level, and many individuals report a 90% success rate at improving symptoms. Other benefits are minimal scarring, covered by most medical insurance, and can treat multiple fibroids at one time. With a 7-10 days recovery period with an at-home recovery, it is considered the most common treatment for severe fibroids. Your doctor may recommend a more invasive procedure for individuals with extreme, multiple, or deep-rooted fibroids. Other methods include an abdominal myomectomy in which a doctor removes the fibroids by entering through the abdomen. Depending on the severity of the fibroids, this may lead to complications of damage to the reproductive organs. However, some individuals seek a permanent solution to treating/ removing their fibroids. This may include a hysterectomy. This is, statistically, the only permanent solution to uterine fibroids. This surgery has long-lasting effects as it permanently ends your reproductive years and will begin menopause. Uterine fibroids diagnosis and treatments are considered highly effective. It is essential to consult with your provider to discuss your goals and what treatment option is best for you.