Chances are that you aren’t aware you have fibroids, which are also referred to as leiomyomas or myomas. Most women don’t experience any symptoms. These fibroid cysts grow in the muscular wall tissue of your uterus. Not only are they non-cancerous, but also they won’t turn into cancer in a vast majority of cases. Women who do experience symptoms may communicate any of the following symptoms:
- Heavy bleeding or painful periods
- Feeling a sense of fullness in your lower stomach
- Noticing your lower abdomen appears to be distended
- Having to frequently urinate
- Pain during sex
- Lower back pains
- Complications during pregnancy and labor
- Rarely, reproductive problems
There is no proof of what causes uterine fibroids; however, a clear link has been established between hormones (in particular, estrogen and progesterone) and their impact on uterine fibroids. Furthermore, the condition is found to be genetic, so if you have a close family member who experiences fibroids, you’re at a greater risk. Other risk factors include race, with African American women being more likely to get fibroids, and environmental factors such as birth control use, obesity, and early onset periods. Uterine fibroids should always be evaluated with a thorough consultation and examination by a physician for an accurate diagnosis and treatment plan.
Diagnosing Uterine Fibroids
It’s not unusual for your doctor to locate a uterine fibroid simply by touching during a pelvic exam. There are several different kinds, based on where they’re located:
- Submucosal fibroids grow in the uterine cavity.
- Intramural fibroids are located in the wall of the uterus.
- Subserosal fibroids are found growing on the outside of the uterus.
Fibroids lead to a swollen uterus. They impact the size of your uterus just as pregnancy does. Because of this, your NYC OBGYN refers to your uterus size (normal size of uterus vs not) in comparison to a specific number of weeks pregnant. For example, your doctor may tell you that fibroids have put your uterus into the 10-week of pregnancy range, which of course is larger than usual. Your gynecologist may also describe your fibroids by comparing them to any of several round objects, from seeds to nuts, a golf ball to a fruit. Your doctor might order some imaging tests to be sure, including:
- Ultrasounds are painless, noninvasive and can show your doctor all of your internal organs.
- Magnetic resonance imaging, or MRI, uses a magnetic field to produce its pictures.
- X-rays are well known and use radiation to create a picture of solid elements of your body, such as bones and organs.
- Computerized tomography, or CT scan, creates a more three-dimensional image by taking many X-rays and piecing them together.
- Hysterosalpingogram uses injected dye and X-rays to create a picture.
- Sonohysterogram uses injected water and ultrasound to create an image.
- Laparoscopy allows your doctor to see inside your uterus via a small incision in your abdomen. After inserting a thin tube with a light and a camera on the end of it, your OBGYN can take pictures during this procedure.
- Hysteroscopy also involves a scope on a thin tube with a light, but in this procedure, the scope is inserted through your vagina, past your cervix and further into your uterus. Polyps can also be detected using this procedure.
Treatment Without Symptoms?
Most of the time, uterine fibroids are only treated if the symptoms are annoying or painful for you depending on your doctor’s recommendation after careful examination. So normally your doctor either treats your symptoms or removes the fibroids via medications or surgical procedures.
For example, your gynecologist may prescribe medications for fibroids, including:
- Over-the-counter pain medications of your choice, usually nonsteroidal anti-inflammatory drugs (NSAIDs)
- Iron supplements, as the potential for anemia due to heavy bleeding is a potential hazard with fibroids
- Low-dose birth control pills containing a combination of hormones that will not stimulate fibroid growth, but can slow or stop bleeding
- Birth control injections that are heavy on progesterone, which can provide relief of symptoms
- Hormonal IUDs, which contain small doses of medicine that’s progesterone-like and can also perform double duty as both a birth control and a control of symptoms like heavy bleeding
Surgical solutions for uterine fibroid cysts are rare, but include:
- Myomectomy is performed to remove fibroids with minimal damage to the healthy uterine tissue surrounding the fibroids. Women who would like to get pregnant often opt for this procedure. This procedure can be minimal or it can be a major surgery, depending on the location and size of your fibroids.
- Hysterectomy is the removal of your entire uterus. It’s usually only performed when it’s the last solution available to remove fibroids from your reproductive system. It’s a complete and total cure for fibroids, but it means pregnancy is impossible after this surgery. Typically, your ovaries are retained, especially if you’re a younger woman, to keep you from starting menopause too early.
- Endometrial Ablation involves removing or burning out the lining of the uterus by almost any means available, including laser, wire loop, boiling water, electrical current and extreme cold, among others. This procedure will also make pregnancy impossible later.
- Myolysis uses a needle on the fibroids, which then conducts cold or electricity through it to destroy the fibroids.
- Uterine Fibroid Embolization (UFE) or Uterine Artery Embolization (UAE) cuts off the blood supply to the fibroids using tiny gel particles that are placed in the fibroids via a tiny tube threaded through the blood vessels. Again, this procedure will not allow you to become pregnant later.
Fibroids and Pregnancy
Fibroids are usually considered a complication of pregnancy, because while they don’t typically interfere with the getting pregnant part, it’s possible for fibroids to cause miscarriage or infertility. There are also concerns that fibroids could raise the risk of certain pregnancy complications.
If you’re trying to get pregnant and you’re aware you have fibroids or have had them in the past, alert your doctor to this immediately. If you are already pregnant and your doctor discovers uterine fibroids, follow all of his directions to keep your pregnancy moving smoothly forward. You’re not in danger with fibroids and pregnancy, but it’s best to be on the safe side.
Important Reminder: This information is only intended to provide gynecology guidance, not a definitive medical advice. Please consult obgyn doctor about your specific condition. Only a trained, experienced board certified gynecologist or certified gynecology NYC specialist can determine an accurate diagnosis and proper treatment.
Do you have questions? Would like to schedule an appointment with the leading OB Gynecologist in Midtown NYC, Dr. Pedram Bral, please contact our office.
Dr. Pedram Bral, Gynecologist (Gynecologist NYC, Midtown)
New York, NY10010
(Between Madison Ave & Park Ave)
☎ (212) 533-4575