Learn more. Mindy Christianson, M. What are fibroids? Are they dangerous? Can they be removed? Should they be removed? First, take a deep breath. Fibroids are pretty common — between percent of women will develop fibroids during their reproductive years. Fibroids can cause complications like excessive bleeding and reproductive problems.
Johns Hopkins gynecologist Mindy Christianson, M. Uterine fibroids are benign, or noncancerous, fibrous growths that form in the uterus. They can grow on the outside of the uterus called subserosal fibroids , inside the muscle of the uterus called intramural fibroids , or into the uterine cavity called submucosal fibroids.
There are two types of procedures to do this:. In some cases, fibroids are severe enough to prevent a woman from becoming pregnant infertility.
If a woman is pregnant, fibroids can cause problems complications during pregnancy, labor and delivery. Since fibroids are controlled by hormone levels they grow rapidly during pregnancy. Hormone levels are high during pregnancy. If a woman is having heavy bleeding which could cause a low blood count, or is experiencing severe cramping, painful periods, infertility or bladder or bowel problems, she will need treatment.
Before deciding on a treatment, it is important to talk with your health care provider to get more information. Ask your health care provider:. If you need more information before deciding on a treatment, you can ask your health care provider to refer you to another doctor for a second opinion to be sure you are making the best decision. For occasional mild to moderate pain or discomfort, an over-the-counter medication such as ibuprofen or acetaminophen can be taken.
Over the counter nonsteroidal anti-inflammatory drugs NSAID , such as ibuprofen, if used during early pregnancy, may cause miscarriage. For symptoms of heavy bleeding, which can cause anemia, taking an iron supplement and an iron-rich diet can help to prevent anemia or treat anemia.
More serious symptoms may require stronger drugs available by prescription from your health care provider. Birth control pills oral contraceptives can be used to treat the bleeding symptoms of fibroids. Low-dose birth control pills or progesterone-like injections such as Depo-Provera do not make fibroids grow and can help control heavy bleeding. An intrauterine device IUD which contains a small amount of progesterone-like medication such as Mirena IUD can also control fibroid symptoms and provide birth control.
Some fibroids are treated with GnRHa, a hormone that reduces the amount of estrogen to shrink the fibroids and control symptoms. Sometimes GnRHa is used before surgery to make fibroids easier to remove. The side effects go away when the GnRHa is stopped, and once you stop taking the drugs the fibroids often grow back quickly.
Most women don't get a period when taking GnRHa. This can relieve the symptoms of heavy bleeding and improve the low blood count anemia which can happen with heavy bleeding. Since GnRHa can cause bone thinning, it is generally used for six months or less. Myomectomy is removing fibroids without taking out the uterus, which makes pregnancy possible for some women. A woman who has had a myomectomy can have problems with the placenta or can make a cesarean delivery more likely if she becomes pregnant.
Fibroids may also develop again, even after a myomectomy. Endometrial Ablation is when the lining of the uterus is removed or destroyed by using laser, wire loops, freezing or other methods to control very heavy bleeding. This procedure is usually considered minor surgery and can be done on an outpatient basis. A woman having this procedure will be unable to have children. Complications can occur, but are not common.
A hysterectomy an operation to remove the uterus womb. The only absolute cure for uterine fibroids is a hysterectomy. This procedure results in permanent infertility; a woman will be unable to have children.
A hysterectomy is major surgery. All of the possible risks of surgery listed above are the same for hysterectomy. Embolization is done with local anesthesia, and there are no incisions or cuts in the skin.
A thin flexible tube is threaded into the blood vessels that supply blood to the fibroid; a solution is then injected into the blood vessels. This blocks the blood supply to the fibroid, causing it to shrink.
Fibroids treated with embolization shrink by half or more. Normal uterine tissue usually remains unharmed, because it is supplied by other arteries. Pregnancy is possible after embolization, but the risks to pregnancy after embolization are not fully known.
