For many women it’s a common problem. Non-cancerous (benign) growths called fibroids grow on the wall of the uterus, causing pain and heavy bleeding. The fibroids can be very small or may grow to the size of a cantaloupe. The location of the fibroids within the uterus as well as the size plays a role in whether or not the woman has symptoms and in how severe the symptoms are.

Fibroids typically affect women in their 30s and 40s with as many as 20 to 40 percent of women older than 35 having some fibroids. For some reason, African American women are especially prone to fibroids with nearly 50 percent having fibroids of significant size.

Diagnosing Fibroids

Fibroids are generally diagnosed during a woman’s routine gynecological exam. Imaging studies like CT and MRI can be used to confirm the diagnosis.

If you are having these symptoms, you should talk to your doctor about whether you might have fibroids:

• Heavy, prolonged menstrual periods
• Unusual monthly bleeding with clots
• Pelvic pain, including pain during intercourse
• Pain in the back or legs
• Bladder pressure that makes you feel like you need to urinate
• Problems with constipation or bloating associated with pressure on the bowel
• Abnormally enlarged abdomen

Treatment Options

For some women with mild or no symptoms, the best treatment is called “watchful waiting” where the fibroids are monitored during regular checkups. If the fibroids are causing some of the problems listed above, your doctor may try medications including non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, birth control pills or hormone therapy. Medication therapy often is the first line of treatment for problem fibroids.

If medications don’t work, then there are other options. Surgery to remove the fibroids (myomectomy) may be an option. Generally myomectomy helps control symptoms and is about 80 percent effective. However, studies have shown that about 10 to 30 percent of the fibroids grow back after several years. The procedure can be done in several ways with recovery time varying from two to six weeks.

Hysterectomy, either open or laparoscopic, is commonly used for fibroids. About one-third of all hysterectomies in the U.S. are due to fibroids. However, hysterectomies are major surgical procedures and remove the entire uterus. A 3-4 day hospital stay is required and recovery time is about six weeks.

A minimally invasive approach

Another treatment option called uterine fibroid embolization works to get at the underlying cause of the problem fibroids. An interventional radiologist uses a catheter to access the blood supply to the fibroid and cut off the supply of blood. By depriving the fibroid of blood, the fibroid shrinks.

Uterine fibroid embolization uses minimally invasive techniques that may help reduce recovery time and leaves the uterus intact. In this procedure, the doctor makes a small cut in the skin in the groin and threads a catheter (a small, flexible tube) into the femoral artery up to the artery supplying the fibroid. A special X-ray helps guide the doctor in correctly placing the catheter. Once the catheter is in place, tiny plastic particles are injected into order to block the blood to the fibroid.

Embolization requires an overnight stay in the hospital. Medications to control pain and swelling are prescribed. Women may experience cramps, pain and fever following the procedure. Other rare side effects include infection and injury to the uterus that may result in a hysterectomy. A few women in their mid-40s or older (less than 2 percent) have begun menopause after UFE.

After a few days, you can resume light activities and generally can resume normal activities within a week to 10 days. The majority of women treated with embolization (85 to 90 percent) have significant reduction in the heavy bleeding and pain associated with fibroids. Only in rare cases do the treated fibroids return.

In some cases, women who have been treated with UFE have been able to become pregnant. However, the studies on fertility have not been confirmed as yet.

What treatment is right for me?

You and your doctor should discuss all available treatment options along with their associated benefits and risks. If you’d like to learn more about uterine fibroid embolization at North Fulton Regional Hospital, please call 770-751-2660.