December 9, 2024
What are Fibroids?
Fibroids are small, non-cancerous growths in the uterus. They can grow in a single node (that is, by themselves) or in a group. They usually grow to between 1mm and 20cm in size, and the diameter and location is often a determining factor in whether they are asymptomatic or not.
Fibroids can present with a number of symptoms, varying in severity. They include:
- Pelvic pain that doesn't go away
- Heavier than normal periods
- Painful periods
- Spotting or bleeding between periods
- Difficulty emptying your bladder
Diagnosing Fibroids
Before we can treat, we need to diagnose and understand your individual circumstances. When it comes to diagnosing, there are a few tests that can be performed:
- Ultrasound – While ultrasounds are useful for detecting abnormal growths in the uterus, they often have trouble differentiating uterine fibroids from other gynecological conditions (such as adenomyosis).
- MRI – MRI scans are used to give the full picture in regards to your uterine fibroids. This helps us to determine whether they’re best managed through medication, surgery, or embolisation.
- Hysteroscopy – This procedure uses a small camera to examine the inside of the uterus and look for abnormalities.
Treatment Options for Fibroids
When it comes to treating fibroids, there are a few options but the best choice for you really comes down to your symptoms and how much your day is disrupted. Let’s look further at the different treatment options available.
Medication
Certain medications can be taken to help shrink fibroids and reduce the severity of symptoms, but you can’t ‘cure’ or remove fibroids with medication. Most medications work by targeting hormones that regulate your menstrual cycle.
Gonadotropin-releasing hormone (GnRH) agonists
These block production of estrogen and progesterone, putting women in a temporary menopause-like state. They will stop your menstruation, helping shrink your fibroids and reduce symptoms. They can be prescribed to treat your symptoms, or in conjunction with other treatment options, such as uterine fibroid embolisation, or even help your transition to menopause.
Progestin-releasing intrauterine device (IUD)
A progestin-releasing IUD can relieve heavy bleeding caused by fibroids. A progestin-releasing IUD It provides symptom relief only and doesn't shrink fibroids or make them disappear. This treatment option also prevents pregnancy, making it unsuitable/undesirable for some sufferers.
Pain relief and other medication
Oral contraceptives (i.e. the pill) can stop bleeding and reduce pain, but like a progestin-releasing IUD, won’t shrink fibroids. The same applies to nonsteroidal anti-inflammatory drugs (NSAIDs), which are not hormonal medications and only treat the symptoms, not the cause.
Natural Treatments
For many women, making lifestyle changes, such as adding and removing certain foods from their diet, exercising more and losing weight, or trying new supplements can help them better manage their symptoms and improve their quality of life. Discover more about natural treatments for fibroids here.
Surgical Treatment
If treating the condition, and not just the symptoms, is an option you are exploring, there are a number of surgical procedures available to you.
Myomectomy
A myomectomy is a surgical procedure that removes fibroids while leaving the uterus intact. It can be done in a number of ways: abdominal myomectomy, laparoscopic myomectomy, or hysteroscopic myomectomy.
An abdominal myomectomy is an open abdominal surgical procedure to remove the fibroids. A large incision is made across the abdomen, usually just above the bikini line. It’s usually a horizontal incision, but can sometimes be vertical. The uterus is then cut, often with a laser, and the fibroids are removed.
Abdominal myomectomies are used when sufferers have large fibroids, they are located deep in the uterus, or if they have a large number of fibroids. While an abdominal myomectomy can remove the fibroids and leaves the uterus in place (unlike a hysterectomy) there is still a chance the procedure can impact future fertility.
A laparoscopic myomectomy, sometimes known as keyhole surgery, involves a small incision through which a camera (a laparoscope )is passed.
A hysteroscopic myomectomy involves removing the fibroids through the cervix, so no incision is required.
Hysterectomy
A hysterectomy involves complete removal of the uterus. While this approach remains the only way to completely remove fibroids, and eliminate any chance of them returning, it also prevents pregnancy and brings on menopause.
Interestingly, 8 percent of women who had a hysterectomy did not report any improvement in symptoms, according to a Maryland Women's Health Study in 2000, and another study found that women developed entirely new symptoms such as hot flushes, weight gain and depression.
Minimally Invasive Treatment
Medication and surgery are not the only ways to treat fibroids, there are minimally invasive ways that remove fibroids and avoid the serious side effects of surgery.
Uterine Fibroid Embolisation
Uterine fibroid embolisation (UFE) is a minimally-invasive, image-guided alternative to the invasive surgical procedures used to remove uterine fibroids.
UFE has been used to treat uterine fibroids for over 20 years and has an established role in the management of symptomatic fibroids. It has been shown to reduce symptoms and provide lasting results in up to 95% of cases and is approved by Medicare.
This is a complex procedure that can only be performed by a specialist interventional radiologist with expertise in the area.
The below video, from Fairfax Radiology, explains the procedure in more detail:
If you’re interested in treating your fibroids with a minimally invasive procedure, learn more about uterine fibroid embolisation and how Northern Beaches Interventional Radiology can help improve your quality of life.
Radiofrequency ablation
Radiofrequency energy destroys fibroids and the blood vessels that feed them. This can be done during a laparoscopic (Lap-RFA or Acessa) or transcervical (Sonata) procedure.
A Lap-RFA involves a small incision in the abdomen and a laparoscope (viewing instrument) is inserted with a small camera in the tip. This guides the doctor to help find the fibroids, at which point they are heated up and destroyed. Over the next 3-12 months the fibroids shrink and symptoms are relieved.
Recovery is good since there is no cutting of uterine tissue and many women are back to regular activities after a week.
Endometrial ablation
This treatment reduces abnormal bleeding and is done through a combination of heat, microwave energy, hot water, and electric current to destroy the lining of the uterus.
Pregnancy is unlikely to occur following endometrial ablation and is a factor that must be considered during your choice of treatment option.
Take Control of Your Fibroids Treatment
Fibroids can lead to pain and discomfort, can reduce your quality of life and can even have an impact on fertility. Thankfully, there are multiple treatment options available to women suffering the symptoms of fibroids. At Northern Beaches Interventional Radiology, we specialise in treating fibroids with a minimally invasive procedure known as Uterine Fibroid Embolisation. Book a consult today to discuss your treatment plan.
