Uterine Fibroids: Treating the Pain,
Rather Than Just Dealing with It
Nearly half of all women in their reproductive years develop uterine fibroids – non-cancerous tumors that develop in the uterus.
A woman with problematic fibroids could be experiencing one or more of the following symptoms:
- heavy or prolonged menstrual periods
- abnormal bleeding between menstrual periods
- pelvic pain (caused as the tumor presses on pelvic organs)
- frequent urination
- low back pain
- pain during intercourse
- a firm mass, often located near the middle of the pelvis, which can be felt by the physician
For many women, the discomfort caused by the fibroids can be persistent and painful. Fortunately it is not something she has to live with.
Treatment Options
When the pain and discomfort of uterine fibroids becomes too great to bear, there are several ways doctors can treat them, including:
- Hormonal treatment, the lowering of estrogen to trigger a medical menopause
- Myomectomy, or the removal of the fibroids while keeping the uterus in tact
- Hysterectomy, the removal of the uterus
- Uterine Artery Embolization (UAE), a minimally-invasive procedure performed by an interventional radiologist to shrink the fibroids.
Patients are usually examined and evaluated by their doctor or gynecologist to determine if there are fibroids, and if they are causing the patient’s symptoms.
“Fibroids do not put a woman at greater risk for cancer, so you don’t have to get treatment if you aren’t experiencing any symptoms,” says John Eichenlaub, MD, a gynecologist with Eichenlaub & May of Lancaster, and Medical Director of Women & Babies Hospital.
He says that ultrasound is the best way to determine if a woman has uterine fibroids.
“It comes down to a question of, can you live with the symptoms, or are the symptoms bad enough to warrant treatment,” Dr. Eichenlaub says.
Women who are planning to have children may choose a hormone treatment, which can temporarily shrink the fibroids, or a myomectomy – both of which leave the uterus in tact.
Fibroids rarely cause any complications for a pregnancy, although they are more apt to grow and can cause greater discomfort for the mother during this time.
Uterine Artery Embolization
For many patients, the minimally-invasive UAE is a desirable option, considering its short recovery time and excellent outcomes, with more than 90% of patients experiencing significant relief following the procedure.
“UAE blocks the blood flow to the fibroids,” says John Briguglio, MD, of Lancaster Radiology Associates. “By purposefully starving the fibroids of the blood supply, they shrink and die.”
UAE requires only a small incision in the groin area, where a catheter is then used to reach the uterus. Small particles are used to block off the arteries supplying blood to the fibroids.
Recovery from UAE typically lasts 5-7 days, whereas patients usually require 4-10 weeks to fully recover from a hysterectomy.
The best course of treatment is determined on a case-by-case basis. In some instances, fibroids may be so large that the patient would benefit more from a surgical option, Dr. Briguglio says.
“We work with a patient’s gynecologist and look at each of the options to determine which one has the best chance of making a woman less symptomatic,” Dr. Briguglio says. “If a patient gets the embolization and it turns out that it is still not enough, she can still have a hysterectomy to treat the symptoms.”
Myomectomy/Hysterectomy
When noninvasive and minimally invasive methods are not effective, a woman may wish to have the problem resolved surgically through a myomectomy or hysterectomy.
“Fibroids are the most common reason a woman has a hysterectomy,” Dr. Eichenlaub says. “It is the most definitive treatment of fibroid symptoms.”
Hysterectomy is typically the preferred surgical option unless the patient is planning a future pregnancy.
“We find that usually, when a woman takes care of her fibroids, she begins to feel better overall,” Dr. Briguglio adds. “And that enhances her quality of life.”
For more information about uterine fibroids consult your doctor or gynecologist.
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