Fibroids are noncancerous growths that develop in the uterus that often appear during a women’s childbearing years. They can vary in size from very small and virtually undetectable to the human eye to large masses that can distort the uterus. You can also have just one fibroid or multiple fibroids. Most women will have uterine fibroids at one point in their lives, but may not know it since they do not experience any symptoms.

For those who do develop uterine fibroid symptoms, they may experience:

  • Pressure or pain in the pelvic region.
  • Heavy bleeding during menstruation.
  • Periods that last longer than a week.
  • A frequent need to urinate.
  • Difficulty emptying the bladder.
  • Constipation
  • Leg pains or backache.

While the exact cause of fibroids is not completely understood, it is believed to be caused by a number of factors such as genetic changes, hormones, extracellular matrix (ECM), and other growth factors.

DIAGNOSIS AND TREATMENT OF FIBROIDS

In many cases, uterine fibroids are discovered during a routine pelvic examination or during an ultrasound performed for another reason. If you are experiencing symptoms such as heavy menstrual bleeding, pelvic pain or pressure, frequent urination, or difficulty becoming pregnant, I will perform a thorough evaluation to determine whether fibroids are the cause. Depending on your symptoms, I may recommend additional tests such as a pelvic ultrasound, blood tests, MRI, or saline infusion sonography (hysterosonography) to accurately determine the size, number, and location of your fibroids and develop the most appropriate treatment plan.

The treatment I recommend will depend on several factors, including the severity of your symptoms, the size and location of your fibroids, your age, your overall health, and whether you wish to become pregnant in the future. The reassuring news is that uterine fibroids are almost always benign (non-cancerous) and many women with fibroids have healthy pregnancies. If your fibroids are not causing symptoms, I may simply recommend regular monitoring with periodic examinations and ultrasound scans to ensure they are not growing or causing problems. However, if your fibroids are affecting your quality of life, I will discuss the most appropriate treatment options with you, which may include medications, minimally invasive procedures, or surgery, depending on your individual needs.

MEDICATIONS

  • Pain Medications: Over-the-counter (OTC) pain medications such as ibuprofen or acetaminophen can be used to control discomfort caused by fibroids.
  • Birth Control: Birth control can be used to help manage heavy bleeding during and between periods and uncomfortable menstrual cramps. Birth control options include pills, intravaginal contraception, IUDs, and injections.
  • Gonadotropin-Releasing Hormone (GnRH) Agonists: These are medications available as a nasal spray or injection. They work by shrinking the size of your fibroids and are sometimes used to make fibroids smaller before removing them in surgery.
  • Oral Therapies: Oral therapies such as Tranexamic acid or Elagolix can be used to help ease heavy bleeding during your period. Dr. Krizzie can speak with you
    regarding the pros and cons of this therapy and if it is right for you.

SURGERY

  • MRI-guided Focused Ultrasound Surgery (FUS): This is a non-invasive treatment option to remove uterine fibroids without harming the uterus. It requires no incisions and is done on an outpatient basis. This procedure is performed while you are inside of an MRI scanner during which the exact location of your fibroids is targeted and destroyed using sound waves.
  • Myomectomy: During this procedure, your fibroids can be removed without harming the uterus. There are different kinds of myomectomy, and the one that is
    best for you will depend on the size, number, and location of your fibroids. This is often a good option for women who plan to become pregnant in the future.
  • Hysterectomy: If you are not planning on pregnancy in the future, a hysterectomy can be performed to remove your uterus.This option is the only way to completely cure fibroids.
  • Radiofrequency Ablation (RFA): This option uses radiofrequency to destroy the fibroids, and may be performed laparoscopically, or by transvaginal or transcervical means.