Fibroid Management - New Day OBGYN

Fibroid Management OBGYN South Florida Alicia Acon Physician

What are uterine fibroids?

Uterine fibroids (also called leiomyomas) are growths made of muscle and tissue that form in or on the wall of your uterus. These growths are usually not cancerous (benign) and are the most common noncancerous tumor in females.

Uterine fibroids can cause a variety of symptoms like pain and heavy, irregular vaginal bleeding. Sometimes, a person has no symptoms and is unaware they have fibroids. Treatment for fibroids typically depends on your symptoms.

Where do fibroids grow?

Fibroids can grow as a single nodule (one growth) or in a cluster. Clusters of fibroids can range in size from 1 millimeter to more than 20 centimeters (8 inches) in diameter or even larger. For comparison, fibroids can be as small as a seed or get as large as a watermelon. These growths can develop within the wall of your uterus, inside the main cavity of your uterus or on the outer surface of your uterus.

Types of uterine fibroids

There are different types of uterine fibroids depending on where they’re located and how they attach. Specific types of uterine fibroids include:

Intramural fibroids: These fibroids are embedded into the muscular wall of your uterus. They’re the most common type.
Submucosal fibroids: These fibroids grow under the inner lining of your uterus.
Subserosal fibroids: This type of fibroid grows under the lining of the outer surface of your uterus. They can become quite large and grow into your pelvis.
Pedunculated fibroids: The least common type, these fibroids attach to your uterus with a stalk or stem. They’re often described as mushroom-like because they have a stalk and then a wider top.

Are fibroids common?

Fibroids are a very common type of growth. Approximately 40% to 80% of people with a uterus have fibroids. They occur most often in people between 30 and 50 years old. People who haven’t had their first period (menstruation) yet typically don’t have fibroids. They’re also less common in people who’ve entered menopause.

Symptoms and Causes

What are uterine fibroids and what are the risk factors?

What are the symptoms of uterine fibroids?

Most small fibroids don’t cause any symptoms and don’t require treatment other than regular observation by your healthcare provider. Larger fibroids can cause you to experience a variety of symptoms, including:

Excessive or painful bleeding during your period.
Bleeding between your periods.
A feeling of fullness in your lower belly (abdomen)/bloating.
Frequent urination (this can happen when a fibroid puts pressure on your bladder).
Pain during sex.
Low back pain.
Constipation or feeling pressure on your rectum.
Long-term (chronic) vaginal discharge.
Inability to pee or completely empty your bladder.
Increased abdominal distention (enlargement), causing your abdomen to look pregnant.

The symptoms of uterine fibroids usually stabilize or go away after you’ve gone through menopause because hormone levels decline within your body.

What does uterine fibroid pain feel like?

There are a variety of feelings you might experience if you have fibroids. If you have small fibroids, you may feel nothing at all and not even notice they’re there. For larger fibroids, however, you can experience discomfort and pain. Fibroids can cause you to feel back pain, stabbing pains in your abdomen and even pain during sex.

What do fibroids look like?

Fibroids are typically rounded growths that look like smooth bumps. In some cases, they can be attached with a thin stem, giving them a mushroom-like appearance.

What causes uterine fibroids?

The exact cause is unknown, but healthcare providers believe the hormones estrogen and progesterone play a role. Most fibroids happen in people of reproductive age. Studies show that fibroids tend to grow when hormone levels are higher (like during pregnancy) and shrink when hormone levels are low (like during the transition to menopause).

What are risk factors for uterine fibroids?

There are several risk factors that can play a role in your chances of developing fibroids. These can include:

Obesity and a higher body mass index (BMI).
Family history of fibroids.
Not having children.
Early onset of menstruation (getting your period at a young age).
Late age for menopause.

What are the complications of uterine fibroids?

Most uterine fibroids don’t cause serious complications. However, the most common complications of fibroids are:

Pain that becomes unmanageable.
Swelling of your abdomen or pelvic area.
Excessive bleeding.
Anemia.
Infertility (this is rare).

