Uterine fibroids, which are benign growths in the uterus, affect millions of women worldwide and cause a variety of symptoms, including excessive menstrual bleeding, pelvic pain, and infertility issues to name a few. The good news is that while fibroids are a common cause for concern, there are effective treatment options available to help alleviate symptoms and enhance a woman’s quality of life.
Two of the most commonly suggested treatments for dealing with uterine fibroids are myomectomy and uterine fibroid embolization (UFE). Both procedures have the same goal of keeping the uterus while also treating symptoms caused by fibroids. Many women have questions about these two procedures and about their recovery including what to expect from their first period after a myomectomy or UFE.
This article takes a look at uterine fibroids, discussing the different treatment options like myomectomy and UFE, and how these procedures can affect your menstrual cycle afterward. Women need to know what to expect when it comes to changes in their menstrual cycle so they will know if what they are experiencing is normal and when they can expect to find relief from fibroid symptoms.
First, A Bit About The Different Types Of Fibroids
The type of treatment suggested by your doctor may be directly related to the type of fibroids you are dealing with. Three types of fibroids are classified by where they grow in the uterus.
- Intramural fibroids are the most common and grow within the muscular wall of the uterus (myometrium). They can cause the uterus to enlarge or change shape and create symptoms such as heavy menstrual bleeding, pelvic pain, and pressure. Often, these can be embedded deep inside the wall and difficult for a surgeon to access;
- Subserosal fibroids develop on the outer surface of the uterus, protruding outward. They can grow large and may cause pain and pressure on nearby organs, such as the bladder or bowel;
- Submucosal fibroids grow alone or in clusters just underneath the inner lining of the uterus (endometrium). They can cause significant menstrual bleeding and irregular bleeding and may contribute to pain and pressure symptoms as well.
Some fibroids may remain small and asymptomatic, while others can grow larger and cause more noticeable symptoms. It is also possible to have multiple types and sizes of fibroids at the same time. These variables will vary from woman to woman and can influence the type of treatment your doctor recommends.
An Overview Of Myomectomy vs Uterine Fibroid Embolization (UFE)
Unlike a hysterectomy, which involves the complete removal of the uterus, a myomectomy aims to preserve the uterus while addressing the symptoms caused by fibroids. It is a surgical treatment option for women who experience heavy menstrual bleeding, pelvic pain, fertility issues, etc. due to the presence of fibroids.
There are different types of myomectomy procedures, including abdominal, laparoscopic, and hysteroscopic, chosen based on the size, number, and location of the fibroids.
A laparoscopic myomectomy is the most commonly performed technique, is less invasive than an abdominal myomectomy, and uses several small incisions and specialized surgical instruments.
The patient is placed under general anesthesia, and incisions are made in the abdomen to insert a laparoscope (a thin, lighted tube with a camera) and surgical tools. The surgeon uses the laparoscope to visualize the fibroids and then removes them from the uterus one at a time. Once as many fibroids as possible can be removed, the uterus is repaired, and the incisions are closed with sutures.
A laparoscopic myomectomy can only remove specific types of fibroids, and an abdominal myomectomy may be necessary if the fibroids are large, numerous, or deeply embedded in the uterus. Sometimes, during the surgery, there may be a need to transition from a laparoscopic myomectomy to an abdominal myomectomy or, in some cases, a hysterectomy.
One of the drawbacks of the myomectomy procedure is that sometimes the surgeon is unable to remove the entire fibroid due to its location, and the fibroid continues to grow or reoccurs. Another issue is that often cutting large or hard-to-reach fibroids out leaves your uterus compromised (think of Swiss cheese). The uterus has to be stitched back together, but it is never the same. Most doctors will require a woman who has had a previous myomectomy to deliver a baby via C-section because they are concerned the uterus will be unable to function properly during a vaginal delivery.
Uterine Fibroid Embolization
Uterine Fibroid Embolization (UFE), also known as Uterine Artery Embolization (UAE), is a minimally invasive, non-surgical procedure used to treat uterine fibroids. It is an effective and appealing alternative to traditional surgical methods like myomectomy or hysterectomy and offers several benefits for women seeking symptom relief without compromising their uterus or exposure to the risks and recovery associated with surgery.
An interventional radiologist performs the UFE procedure, typically in a specialized radiology suite. The patient is given local anesthesia to numb the area around the groin, where a small incision is made to access the femoral artery. Using this incision, a catheter is threaded into the uterine arteries that supply blood to the fibroids. Tiny microspheres are injected through the catheter into these arteries, blocking blood flow to the fibroids. Deprived of their blood supply, the fibroids die and become smaller leading to significant symptom improvement.
Recovery After Myomectomy And UFE
The recovery time following a myomectomy can differ based on the specific type of procedure performed (abdominal, laparoscopic, or hysteroscopic) and individual factors such as the size and number of fibroids removed, the patient’s overall health, and any potential complications that may occur during or after the surgery. Patients may stay in the hospital for 1 to 3 days, and recovery times run on average from four to six weeks.
