What are uterine fibroids?
Fibroids are a common gynaecological diagnosis, often misrepresented and can sometimes can be ignored. Fibroids are benign (non-cancerous) growths in the uterus which are very common, and most women who have them do not even realise it. In fact, two in five women in the UK suffer from the problem.
Most of the time they do not cause any problems, but women who have fibroids are troubled by symptoms such as heavy menstrual bleeding, abdominal pain, pressure on the abdomen and bladder problems. In rare instances, they can lead to problems with fertility and pregnancy.
How are the fibroids diagnosed?
Many experienced gynaecologists easily diagnose a fibroid during a pelvic examination. Regardless, the doctor will recommend an ultrasound to determine the size and location in the uterus and then follow its behaviour over time.
Two types of ultrasound scan can be used to help diagnose fibroids:
- An abdominal ultrasound scan – where the ultrasound probe is moved over the outside of your tummy (abdomen)
- A transvaginal ultrasound scan – where a small ultrasound probe is inserted into your vagina
How to treat fibroids
Because the growths are not cancerous and tend to grow slowly, you do not always have to get rid of them. However, if you are attempting to get pregnant or your symptoms are severe there are options. The issue of uterus-sparing treatments and surgery has become increasingly relevant with more women putting off child-bearing to their late thirties or early forties – when fibroids are more common and symptomatic.
Unlike a hysterectomy, which removes your entire uterus, a myomectomy removes only the fibroids and leaves your uterus intact. A myomectomy is an operation to remove fibroids, leaving the womb in place. It may be done through a cut in the tummy, or sometimes it may be possible to use keyhole surgery. Sometimes fibroid in the lining of the womb is removed to reduce heavy periods and also improve pregnancy outcome. This is done through a key hole via the neck of the womb
Women who undergo myomectomy report improvement in fibroid symptoms, including reduction in heavy menstrual bleeding and pelvic pressure. Drugs treatment may also be possible in women who wish to defer surgery or women approaching change.
A hysterectomy may be appropriate for a woman who has finished her family or does not want children, as it is the best way of preventing fibroids from coming back. However, it is the most severe course of treatment and would not be the answer for everyone.
Mr Fakokunde from Harley Street Fertility Clinic is a Consultant Gynaecologist whose clinical interests include the management of fibroids. For more information about treatments and to make an appointment with Mr Fakokunde call: 020 7436 6838.