Periods & Fibroids
What are fibroids?
A uterine fibroid is the most common benign (non-cancerous) tumour of a woman’s uterus (womb). They are tumours of the smooth muscle found in the uterine wall.
Also called uterine myoma, fibroids can not only develop within the uterine wall itself but can also attach to it. While fibroids are not typically life-threatening, the can change the structure of the uterus which can affect a woman’s fertility and her ability to become pregnant. Fibroids may grow as a single tumour or in clusters.
What are the symptoms of uterine fibroids?
- excessive menstrual bleeding (menorrhagia)
- prolonged periods
- pelvic pain
- constipation
- frequent urination
- back pain
- painful sex
- bleeding between periods
What causes uterine fibroids?
- Family history of fibroids, genetics predisposition
- Experience early onset of periods
- Overweight
- Excessive oestrogen hormone exposure
How are uterine fibroids diagnosed by Dr Shammas?
- Pelvic examination / Internal examination
- Ultrasound scan
- MRI scan
- Hysterosonography
What are the complications associated with uterine fibroids?
There a re a number of complications that can occur from uterine fibroids. Submucosal fibroids can affect the shape and internal environment of your womb, which can make it more difficult for you to become pregnant.
Fibroids in pregnancy can also sometimes cause problems such as miscarriage, premature labour, rapid increase in fibroid size and bleeding, but this is rare. Dr Shammas will be able to discuss all aspects of uterine fibroids and the treatment options at your consultation.
What are the types of fibroids?
- Intramural fibroids. These are the most common type of non-cancerous fibroid. They grow within the muscular wall of your womb.
- Submucosal fibroids. These fibroids bulge into the uterine cavity and grow from the inner wall of your womb into the space inside your womb.
- Subserosal fibroids. These fibroids grow from the outside wall of your womb into your pelvic cavity and can become very large.
What is the treatment for fibroids?
Medication
Hormone-based treatments such as the oral contraceptive pill can help regulate your periods and relieve your symptoms. There are medicines that lower your oestrogen levels to try and shrink fibroids. Some of these medicines will have side effects such as hot flushes and vaginal dryness and osteoporosis if used for more than 6 months.
These medicines are most likely to be used for the three to four months prior to surgery, to try and reduce the size of the fibroids to make it easier for Dr Shammas to remove them.
Non-steroidal anti-inflammatory drugs (NSAIDs) may be effective in relieving pain related to fibroids such as Analgesia (Ibuprofen, Naproxen).
Surgery
Myomectomy
A myomectomy is an operation to remove fibroids, leaving your uterus in place. It may be done through a cut in your tummy, or sometimes it may be possible for Dr Shammas to use keyhole surgery. Myomectomy is usually only offered to women who would like the option to become pregnant in the future. It should be noted that because your womb isn’t removed there is a chance that more fibroids will grow in the future, so you may need to have further treatment.
Uterine artery embolisation (UAE)
This procedure blocks the blood supply to a fibroid, causing it to shrink. It’s performed under local anaesthesia, meaning that feeling in the area will be completely blocked but you will stay awake during the operation.
UAE gives relief from symptoms such as bleeding and pain for at least six in every 10 women treated. It’s only recommended to be used for treating women with infertility related to fibroids as part of a clinical trial.
Endometrial ablation or resection
For menorrhagia and a small uterine fibroid an Endometrial ablation is a procedure to remove most of the lining of your womb or to destroy or remove an individual fibroid using energy such as microwaves or heat.