Patients who undergo UFE can expect to be released the same day to recover comfortably at home. Most women return to their normal routine within a week.
Uterine Fibroid Embolization is a safe and effective treatment option for women experiencing symptoms related to uterine fibroids without the need for invasive surgery, offering a quicker recovery and preservation of the integrity of the uterus. Many women have delivered babies vaginally after the UFE procedure.
Is The First Period After Myomectomy Painful?
A woman’s first period after a myomectomy can vary depending on several factors, including the extent of the surgery, the size and location of the removed fibroids, their overall health, and where they are in the healing process when menstruation starts.
Generally, the first menstrual cycle after a myomectomy will be different from regular periods and may involve the following factors:
- Heavier Bleeding: Some women experience heavier bleeding during their first period after a myomectomy. This is because the procedure involves removing fibroids from the uterine wall, and the not-yet-fully healed tissue may cause additional blood flow during menstruation;
- More Discomfort: The first period after myomectomy may last as long as six weeks. It may be more painful and accompanied by more significant discomfort or cramping compared to regular periods. The uterine lining has been dissected and stitched back up and needs to heal, which can create temporary changes in menstrual symptoms and is the reason why the first period after a myomectomy is heavy and painful;
- Irregular Cycles: In some cases, women may experience irregular menstrual cycles during the initial months after a myomectomy. This irregularity is usually temporary and should stabilize over time. As their bodies continue to heal and adjust after the surgery, subsequent menstrual cycles are more likely to return to a more normal pattern;
- Improved Symptoms: On a positive note, many women notice improvements in their menstrual symptoms after a myomectomy, especially if heavy bleeding and pelvic pain are associated with the presence of fibroids.
A woman on the HysterSisters online forum posted her experience after a myomectomy because she mistakenly thought that once she had her myomectomy, her periods would improve immediately. Here is her story.
Another woman shared her post-myomectomy story, saying that after having a myomectomy, her fibroids returned. She described her symptoms as “horrendous, with massive, heavy bleeding that even soaked through a double barrier of a maxi-pad and a tampon. She needed to seek treatment, but she knew another surgical myomectomy was not going to help. She happened to hear about UFE while at work one day, and she had no idea what it was or that it was an option for the treatment of fibroids. She chose to undergo the UFE procedure, and she is delighted with the results one month later! She is aware that it will take time for the fibroids to entirely shrink, but she is already experiencing less pain, a lighter menstrual flow, and no clots.
What Will My First Period After The UFE Procedure Be Like?
After a UFE procedure, it is common for women to experience changes in their menstrual cycle, although the specific changes vary from person to person. Some women may notice changes in the timing, duration, and intensity of their periods, but the first cycle after UFE is a “wild card” because everyone is different.
Here are some possible scenarios you may encounter during your first period after UFE:
- Delayed Period: It’s possible that your first period after the UFE procedure may be delayed. This is because the body needs some time to adjust to the changes in the uterus caused by the procedure. Also, the timing of where you were in your cycle when the procedure was performed can influence when your next cycle will start;
- Lighter or Heavier Bleeding: Some women may experience lighter periods after UFE, while others may experience heavier bleeding; however, any heavy bleeding should resolve within the first three months following the procedure;
- Irregular Periods: Your menstrual cycle may become irregular initially, with variations in the length of the cycle and the amount of bleeding, but should resolve within a few months to be more in line with what is considered “normal”;
- Changes In Menstrual Symptoms: You should notice significant changes in the severity of your symptoms, such as heavy bleeding, pain, pressure, excessive cramping, bloating, etc;
- Pain And Bloating Will Improve: Once the blood supply to the fibroids gets cut off, they will begin to shrink, alleviating the excess pressure being exerted on other organs and nerves. Frequent urination issues should be resolved, as should back and leg pain, pain during sex, etc. Large fibroids that were creating uterine distention should reduce significantly in the first few months, so you no longer appear pregnant.
After UFE, patients should wait at least 2 weeks before having intercourse and 3-6 months before trying to conceive. This will give your body adequate time to heal and your reproductive system time to be fully functional before giving it such an important job to do.
Most women will experience significant changes in their menstrual cycle after a UFE procedure or undergoing a myomectomy. It is important to speak to your healthcare professional, ask questions, and learn all you can about the procedure they are proposing as a treatment for your fibroids.
If you have fibroids and are suffering every month or even in between menstrual cycles with debilitating fibroid symptoms, contact the Atlanta Fibroid Center today. For over thirty years, the experts at AFC have helped women from all walks of life gain freedom from being held hostage by heavy bleeding, pain, and other life-ruining fibroid symptoms.
As early as your first period after UFE, you can find relief from these terrible symptoms. This 45-minute outpatient procedure has been proven safe and effective for most women. Contact The Atlanta Fibroid Center Today for an appointment to learn more!