Embolization is a procedure for women who do not want to have children in the future. It is important to note though that all women are different and treatment may vary. Only your health care provider can provide you with the best options to treat uterine fibroids. There are several new ways of destroying fibroid tissue or removing fibroids. These methods are not yet standard treatments so your health care provider may not offer them and your health insurance may not pay for them.
Fibroids do not need to be treated if they are not causing symptoms. Over time, they'll often shrink and disappear without treatment, particularly after the menopause. If you do have symptoms caused by fibroids, medicine to help relieve the symptoms will usually be recommended first.
There are also medications available to help shrink fibroids. If these prove ineffective, surgery or other, less invasive procedures may be recommended.
Page last reviewed: 17 September Next review due: 17 September Fibroids are non-cancerous growths that develop in or around the womb uterus. Many women are unaware they have fibroids because they do not have any symptoms.
The scope has a bright light and a camera. This allows the doctor to view the uterus and other organs on a monitor during the procedure. Pictures also can be made. Hysteroscopy hiss-tur-OSS-koh-pee — The doctor passes a long, thin scope with a light through the vagina and cervix into the uterus.
No incision is needed. The doctor can look inside the uterus for fibroids and other problems, such as polyps. A camera also can be used with the scope. What questions should I ask my doctor if I have fibroids? How many fibroids do I have? What size is my fibroid s? Where is my fibroid s located outer surface, inner surface, or in the wall of the uterus? Can I expect the fibroid s to grow larger? How rapidly have they grown if they were known about already?
How will I know if the fibroid s is growing larger? What problems can the fibroid s cause? What tests or imaging studies are best for keeping track of the growth of my fibroids? What are my treatment options if my fibroid s becomes a problem? What are your views on treating fibroids with a hysterectomy versus other types of treatments? How are fibroids treated? Some of these things include: Whether or not you are having symptoms from the fibroids If you might want to become pregnant in the future The size of the fibroids The location of the fibroids Your age and how close to menopause you might be If you have fibroids but do not have any symptoms, you may not need treatment.
Medications If you have fibroids and have mild symptoms, your doctor may suggest taking medication. Surgery If you have fibroids with moderate or severe symptoms, surgery may be the best way to treat them. Here are the options: Myomectomy meye-oh-MEK-tuh-mee — Surgery to remove fibroids without taking out the healthy tissue of the uterus. It is best for women who wish to have children after treatment for their fibroids or who wish to keep their uterus for other reasons.
You can become pregnant after myomectomy. But if your fibroids were imbedded deeply in the uterus, you might need a cesarean section to deliver. Myomectomy can be performed in many ways. It can be major surgery involving cutting into the abdomen or performed with laparoscopy or hysteroscopy. The type of surgery that can be done depends on the type, size, and location of the fibroids.
After myomectomy new fibroids can grow and cause trouble later. All of the possible risks of surgery are true for myomectomy. The risks depend on how extensive the surgery is.
Hysterectomy hiss-tur-EK-tuh-mee — Surgery to remove the uterus. This surgery is the only sure way to cure uterine fibroids. Fibroids are the most common reason that hysterectomy is performed. This surgery is used when a woman's fibroids are large, if she has heavy bleeding, is either near or past menopause, or does not want children.
If the fibroids are large, a woman may need a hysterectomy that involves cutting into the abdomen to remove the uterus. If the fibroids are smaller, the doctor may be able to reach the uterus through the vagina, instead of making a cut in the abdomen. In some cases hysterectomy can be performed through the laparoscope. Removal of the ovaries and the cervix at the time of hysterectomy is usually optional. Women whose ovaries are not removed do not go into menopause at the time of hysterectomy.
Hysterectomy is a major surgery. Although hysterectomy is usually quite safe, it does carry a significant risk of complications. Recovery from hysterectomy usually takes several weeks. This can be done with laser, wire loops, boiling water, electric current, microwaves, freezing, and other methods.
This procedure usually is considered minor surgery. It can be done on an outpatient basis or even in a doctor's office.
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