Myoma or leiomyoma of the uterus, formed from the muscle cells of the uterus are called as uterine fibroids. These fibroids can grow on or within the uterine wall, project from the wall into uterine cavity, or can grow further into the bladder, intestine or bowel. Fibroids can be very small like a pea or as large as football, but are always benign tumors with no risk of cancer.
Uterine fibroids are known to form during high oestrogen levels and hence, commonly seen in women within reproductive age. Normally, these fibroids are harmless with no symptoms and get shrink or disappear while approaching menopause. The best treatment is, to have monitored analysis with regular pelvic examination, to ensure fibroid growth does not cause any problem. On rare occasions, big fibroid may obstruct the opening of uterus and then a pregnant woman is bound to go for caesarean delivery.
For those who experience some fibroid problems like painful and heavy menstrual bleeding, pressure over internal organs or pregnancy related issues, there exist many treatments to consider. But before taking final decision, do take into account all pros and cons of each treatment in accordance to the level of your fibroid trouble.
Treatments For Fibroids
For Heavy menstruation and pain, one can make use of drugs that lower oestrogen levels to temporarily shrink fibroid growth. These drugs mimic the menopause symptoms like hot flushes, decreased bone density and vaginal dryness.
The treatment runs for three to six months period and then fibroid re-growth occurs, soon after the drugs are stopped. Drugs that can be used are oral contraceptives (progestin), GnRH agonists (Lupron) and androgens (Danazol).
Pregnancy problems and infertility rarely occurs and there is no way one can decipher that and avoid it beforehand. In case, a fibroid affects the uterus wall and prevent implantation of fertilized egg, then surgical removal of fibroid called myomectomy, is the only option to improve the chances of having babies.
It is useful for ladies who plan to have babies in future as this procedure only removes fibroids, keeping the uterus intact. For best results, one needs to try getting pregnant soon after the surgery as fibroids may grow again later.
But myomectomy is technically quite challenging, and usually lead to higher blood loss than hysterectomy. Laparoscopic myomectomy is performed when the fibroids are small, few in numbers and have grown out of the uterine cavity. In case of multiple fibroids that are big and deep embedded ones, open abdominal surgical procedure is done to remove fibroids, known as abdominal myomectomy.
In case, fibroids are sub mucosal (inside the uterus), surgery is done with help of hysteroscope (long, slender tube) that is passed through vagina and cervix into the uterus, and fibroids are removed through hysteroscope. This method is called as hysteroscopic myomectomy and involves great expertise and hence, should be performed by an experienced doctor.
The standard and permanent solution to end uterine fibroids is the major surgery that involves removal of the uterus known as hysterectomy. It puts an end to child bearing capacity of women and if it involves removal of ovaries too, then will also lead to menopause. It should only be considered with the women who are approaching menopause and no more concerned with infertility issues
Uterine artery embolisation is a latest technique performed using advanced X-rays that could locate the fibroid and surrounding blood vessels at their exact position, thereby cutting off the blood flow to fibroids.
It is done by injecting small particles like plastic plug into the vessels. This method has proven to be effective in starving and gradually shrinking the fibroid to a point that it disappears. It has advantages of shorter recovery without incision, over surgical methods.
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