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With July being fibroid awareness month and as someone who has suffered with fibroids for
as long as I can remember, I thought it fitting to write this post to share more information on
this condition, how it affects women and the potential treatment options!
Whilst it’s Fibroid Awareness month in the US, women are affected by fibroids everywhere and more conversations about fibroids are needed! So I’m here to start that conversation off...
What are Fibroids?
Fibroids are very common, affecting approximately a third of women.
Fibroids (Uterine myomas or leiomyomas) are tumours of the smooth muscle of the uterus
(womb). They are usually benign (non-cancerous) although in some very rare cases they can become cancerous.
Fibroids are very common, affecting approximately a third of women.
They are most common between the ages of 30-50 years old.
They are more common in Afro-Caribbean women.
There is also a higher incidence in those who are obese due to the hormone oestrogen being increased.
Fibroids are classified by their position within the uterine cavity (submucosal), the muscles wall itself (intramural) or on the outside of the outside (subserosal) and the symptoms experienced therefore varies. Some subserosal and submucosal fibroids that are attached the surface by a thin fibrous cord- therefore known as pedunculated fibroids
Fibroids generally tend to shrink once you have become menopausal. As their growth is
dependent on the hormone oestrogen, which decreases after the menopause.
Symptoms of Fibroids
Not all those with fibroids have symptoms
Not all those with fibroids have symptoms and they are sometimes picked up by chance on routine scans. Those who do have symptoms may experience:
Heavy menstrual bleeds - this may also lead to anaemia (low iron) and increased tiredness
Painful periods
Abdominal pain
Pain in the lower back
Increased need to urinate
Constipation
Pain or discomfort during sex
Infertility - caused in some caused by bulky fibroids within the uterine cavity
How are fibroids diagnosed?
Fibroids can be picked up incidentally on ultrasound or MRI scans. However, they are
usually diagnosed by ultrasound as a result of referral for symptoms.
Fibroids which are not causing symptoms do not need to be treated. However, there are
many treatment options to alleviate the pain and other symptoms caused by Fibroids. Some
options are better for women who are trying to conceive and others are better for those who
have completed their families.
How do we treat them?
Medical therapies
The Coil (Intrauterine system / IUS): This is a T shaped plastic device inserted into the womb which slowly releases hormones which reduce the growth of the womb lining. This makes the periods lighter. Click here to find out more about the coil
Tranexamic Acid: This works by reducing the blood flow to the womb lining by up to half. Tablets are taken 3-4 times a day during the period for a maximum of 4 days. This treatment can take time to work. However, if within 3 months you do not see any improvements in your symptoms you should stop this medication.
Non-steroidal anti-inflammatory (NSAIDS): This class of drugs includes ibuprofen. These painkillers can be taken during the whole period up to 3 times a day and help to reduce the cramps and pain.
Surgical Therapies
If medical therapies are unsuccessful there are also surgical options that can be explored.
Small fibroids can be removed using keyhole surgery
Hysterectomy: For those who have completed their families this is a definitive treatment
option as the fibroids will not return. This surgery involves the removal of the womb and
is useful for women suffering with larger fibroids. Having a hysterectomy can induce
early menopause and the surgery takes around 6-8 weeks.
Myomectomy: This is surgery to remove fibroids from within the uterus. It is useful
treatment for those who have not yet completed their families. The size and the location
of your fibroids will determine whether you are able to have a myomectomy. The surgery
is usually keyhole surgery and therefore, usually has a faster recovery than a
hysterectomy.
Uterine artery embolisation: Where the main blood supply to the uterus is reduced
therefore reducing the flow of blood and the amount of bleeding during menstruation.
Don’t suffer unnecessarily
My take home message is that fibroids are very common. If you have symptoms associated
with fibroids, don’t suffer unnecessarily. Seek help from your general practitioner to
investigate the cause of your symptoms and explore your treatment options to best help you
manage those symptoms!
Janet X
Janet is a final year medical student, future OBGYN and the events officer for SHAKE!
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