Fibroids (sometimes referred to as uterine myomas or leiomyomas) are benign growths of different sizes, which form in or around the womb. These non-cancerous growths are made up of muscle and tissue. Most women with fibroids are unaware of it, as only around 1 in 3 will experience symptoms.
Each type of fibroid should be treated differently, and the choice of treatment depends on the severity of your symptoms, the size and location of the fibroids, your preferences, and other factors, such as your age and whether you want to have children.
Medications will not eliminate fibroids, but they might shrink them or slow down their growth velocity. They work by affecting the hormones that regulate the menstrual cycle. However, medication can be less effective for larger fibroids.
This is a small plastic T-shaped device that is carefully placed inside the womb. It slowly releases the progestogen hormone, levonorgestrel, to stop the uterus lining from growing too quickly. It helps by making the lining thinner and bleeding becomes noticeably lighter.
These block the production of oestrogen and progesterone to create an artificial and temporary menopausal state. This effectively stops periods so fibroids can shrink. Sometimes, we may prescribe a Gn-RH agonist to reduce the size of a woman’s fibroids before elective surgery. It is only prescribed on a short-term basis. There are a range of side effects to bear in mind with this category of treatment. You may experience menopausal symptoms, such as:
To mitigate against these side effects, gynaecologists may prescribe a combination of GnRH as and a low dose of hormone replacement therapy (HRT). Fibroids start growing again and the symptoms gradually return after the medication is stopped.
The contraceptive pill is a popular option for helping with fibroid symptoms. As well as making bleeding lighter, they can also reduce menstrual pain. Similarly, the intra-uterine system (Mirena coil) can be implanted inside the womb. This progesterone-releasing coil can reduce heavy bleeding caused by fibroids. Whilst it can improve the symptoms, it will not reduce the size of the fibroids.
This procedure involves removal of the fibroids while leaving the uterus in place. Through three or four very small incisions, the instruments are inserted into the abdomen and then the fibroids are removed from the uterus. The surgeon is able to view the abdominal area on a monitor through a small camera attached to one of the instruments. It is the preferred treatment for intramural (fibroids growing inside the uterine muscle) and subserosal (fibroids protruding outside the uterine surface) fibroids, as it allows quick recovery, a shorter hospital stay, less pain after the operation and a quick return to regular daily activities.
This is a procedure where hysteroscope (a thin telescope) and small surgical instruments are used to remove submucosal fibroids from inside the womb. No incisions are needed because the hysteroscope is inserted through the vagina and into the womb. The procedure is often carried out under general anaesthetic and patients can usually go home on the same day. After the procedure, patients often report having stomach cramps, but they do not last for long – normally only a couple of hours. There may also be a small amount of vaginal bleeding, but this usually stops after a couple of weeks
1. Changes in menstrual cycles.
2. Pain
3. Pressure
4. Enlarged uterus and abdomen
Sometimes fibroids cause no symptoms at all. Fibroids may be found during a routine pelvic exam or during tests for other problems.
