Do all fibroids need to be removed?

Fibroids are small growths in the uterus, and the condition is so common that around 1 in 3 women develops them at some point in their life. In many cases, fibroids don’t need to be removed, and they often shrink over time, especially after menopause. Many women only detect by chance that they have uterine fibroids during a routine checkup. However, once you know that you have fibroids, you might be anxious, especially for women of childbearing age who may have concerns about the possible effects on their fertility.

In this article, Dr Deepika Aggarwal, lead consultant Obstetrician and Gynaecologist at CK Birla Hospital, will discuss what fibroids are and what causes them? She will also discuss different options for fibroid removal surgery and what are the different conditions when you need treatment?

What are fibroids?

Fibroids are common, but it is difficult for doctors to determine who has them because not everyone has symptoms. According to various estimates, fibroids can affect between 20-80% of the female population under the age of 50.

Although fibroids can sometimes grow to a larger size, they are often very small. Many people with fibroids don’t know they have them. People with asymptomatic fibroids should consult with doctors for a better understanding of their fibroids. 

 Who is at risk for fibroids?

Several factors are responsible for your chances of developing fibroids, including:

• Obesity 
• Family history of fibroids
• Getting period at a young age
• Late menopause
• Not having children

How are fibroids diagnosed?

Fibroids are diagnosed during a regular health check-up by doctors. These fibroids can also be observed during a gynecologic exam, a pelvic exam, or prenatal care. Sometimes heavy bleeding and other symptoms related to fibroids may alert your doctor to examine fibroids as a part of the diagnosis. With the help of different tests, a doctor may confirm fibroids, and these tests are:

• Ultrasonography: It is a non-invasive imaging test that creates an image of the internal organs by using sound waves. Depending on the size of the uterus, the ultrasound can perform through transabdominal or transvaginal.
• Magnetic resonance imaging (MRI): MRI creates detailed images of the internal organs with the help of magnets and radio waves.
• Computed tomography (CT): X-ray images are used to produce a detailed image of the internal organs.
• Hysteroscopy: In this procedure, your doctor will use a thin, flexible tube with a camera to look at fibroids inside the uterus. 
• Hysterosalpingography (HSG): This is the process of detailed X-ray. First, a contrast material is injected and then X-rays of the uterus are taken. 
• Sonohysterography: A doctor uses a small catheter that is placed into the uterine cavity transvaginally to create a clearer image of the uterus.
• Laparoscopy: A doctor will do a small incision in the lower abdomen. After the incision, a thin and flexible tube with a camera is inserted to look at the internal organs.

What are the symptoms of fibroids?

Although people with no symptoms sometimes do not require any surgery, some show symptoms and these individuals may require surgery. Following are some of the symptoms of fibroids, including-

• Abdominal pain
• Abdominal pressure
• Bloating
• Pain during sexual intercourse
• Frequent urination
• Heavy or painful periods
• Low back pain
• Chronic vaginal discharge

You should consult your doctor if you experience any kind of discomfort or pain. Fibroids are treatable, and with the help of treatment, your symptoms can be improved.

What are the different types of fibroids?

There are mainly four types of fibroids found in the uterus-

1. Intramural fibroids: These are the most common fibroid type. These fibroids develop within the muscular wall of the uterus and can grow larger by stretching the womb.
2. Subserosal fibroids: These formed on the outside of the uterus (known as a serosa). These fibroids may grow large making one side of your womb bigger.
3. Pedunculated fibroids: These fibroids are connected to the uterine wall by a stalk-like growth called a peduncle.
4. Submucosal fibroids: These types of tumours develop in the middle of the myometrium of the uterus. These fibroids are not as common as the other types.

What are the options for fibroid treatment?

Your doctor will create a treatment plan for you after taking into consideration your medical history, your age, and the size of fibroids. A doctor may also suggest a combination of treatments for you. 

• Medications

A doctor may prescribe you different medications to regulate your hormone levels and shrink fibroids.

• Surgeries

Traditional surgical procedures involve:

Abdominal myomectomy

If you have multiple fibroids, very deep fibroids, or large fibroids, the doctor may do open abdominal surgery to remove the fibroids. The scars after the abdominal surgery can affect future fertility.

Hysterectomy

This surgery is performed to remove the uterus, the only permanent solution for fibroids. Hysterectomy is major surgery, and it may affect your fertility. 

Uterine fibroid embolization

In this procedure, the doctor will put a small catheter in the uterine artery or radial artery. This small catheter will help in blocking the flow of blood from the uterine artery to the fibroids. The loss of blood flow will automatically shrink the fibroids and will improve your fibroids symptoms.

Radiofrequency ablation (RFA)

RFA is a safe and effective treatment option for women with symptomatic fibroids. RFA can deliver through transvaginal, transcervical, or laparoscopic approaches.

Do all fibroids need to be removed?

Not everyone with fibroids needs surgery. In most cases, people with no symptoms of fibroids can consult with a doctor to know the need for any treatment. Try not to leave these fibroids untreated. In some cases of fibroids, a doctor can treat it successfully with medication, such as hormonal birth control pills. The doctor may also suggest pain relievers and other management strategies to ease fibroid symptoms. After menopause, fibroids can shrink or disappear by themselves, so women nearing menopause having no severe symptoms may opt to postpone treatment after doctors’ consultation. 

Outlook

Fibroids surgery can be a life-changing step for women whose fibroids and their symptoms are conflicting with their quality of life. Surgeries can improve many aspects of a woman’s health and life. For any information regarding uterine fibroids, you can book your appointment or call at +91 124 4882248.

FAQs

1. Can fibroids be prevented?

In general, you can not prevent fibroids, but you can reduce the risk of having fibroids by maintaining healthy body weight and getting regular pelvic examinations.

Ques 2. Can I get pregnant if I have uterine fibroids?

Ans. Yes, you can get pregnant if you have uterine fibroids. Before planning pregnancy, you can go for pelvic examinations and other health check-ups. If you are diagnosed with fibroids, your doctor will suggest to you how to move forward by a monitoring plan for the fibroids. In some cases, fibroids can trigger infertility, and it can be difficult to point out the exact cause of infertility. But women with fibroids can become pregnant after receiving proper fibroid treatment.

Ques 3. What are the home remedies and natural treatments for fibroids?

Ans. There are some home remedies, and natural treatments for fibroids, including:

• Acupuncture
• Yoga
• Massage
• Using heat for cramps (avoid heat if you are experiencing heavy bleeding)
• Dietary changes
• Maintaining stress levels
• Maintaining healthy body weight

Ques 4. What are the benefits of fibroid removal surgery?

Ans. The benefits of fibroid removal surgery depend on the type of surgery, and it may vary from person to person. In hysterectomy surgery, fibroids will never grow back. Some possible benefits are relief from pain and reduced bleeding.