Uterine Fibroids: A Non-Surgical Solution

Most women will develop one or more uterine fibroids during their reproductive lifespan.

While some women will turn to hysterectomies to remove their fibroids, other, less-invasive treatments are available.

What Are Uterine Fibroids?

Uterine fibroids are muscular tumors, typically non-cancerous, that grow in the wall of the uterus (womb). Fibroids can grow as a single tumor, or there can be many of them in the uterus. They can be as small as an apple seed or as big as a grapefruit. In unusual cases they can become very large.

Uterine fibroids contain fibrous tissue that's similar to the normal tissue of the uterus. They usually grow along the uterine wall, but sometimes they protrude into the cavity of the uterus or grow outside it altogether. The hormones progesterone and estrogen stimulate their growth, which is usually slow, but can be very rapid. Since estrogen levels decline with age, fibroids usually affect women during their reproductive years and shrink after menopause. Depending on the number, size and location of the fibroids, pregnant women may experience localized pain or more serious complications, such as miscarriage or premature delivery.

Who Is At Risk for Fibroids?

In the United States, an estimated 26 million women between the ages of 15 and 50 have uterine fibroids. According to the American College of Obstetricians and Gynecologists, fibroids can occur at any age but are most common in women ages 30 to 40 years.

Recent studies indicate that genetics may play a part: Women who have family histories of fibroid development are twice as likely to get them as those who don't. And according to the Mayo Clinic, black women's chances of having the tumors, of having larger tumors, and having them at a younger age are greater than women of other racial groups.

What Are Symptoms Of Uterine Fibroids?

Most uterine fibroids do not cause any symptoms, but some women with fibroids can experience:

• Heavy bleeding (which can be heavy enough to cause anemia) or painful periods
• Feeling of fullness in the pelvic area (lower stomach area)
• Enlargement of the lower abdomen
• Frequent urination
• Pain during sex
• Lower back pain
• Complications during pregnancy and labor, including a six-time greater risk of cesarean section
• Reproductive problems, such as infertility, which is very rare

For many years, Sandra Avelar suffered with steadily growing uterine fibroids. Symptoms such as heavy bleeding, painful cramps, back pain, abdominal pain, and eventually, bladder pressure led her to give serious consideration to the hysterectomy her gynecologist had recommended.

“A few times I was ready to go ahead with a hysterectomy, but I was so nervous about it, I never went through with it,” said Avelar. “Now, I’m very glad I didn’t.”

How Are Uterine Fibroids Detected?

Uterine fibroids are usually found during a routine pelvic exam, in which your doctor feels your abdomen to see if there are any unusual growths. If your uterus seems lumpy or its shape is irregular, you may have fibroids. An ultrasound exam, which creates a visual image of the uterus, can confirm that you have fibroids and map them for you.

How Are Uterine Fibroids Treated?

For many years, hysterectomy was the go-to solution for uterine fibroids, but that isn’t the case anymore.

“If you’re told you need a hysterectomy for your uterine fibroids, you shouldn’t be satisfied with that option,” said Franciscan Health interventional radiologist Saud Ahmed, MD. “A uterine fibroid embolization should be the first-line procedure because it’s minimally invasive with a fantastic success rate.”

Uterine fibroid embolization

According to Dr. Ahmed, data shows 90 percent of women have improved symptoms following a uterine fibroid embolization.

A uterine fibroid embolization is accomplished by inserting a catheter through a tiny, quarter-inch nick in the wrist or groin to gain access to the artery. The catheter is navigated to the fibroids’ blood supply, where it deposits microscopic “beads” that cut the blood supply to the fibroids while preserving the blood supply to the uterus.

Starving the fibroids of blood shrinks them and renders them inactive. In some cases, they disappear entirely.

Avelar’s gynecologist ultimately recommended that she see Dr. Ahmed to discuss having a uterine fibroid embolization. She agreed to the procedure and has no regrets. “It all went well. I feel like a brand-new person,” Avelar said.

Dr. Ahmed pointed out that, should a patient require surgery at some point after an embolization, that option remains open.

Surgical treatment of fibroids

Franciscan Health offers several surgical treatment options for uterine fibroids, including:

• Myomectomy: This minimally invasive robotic procedure removes uterine fibroids for women who find that symptoms are painfully interfering with their daily lives.
• Hysterectomy: Hysterectomies - the surgical removal of the uterus - are often recommended as a definitive solution for some gynecological conditions. These can be done many times as minimally invasive or robotic procedures.

If you are living with discomfort, pain, heavy bleeding or other symptoms of uterine fibroids, talk to your doctor about what treatment for fibroids is right for you.

Healthday News contributed information to this article.