Fibroids: Exploring Your Treatment Options

Uterine fibroids are benign (non-cancerous) tumors of the uterus and the most common GYN problem for women. By the age of 50, about 80% of Black women will be diagnosed with fibroids. So chances are good that either you, a relative or friend will be treated for fibroids in your lifetime.

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Fibroids can range from the size of a pea to the size of a football, and fibroid size and location determine if you will have symptoms that require treatment. Common fibroid symptoms include heavy or irregular menstrual cycles, pelvic pain, painful intercourse or pressure on the bladder or intestines, which can lead to frequent urination or constipation.

Uterine fibroids can also cause infertility by blocking sperm entry into the uterus or tube or by making the uterus an unfavorable place for a baby to develop. If fibroids are very large, they can be detected on a routine pelvic exam. Ultrasound is an outpatient diagnostic procedure which can identify fibroids of various sizes.

When To Seek Treatment

Being diagnosed with fibroids alone is not a reason for treatment; however women with symptoms or infertility related to their fibroids should consider having their fibroids removed or reduced. The currently available therapies for fibroids are surgery and uterine artery embolization (UAE).

Surgical Options

The most definitive treatment for fibroids is hysterectomy, which involves surgical removal of the entire uterus and all fibroids contained within. Once a hysterectomy is performed, a woman can no longer carry a pregnancy. Myomectomy is an alternative surgical procedure, where fibroids are removed while leaving the uterus in place.

Myomectomy may be the best option for women who want to treat their fibroids, but maintain the possibility for pregnancy in the future. Having a myomectomy does not guarantee that fibroids won’t grow back, and some women will require re-treatment if fibroids recur.

Uterine Artery Embolization (UAE)

The UAE procedure is an alternative therapy for women who want to avoid a surgical procedure and who wish to preserve their uterus. With UAE, a radiologist inserts particles into the blood vessels which deliver most of the blood flow to the uterus (the uterine arteries). Once these particles are deposited, the uterine arteries are permanently blocked and blood flow to the uterus is decreased. This decrease in blood flow causes the fibroids to shrink, but there is still enough blood flow from surrounding blood vessels to keep the uterine tissues healthy and alive.

While some women will conceive and deliver a pregnancy after UAE, others may have fertility problems after the procedure. For this reason, UAE is best suited for women who do not plan to have children in the future.

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Uterine fibroids are extremely common and may require treatment if they cause symptoms or infertility. Hysterectomy, myomectomy and UAE are standard treatments that can relieve symptoms caused by fibroids. Women should be sure to discuss any plans for future pregnancy with their doctor when deciding on a treatment.