Uterine Fibroids - Different Ways They Can Be Treated & Surgeries That Can Help!

A Fibroid is a non cancerous (benign) growth of the womb (uterus). They are also called myomas, fibromyomas or leiomyomas. Their size varies from a size of a pea to as big as a melon. They can increase (like in pregnancy) or decrease with time (like after the menopause) and even go away. It is important to understand that a large number of fibroids are asymptomatic and do not require treatment. Also many times especially in India surgeries like hysterectomies are performed without any valid reason or proof for doing so. 

Symptoms 

Most women with fibroid are not aware that they have them as they do not have any symptoms. Sometimes one is found during a routine examination or during a scan. Few of the common symptoms are heavy or more painful periods, bloating or swelling, increased frequency of urine, constipation, pain during sexual intercourse. 

Fibroid treatments Observation – If your fibroids are not causing any symptoms then treatment is not needed. After menopause they would shrink anyways 

Medication to improve symptoms – Medications like Tranexemic acid, combined oral contraceptive pills and progesterones may be used in selected cases. 

LNG – IUS- The levonorgestrel intrauterine system a plastic device that sits inside the womb and releases a regular small amount of progesterone may help some women 

Medication to shrink the fibroid – Some women are given a gonadotrophin-releasing hormone (GnRH) analogue. This hormone medicine causes a very low level of oestrogen in your body and thus shrinks the fibroid. However, they are expensive and cause symptoms similar to menopause and increase the risk of thinning the bones (osteoporosis). 

Surgery and other operative treatments-

1. Hysterectomy: It means removal of the womb. This can be done through a bikini line scar in lower tummy or keyhole (laparoscopic) surgery.
2. Myomectomy: In this operation the fibroid is removed and the womb is left. This is done especially in women who wish to have children in future. 
3. Uterine artery embolization: This procedure is done by a specially trained X ray doctor (radiologist). It is done by putting a substance that blocks the artery that the supplies the fibroid. This procedure can be done in selected case with variable success. 
4. Myolysis: This means shrinking the fibroid in some way surgically. This is done by endometrial ablation (Removal the lining of the womb by using laser energy or a heated wire loop or a microwave heating).