Fibroid Treatment

Uterine fibroids, also known as leiomyomas, are benign growths composed of muscle and tissue that develop within or on the uterine wall. These growths, the most prevalent noncancerous tumors in women and individuals assigned female at birth (AFAB), may manifest in various symptoms such as pelvic pain and excessive or irregular menstrual bleeding. 

While some individuals remain asymptomatic, others experience discomfort and are often unaware of the presence of fibroids. Treatment options for fibroids, ranging from medications to surgical intervention, are typically tailored to address specific symptoms.

Different Types of uterine fibroids

Types of uterine fibroids vary based on their location and attachment within the uterus. These include:

• Intramural fibroids: Embedded within the muscular wall of the uterus, they are the most prevalent type.

• Submucosal fibroids: Growing beneath the inner lining of the uterus.

• Subserosal fibroids: Developing under the outer lining of the uterus, potentially growing large and extending into the pelvis.

• Pedunculated fibroids: Rare and characterized by attachment to the uterus via a stalk or stem, often likened to mushrooms due to their structure with a narrower stalk and wider top.

How is Uterine Fibroid diagnosed?

Diagnosis of uterine fibroids typically begins with a pelvic exam, where irregular changes in the shape of the uterus may indicate their presence. If symptoms are present, further diagnostic tests may be necessary, including:

• Ultrasound: Utilizing sound waves, ultrasound imaging can confirm the presence of fibroids and provide detailed mapping and measurements. This can be done externally (transabdominal ultrasound) or internally via the vagina (transvaginal ultrasound).
• Lab tests: For individuals experiencing irregular menstrual bleeding, blood tests may be conducted to identify potential underlying causes. These tests may include a complete blood count to assess for anemia resulting from blood loss, as well as screenings for bleeding disorders or thyroid abnormalities.

The complications of Fibroid 

Complications from uterine fibroids are typically not severe, but may include:

• Excessive bleeding during menstruation.
• Persistent, severe pain.
• Difficulty to conceive 
• Swelling in the abdomen or pelvic region
• Anemia resulting from prolonged blood loss.

How are uterine fibroids Treated?

Treatment options for uterine fibroids depend on factors such as size, number, location, and associated symptoms. If symptoms are absent or mild, monitoring with pelvic exams or ultrasounds may suffice. However, symptomatic fibroids necessitate treatment, considering factors like fertility goals and desire to retain the uterus. Treatment options include:

Medications:

• Over-the-counter pain relievers like acetaminophen or ibuprofen.
• Non-hormonal therapies like tranexamic acid for heavy bleeding
• Birth control methods to manage bleeding and cramps.
• Gonadotropin-releasing hormone (GnRH) agonists to shrink fibroids temporarily.
• Iron supplements for anemia

Fibroid Surgery:

• Myomectomy, which removes fibroids while preserving the uterus, with options like hysteroscopy, laparoscopy, or laparotomy.
• For those not seeking future pregnancies, options such as hysterectomy (removing the uterus) or uterine fibroid embolization (blocking blood flow to fibroids) may be considered.
• Radiofrequency ablation (RFA) is a minimally invasive option using microwave energy for smaller fibroids.