Fibroids or uterine fibroids are non-cancerous tumours found on the inner layers of the uterine walls, often bringing about an anomaly in the size or shape of the uterus, and log with it several unpleasant symptoms. They can vary in size from a few millimetres to the size of a lemon. Nearly half the female population experiences fibroids at some stage of their lives, and more than 200,000 hysterectomies are performed in severe cases of fibroids. While some women complain of pain, changes in menstrual cycle and other complications, fibroids can just as often be symptomless. Since the presence of fibroids in the body is not always evident, it is advisable to get regular checkups and seek treatment at the right time.
While most fibroids are easily discoverable through routine pelvic exams and ultrasounds, doctors may sometimes order more detailed imaging studies like magnetic resonance imaging (MRI), hysterosonography, hysteroscopy, or hysterosalpingography when infertility is a possible concern. There is no single best approach to the treatment of fibroids once detected, but your physician will discuss your symptoms with you and suggest the best possible option. A few possibilities are:
Fibroids cannot be entirely eliminated using medication, but can greatly shrink them in size and relieve one of symptoms like pelvic pressure and heavy menstrual bleeding. These medications help shrink fibroids by blocking production of oestrogen and progesterone, which causes menstruation to temporarily stop and thus improves anaemia as well. Progestin-releasing intrauterine devices (IUD) do not cure fibroids but relieve heavy menstrual bleeding, and prevents pregnancy. Other options may include tranexamic acids and non steroidal anti-inflammatory drugs (NSAIDs).
This is an MRI-guided focussed ultrasound surgery (FUS) which does not require incisions and is performed inside an MRI scanner. Images direct the doctor towards the precise location of the fibroids, which are then heated and destroyed using an ultrasound transducer, which focuses sound waves (sonications) onto it. Since this is a relatively newer technology, there is uncertainty about effectiveness and long-term safety.
Minimally Invasive Procedures
Some procedures can successfully eliminate uterine fibroids without surgical incisions. Uterine artery embolisation is performed when small particles are injected into the arteries that supply blood to the uterus, stopping blood flow to the fibroids which cause them to become smaller and die. Myolysis is a technique that makes use of laparoscopic mechanisms, like radio frequencies, laser or minor electric currents to shrink and destroy fibroids. Hysteroscopic myomectomy may be an option if the fibroids are contained inside the uterus.
Traditional Surgical Procedures
Abdominal myomectomy is an option if multiple, large fibroids exist, which are removed in an open abdominal surgery. Hysterectomy is the only known permanent solution to uterine fibroids, which involves removal of the entire uterus. It is a major surgical procedure, and comes with long term consequences for the patient that undergoes the surgery.
Many women with uterine fibroids experience either mild symptoms, or none at all. They are not cancerous and do not interfere with pregnancies. Once a woman reaches menopause, fibroids have been known to shrink and disappear. Hence, for women with mild to negligent symptoms, watchful waiting can be the best possible option.