You have been having no symptoms at all and have been feeling good but your doctor says you have fibroids in the womb. You are not willing to believe it. This may be true, as fibroids may be deceptively silent for long. Do not take unnecessary stress. It is, however, important to learn why they occur and what harm these can do.
About fibroids
Fibroids, also called leiomyomas, myomas, and fibromyomas are noncancerous growths in the womb that usually appear in the childbearing years. Fibroids are composed of both muscle and fibrous tissues. These protrusions may grow into the lumen of the womb or outside into the pelvic cavity from the wall of the womb. Fibroids may form at the neck of the womb called the cervix. Fibroids are formed due to excess of the reproductive hormone in women called estrogen.
Fibroids are very common. At least 1 out of every 4 women can develop fibroids at some point in time in life. Most fibroids go unnoticed as they do not cause symptoms. Such fibroids may be incidentally discovered by the doctor during a routine examination or ultrasound done for any other medical condition. Fibroids are more common in overweight Afro-Caribbean women who are around 30 years or more in age.
Fibroids may or may not cause problems. Many women who have fibroids do not complain of any symptoms. Others may complain of heavy or painful bleeding between monthly periods. Some experience heaviness or fullness in the lower abdomen. Back pain, difficult bowel movement for stool, frequent urination, painful intercourse, infertility, miscarriages, and early labor are other symptoms.
Treatment
Fibroids are harmless and may not need treatment if asymptomatic. However, medical or surgical treatment may be needed if there are symptoms. Medical therapy for heavy and painful periods consists of oral birth control pills or using intrauterine device loaded with another hormone called progestin. Besides these, Gonadotropin–releasing hormone (GnRH) agonists can be used to reduce bleeding and shrink the fibroids. These medicines regulate the hormonal concentrations to decrease the size of the fibroid. Fibroids may be removed surgically. This is called myomectomy and may be done via the abdominal or the vaginal route. It may be done by opening up the abdomen or by passing a flexible tube with a mounted camera, called the endoscope. The innermost lining of the uterus called the endometrium may be damaged using heat or other forms of energy in a procedure known as endometrial ablation to reduce heavy bleeding during periods. The blood vessels feeding the fibroid can be blocked by inserting small particles in the lumen of the blood vessels. This cuts off the blood supply and shrinks the fibroid. If desired relief is not obtained by any of these measures, the womb may be removed. This is done through the vagina or the abdomen. This is generally done for large fibroids, heavy bleeding, and distressing pain in women who have completed their families. Even a silent fibroid needs regular monitoring for growth in size.
Uterine fibroid embolization
Uterine artery embolization works by depriving blood supply to a fibroid. Under radiological guidance, the blood vessel supplying the fibroid is identified and its lumen is blocked by inserting tiny sand like or gel particles into the lumen that obstructs the blood supply. The fibroid, hence, shrinks in size and the symptoms relating to pain or bleeding start improving.
Uterine artery embolization is done by making a small cut in the groin and passing a thread up the major vessel to reach the smaller vessel supplying the fibroid. This is then blocked by tiny particles under radiological guidance. This procedure may be done as daycare or may need hospitalization for a day.
The most ideal candidate for uterine artery embolization is a symptomatic woman who does not want to have the womb removed and has completed her family. The general health should be good, i.e., there should be no diseases like high blood pressure, high blood sugar, bleeding disorders, kidney disease, and any infections or cancers. The woman should also not be allergic to any contrast agents containing iodine or have any type of inflammation in the blood vessels.
Uterine artery embolization has a high overall success rate of 94%. Following this procedure, the growing mass, heaviness, heavy bleeding, and other urinary and pelvic symptoms reduce significantly and the quality of life improves.
Advantages
Uterine artery embolization is a safe, simple, and cost effective approach in fibroid treatment as it does not need prolonged hospitalization. There is minimal cutting or sutures involved in the procedure. The relief is quick and recurrences are few as compared to other surgical options. The womb is retained and fertility rates improve. The patient is able to resume work within a short period of time.
Side effects
There are very few side effects associated with uterine arterial embolization. Some women experience cramping post-procedure. This can be managed with painkillers. Some women experience nausea and vomiting after the procedure. In very rare cases, a blood vessel may be damaged during the procedure or infection may occur. In some women, their menstrual cycles may stop early. In addition to these side effects, the procedure also carries the risk of exposing the ovaries to radiation. Other parts of the pelvis, such as the lower part of the intestine and urinary bladder, may also be injured. If a fibroid hangs into the pelvis, a scar may form between the organs.
Outlook
A diagnosis of fibroids does not mean end of life. Fibroids are not cancers, and are very much treatable. Timely treatment can address any distressing symptoms; it even improves the fertility. Therefore, women who wish to expand their family should not become disappointed, if diagnosed with fibroids. Modern treatments can help you get rid of it.
