Uterine fibroids, also called myomas, are among the most common benign (non-cancerous) tumors of women, and approximately 70% of all women will have fibroids by age 50. Fibroids grow under the influence of female sex hormones. The risk of fibroids increases among women who had their first menstrual bleeding at a young age, who have not given birth, who are overweight and who have fibroids in the family. Also, lifestyle factors may be involved. With menopause, fibroids tend to shrink in size.
What symptoms do fibroids cause?
Usually, fibroids are symptomless and do not need treatment or follow-up. But there are instances where fibroids cause symptoms that affect significantly the woman’s quality of life. The most common symptoms caused by fibroids are prolonged and excessive menstrual bleedings. The bleeding may result in anemia. Other possible symptoms are a feeling of pressure, symptoms related to passing of urine and stools and pain in the lower part of the abdomen. Occasionally, fibroids may make it difficult to become pregnant.
How are fibroids diagnosed?
Fibroids are identified by a physician during a pelvic exam – fibroids usually increase the size of the uterus. Small fibroids and especially fibroids that are located within the uterus can be seen only by intravaginal ultrasound.
How can fibroids be treated?
The traditional treatment of fibroids has been surgery. Over 30% of all hysterectomies (removal of the uterus) for benign reasons are made because of fibroids.
Fibroids and fibroid-related symptoms can also be treated without surgery. If the problem is excessive menstrual bleeding, this may be treated with traditional hormonal products (e.g., hormone-IUD) specifically designed for this purpose. Also newer drugs are available, such as ulipristal acetate, which acts through the progesterone receptor and is indicated for the treatment of fibroids.
The uterine blood vessels may be embolized by a radiologist. Local anesthesia is used and the artery in the groin (the femoral artery) is accessed. The radiologist injects small particles through a cannula whose tip is in the uterine artery. These particles clog the small branches of the uterine artery which bring blood to the fibroid, but when the artery is clogged, the fibroid gets neither blood nor oxygen and disintegrates. This procedure does not affect the uterine muscle to any significant extent.
MTI-HIFU (Magnetic Resonance guided High-Intensity Focused Ultrasound) is a modern, non-invasive form of therapy: ultrasonic energy is directed transcutaneously (from the skin of the abdomen) precisely at the fibroid tissue and this increases the temperature of the fibroid which then disintegrates. MRI-HIFU is administered as an office procedure and the patient recovers quickly – she can return to normal daily life within 1–2 days of the procedure.
Not all fibroids are the same and that is why they react to different therapies differently. The most important thing is to identify the therapy to treat symptomatic fibroids which is best suited and most effective for each individual patient.
At the Aura Klinikka, you can consult experts which are there for you to discuss the best option for treating fibroids.
