In 1961, the famous theatrical composing duo of Rodgers and Hammerstein wrote a song called “I enjoy being a girl” for their new Broadway musical. While it has some cute but somewhat outdated lyrics and the musical was a hit, not all females are thrilled with all that goes along with being a girl!
Many experience the onset of their menstrual cycle as early as 10 years old, and then as they get older, they encounter heavy and prolonged bleeding, pain, and other uncomfortable symptoms. The unfortunate thing is that they do not know that the symptoms they are experiencing are not normal, so they do not seek medical treatment.
Today we are going to talk about one of the main sources that create these types of symptoms, uterine fibroids, and four key steps they should take if they suspect they might have them.
What Is A Uterine Fibroid?
A fibroid is a non-cancerous growth that can develop in or on the uterus. They can grow deeply embedded in the walls of the uterus or grow from a stalk-like structure. A woman can have one fibroid or numerous fibroids, and she may be experiencing symptoms or may not even know she has fibroids.
There is no single known cause of uterine fibroids, but research has shown definite associations between certain contributing factors and a woman’s risk of experiencing fibroids, such as exposure to excess estrogen, ethnicity, obesity, vitamin D deficiency, diet, etc.
Symptoms That Are Often Associated With Fibroids
Historically, women did not initiate conversations about their periods, how much they were bleeding, etc. Thankfully, more women have been stepping up and sharing their experience with uterine fibroids, and they are helping to educate other women on what is and is not normal to experience during their monthly menstrual cycle.
Uterine fibroids have symptoms that are both direct and indirect. Some of the more well-known symptoms include:
- Heavy bleeding;
- Excessively long periods;
- Breakthrough bleeding;
- Pelvic pain and pressure.
Some lesser-known symptoms include:
- Pain during sex;
- Fertility Issues;
- Back or leg pain;
- Nausea, vomiting, or constipation during your period;
- Severe fatigue, dizziness, weakness, or an irregular heartbeat are symptoms associated with anemia.
Some women have such severe symptoms caused by uterine fibroids that their quality of life is significantly diminished. A well-known celebrity from the popular reality show Real Housewives of Atlanta had several instances where her fibroids threatened her social engagements, relationships, and career. The media even incorrectly started a rumor that she may be pregnant because her fibroids were causing her belly to protrude.
As you learn more about uterine fibroids and their associated symptoms, you may begin to notice some that look familiar. If you suspect that you have fibroids, there are four basic steps you can take to get the help you need.
Where To Start If You Are Experiencing Symptoms
Step 1 – Determine If Your Symptoms Are Fibroid-Related
The first step in the treatment of fibroids and getting relief for your symptoms is to find out exactly what is causing them. There are numerous conditions that share some of the same symptoms as fibroids, so determining the underlying cause is critical.
Sometimes fibroids are discovered during a routine pelvic exam, and other times they are found to be the culprits of undesirable side effects through different imaging tests. An MRI is usually the most accurate test and also allows the doctor to get a clearer understanding of the underlying cause of the symptom so they can better treat it. An MRI will show the location, size, and number of fibroids present, which will enable the doctor to select the best plan of treatment.
For instance, if a woman has been experiencing back pain or pain shooting down her leg, the MRI may confirm a large fibroid located on the back of the uterus that is exerting pressure and causing symptoms very similar to sciatica.
If fibroids are confirmed, then it is time to move on to step two, which begins your quest to alleviate the symptoms of fibroids.
Step 2 – Choose To Slow Down The Growth Of The Fibroids Or Eliminate Them
A woman’s decision on what, if any, action to take in how to treat fibroid tumors is usually influenced by the size, location, and a number of fibroid tumors present. There are basically three avenues in the approach to dealing with fibroids.
- Watch and wait;
- Actively attempt to slow fibroid growth;
- Eliminate the fibroids.
For instance, if the fibroids were discovered during a routine pelvic exam but are not causing any current issues, many OB-GYNs will take a “watch and wait” approach. The doctor may advise the woman that there is nothing they need to worry about now and to let them know if anything changes. However, this may not be the best course of action.
Fibroids will not go away on their own, but they are dependent on a few things to live and grow. Research has proven that fibroids grow larger when exposed to sources of estrogen, which is the main reason that women who are pregnant often experience rapid fibroid growth in the first or second trimester.
Many beauty products and things we use routinely every day contain elements that mimic the naturally occurring estrogen in our bodies and will impact fibroid growth. Avoiding excess estrogen sources can sometimes help prevent existing fibroids from growing larger.
Additionally, there are dietary choices we can make and exercise that can help keep fibroids at bay or even cause them to shrink, such as green tea extract. If you have been told to watch and wait, it would be wise to deliberately make lifestyle changes and do all you can to prevent or slow down fibroid growth because they will not begin to subside until menopause (if then).
If you are experiencing fibroid symptoms that are interfering with your daily life, the only way for you to find long-lasting relief is to eliminate the fibroids. Step 3 is all about choosing the type of treatment that will be used.
