Fibroids
Fibroids are benign (non-cancerous) tumours that grow in the walls of the uterus. They are a common condition affecting women. They range in size and it is possible to have more than one.
Cause of fibroids
The exact cause of fibroids is not known. But they have been linked to the hormone your ovaries produce (estrogen).
Other factors that may cause fibroids are your genetics and weight.
Complications of fibroids
Fibroids can cause problems due to their size, such as putting pressure on other organs in the body. They tend to get bigger in pregnancy, and can also cause problems during pregnancy.
Symptoms of fibroids
Symptoms of fibroids depend on the number, size and location. They may cause:
- heavy and long periods
- tummy pain or a swollen tummy
- pelvic pain
- pain during sex
- needing to wee (urinate) more often
- hard poos (constipation)
Fibroids rarely cause problems with pregnancy or getting pregnant.
Diagnosing fibroids
If your healthcare provider thinks you have fibroids they will:
- ask about your symptoms
- do a pelvic exam.
They may order more tests such as:
- an ultrasound scan
- a hysteroscopy (a small telescope inserted into your uterus through your vagina and cervix)
- a laparoscopy (a small cut made through your abdomen which allows a small telescope to be inserted).
In some cases, a biopsy may be taken for closer examination. This is where a small sample of tissue will be removed during a hysteroscopy.
Treating fibroids
Fibroids do not always need to be removed. They usually decrease in size after menopause, as they are dependent on oestrogen.
If you need treatment talk to your healthcare provider about the options.
Medications can be used to control symptoms, but are usually for temporary pain relief. Symptoms will return once therapy stops. Medications include:
- hormonal treatments such as oral contraceptives and provera
- intrauterine contraceptive device for small fibroids that do not distort the uterine cavity
- medications that decrease bleeding such as tranexamic acid
- anti-inflammatory pain medications for symptom relief.
There are a number of surgical treatments depending on the type, size and position of fibroids.
Hysteroscopic resection
Hysteroscopic resection can remove sub mucosal fibroids. This is a procedure where a thin telescope is inserted into the uterus. It allows the surgeon to inspect the cavity and remove any fibroids.
Myomectomy
Myomectomy is a procedure where fibroids are removed but the uterus is saved, especially where fertility is desired. This can be done by laparoscopy (key hole surgery) or laparotomy (cut in the abdomen).The type of surgery depends on the position and size of the fibroids. You surgeon will discuss this with you.
Hysterectomy
Hysterectomy is a further option for women who do not want to have children and have symptomatic fibroids. This can be done vaginally, by laparoscopy or abdominally.
Fibroid embolisation
Fibroid embolisation is performed by an interventional radiologist. It is a minimally invasive procedure performed while you are awake with pain relief and sedation.