What Are Fibroids: 25 percent of women will have fibroids in their lifetime. Women are detected with fibroids either through an ultrasound that they have done for some other reason or when they go to the gynaecologist with heavy pain during periods or some other symptom. Dr. Sudeshna Ray explains the meaning of fibroids, their types and treatment.
What are fibroids?
Fibroids are essentially benign outgrowths from the wall of the uterus or wall of your womb.
Types of fibroids
There are broadly three types of fibroids depending on the wall of the womb from which it arises.
- If it comes from the outer wall of the womb, it is called subserous.
- If it comes from the middle or muscle layer of the womb it is called intramural.
- If it is coming from the inner wall of the womb which bleeds during menstruation, it is called submucous fibroid.
Why is it important to know the types of fibroids?
One of the most important factors which determines how active or how symptom producing the fibroid is the type of fibroid. For example, if it is arising from the inner layer of the womb which is the most active layer of the womb, the submucous types which is the most symptom producing fibroid and needs to be treated asap.
Whereas the fibroids coming from the outer wall of the womb which is any which ways very inactive part of the womb. These fibroids are slow-growing. They are least symptom producing and treatment of these fibroids can be delayed.
What symptoms can fibroids produce?
1. Heavy bleeding during periods
2. Pain during periods
3. Pain while having sex
4. Pressure symptoms especially with fibroids more than 6 cm like increased frequency of urination or sometimes constipation.
5. Dull nagging pain in the lower tummy
6. Feeling of fullness or heaviness or a feeling of bulge in lower tummy
7. Rarely some fibroids can cause fertility issues as they interfere with you getting pregnant.
8. Fibroids can also be completely asymptomatic which means that you don’t have any of the symptoms mentioned above.
9. You discover that you have fibroids either by an examination with your doctor or by an ultra sound examination that is been done for something else.
Treatments for fibroids
1. Not do anything about them if they are not causing trouble or if your doctor feels that there is no potential harm in them.
2. The treatment options available are in form of medications which can be mostly hormonal sometimes strong hormones.
3. Injections which are again hormonal.
4. The burning and melting of fibroid by gas particles is a process called uterine artery embolization or by ultrasonic heat that is called a focused MRI.
5. The surgical treatments for fibroids by removing either the fibroids or sometimes the entire womb with fibroids to prevent them from coming back again and again.
6. This can be done through laparoscopic or a keyhole procedure or hysteroscopy which is a no-hole procedure.
Very rarely you might need a big cut in your tummy especially if the fibroid is huge.
When does my doctor need to treat my fibroids?
1. If the fibroids are giving you heavy bleeding or pain or painful sex.
2. If the heavy bleeding is enough to cause a drop in your haemoglobin or is leaving you very fatigued.
3. If the fibroid is submucosal
4. If the fibroid is more than 5 cm
5. Almost always if the fibroid is more than 8 cm.
When can medicine work effectively for my fibroids?
1. If the fibroids are small in size that is less than 5 cm and still they are giving you symptoms like heavy bleeding.
Medicines can arrest the bleeding and arrest the growth of the fibroids though temporarily.
2. If you are close to menopause and fibroids are giving you heavy bleeding medicines that can be given till you reach the menopause.
3. If you have tendencies towards fibroids or if you are having recurrent fibroids, your doctor might suggest a hormonal loop inside the womb which can shrink the small fibroids and also prevent them from coming back.
When do I need surgery as a treatment option for my fibroids?
Surgery is the best available treatment for fibroids. But what are these conditions?
1. If the fibroid is more than 7-8 cm
2. If the fibroid is large enough to give pressure on the water bag in the front or the poop bag behind or rectum.
3. If the fibroid is in very close proximity to the pipe that carries urine from the kidney to the water bag.
4. If the fibroid can potentially cause fertility issues or interfere with your pregnancy or it can potentially cause complications during pregnancy
5. When the fibroids get damaged or rotten from inside a process called degeneration.
6. If fibroids suddenly grow in size
7. If your doctor feels running for some tests to check if the fibroids are cancerous.
8. If the fibroids do not shrink in size after menopause or sometimes if they start growing after menopause.
Fibroid surgery isn’t that complicated and it is a fairly common surgery. Laparoscopic or keyhole or scarless procedures have the advantage of less pain, less bleeding and a very short hospital stay of 2 days and almost complete recovery by about 2 – 3 weeks.