Step 3 – Choose The Type Of Treatment
Once you have decided that you would like to evict these unwanted fibroids, you have a couple of options for treatment. The unfortunate thing is that not all women are made aware of all of their options or are offered treatments that are only temporary solutions designed to alleviate some of their symptoms.
Myomectomy and hysterectomy are the two most common procedures offered to women who seek treatment for fibroid symptoms. Approximately 600,000 hysterectomies and 65,000 myomectomies are performed annually in the United States. Only 10% of the hysterectomies that are performed each year are medically necessary for reasons such as uterine cancer.
- A hysterectomy is a surgical procedure in which a woman’s uterus is removed. Generally, a hysterectomy is performed under general anesthesia and requires hospitalization and an extended recovery time.
During a hysterectomy, the uterus and sometimes other reproductive organs such as the ovaries, cervix, and fallopian tubes may be removed. Premenopausal women who have a hysterectomy lose the ability to have children and may experience a rise in the risk of cardiovascular disease, stroke, and other health problems in the long run.
- A myomectomy is a procedure performed by a gynecologist to remove fibroids one by one. Myomectomies are performed using a variety of methods, but they all have the potential to weaken and jeopardize the uterus. A C-section is almost always required for a woman who becomes pregnant following a myomectomy.
Scarring of the uterus can have an impact on fertility, and many women experience a recurrence of fibroids within a few years of undergoing a myomectomy. Another drawback of a myomectomy is that it may be impossible for the surgeon to eliminate all of the fibroid tumors, as some may be deeply embedded or difficult to find during the surgery.
A myomectomy is performed under general anesthesia and usually necessitates a hospital stay of 2 to 5 days, depending on the extent of the surgery and the number of fibroids removed.
- Uterine Ablation
- Uterine ablation also called endometrial ablation, is sometimes suggested as a treatment for women who are experiencing heavy bleeding during their periods. It is not an effective treatment for fibroids as it only treats the surface of fibroids along the uterine lining. Fibroids will not be eliminated completely, which leads to early recurrence of heavy bleeding and other symptoms as the fibroids continue to grow.
Since uterine ablation destroys the lining of the uterus, it is not for women who desire to have children in the future. It may also eliminate all future bleeding during menstruation for some women. Studies have shown that many women who undergo uterine ablation procedures require a hysterectomy within 8 years.
There are various techniques used to destroy the endometrium, including scorching it with heated fluid, freezing it with extreme cold, using microwave energy, radiofrequency, etc.
The women who opt for this treatment most often feel it is their only choice for relief from heavy bleeding. They may have tried and exhausted the medications that are made for temporary use and wish to avoid a hysterectomy or myomectomy. Most do not understand the side effects.
- Non-Surgical Uterine Fibroid Embolization (UFE)
- If you were informed that there was an outpatient procedure that does not require surgery or a hospital stay, has a recovery time of about a week, and has been proven effective in treating even deeply embedded fibroids, wouldn’t you choose to try it first before pursuing other more invasive options?
If you are like most women, you answered yes to this question and are probably wondering why so many women are still choosing myomectomies or hysterectomies. The truth is, they have probably never heard of UFE even though it has been around for almost three decades.
The majority of women are diagnosed with fibroid tumors at their OB-GYN’s office, where doctors are trained to treat fibroid tumors with medications and/or surgery. These medications can lead to other unpleasant side effects and therefore cannot be used long-term.
The UFE procedure is performed by interventional radiologists with extensive training in vascular procedures. It takes about 45 minutes to complete and blocks the blood supply that the fibroids need to live and grow. As they die, they begin to shrink, thereby eliminating the symptoms they were causing. This procedure can reach any fibroids that are attached to the uterine blood supply, no matter where they are located or their size. Patients are discharged the same day with only a bandaid as proof they even had UFE.
Step 4 – Select A Doctor To Carry Out The Desired Treatment
When you select a medical professional to perform any type of surgery or medical procedure, you want to have the assurance that you are in good hands and they know what they are doing. After deciding on the type of treatment you want to undergo to relieve your fibroid symptoms, the next most important decision is who will perform it.
To ensure your UFE procedure is done safely and delivers the results you want, it is critical that you choose a doctor who is expertly skilled and has a great deal of experience performing the procedure.
UFE is not a surgical procedure and is not done by an OB-GYN, it is performed by interventional radiologists like Dr. Lipman and Dr. Ermentrout from The Atlanta Fibroid Center. Dr. Lipman is a pioneer in the field of uterine fibroid embolization and is one of the world’s leading experts on the procedure. Over the past two-plus decades, he has helped thousands of women become fibroid-free and regain their quality of life.
If you are experiencing fibroid symptoms, contact the Atlanta Fibroid Center for help. Dr. John Lipman and Dr. Mitchell Ermentrout are ready to answer your questions and address your concerns. If you have been diagnosed with fibroids, we are here to help. Please come visit with us before you choose a more invasive route. We have your best interest in mind, and we want you to live fibroid-free but still have your uterus!