Can fibroids cause anemia?

Anemia is a condition that happens when your body doesn’t have enough healthy red blood cells to carry oxygen to your organs. Anemia can happen to people who have frequent or extremely heavy periods. Fibroids can cause your periods to be very heavy or for you to even bleed between periods. Talk to your healthcare provider if you’re experiencing symptoms of anemia while you have fibroids.

Diagnosis and Tests

How are uterine fibroids diagnosed?

In many cases, a healthcare provider discovers uterine fibroids during a pelvic exam. Quite often, heavy bleeding and other related symptoms may alert your provider to consider fibroids as a part of the diagnosis. There are several tests that can be done to confirm fibroids and determine their size and location. These tests can include:

Ultrasonography: This noninvasive imaging test creates a picture of your internal organs with sound waves.
Magnetic resonance imaging (MRI): This test creates detailed images of your internal organs by using magnets and radio waves.
Computed tomography (CT) scan: A CT scan uses X-ray images to make a detailed image of your internal organs from several angles.
Hysteroscopy: During a hysteroscopy, your provider will use a device called a scope (a thin, flexible tube with a camera on the end) to look at fibroids inside your uterus. The scope is passed through your vagina and cervix and then moved into your uterus.
Hysterosalpingography (HSG): This is a detailed X-ray where your provider injects contrast material and then takes X-rays of your uterus.
Sonohysterography: In this imaging test, your provider places a small catheter in your vagina and then injects saline into your uterus. This extra fluid helps to create a clearer image of your uterus than you would see during a standard ultrasound.
Laparoscopy: During this test, your provider will make a small cut (incision) in your lower abdomen. A thin and flexible tube with a camera on the end will be inserted to look closely at your internal organs.

Management and Treatment

How are uterine fibroids treated?

Treatment for uterine fibroids can vary depending on the size, number and location of the fibroids, as well as what symptoms they’re causing. If you aren’t experiencing any symptoms from your fibroids, you may not need treatment. Small fibroids can often be left alone. Some people never experience any symptoms or have any problems associated with fibroids. In these cases, your provider may recommend monitoring your fibroids with pelvic exams or ultrasounds.

If you’re experiencing symptoms from your fibroids — including anemia from excess bleeding, moderate to severe pain or urinary tract and bowel problems — you’ll need treatment to help. Your treatment plan will depend on a few factors, including:

How many fibroids you have.
The size of your fibroids.
Where your fibroids are located.
What symptoms you’re experiencing related to the fibroids.
Your desire to keep your uterus.

The best treatment option for you will also depend on your plans for pregnancy in the future. Talk to your healthcare provider about your fertility goals when discussing treatment options. Treatment options for uterine fibroids can include:

Medications

Over-the-counter (OTC) pain medications: These medications help manage pain and discomfort caused by fibroids. OTC medications include acetaminophen and ibuprofen.
Iron supplements: If you have anemia from excess bleeding, your provider may also suggest you take an iron supplement.
Birth control: Birth control can also help with symptoms of fibroids — specifically, heavy bleeding during and between periods and menstrual cramps. There are a variety of birth control options you can use, including oral contraceptive pills, rings, injections and intrauterine devices (IUDs).
Gonadotropin-releasing hormone (GnRH) agonists: These medications work by shrinking fibroids. They’re sometimes used to shrink a fibroid before surgery, making it easier to remove the fibroid. However, these medications are temporary, and if you stop taking them, the fibroids can grow back.
Oral therapies: Elagolix is a new oral therapy to manage heavy uterine bleeding in people who haven’t experienced menopause with symptomatic uterine fibroids. It can be taken for up to 24 months. Talk to your provider about the pros and cons of this therapy. Another oral therapy, tranexamic acid, treats heavy menstrual bleeding in people with uterine fibroids.

It’s important to talk to your healthcare provider about any medication you take. Always consult your provider before starting a new medication to discuss any possible complications.

Fibroid Management New Day OBGYN Broward County Florida