Fibroids often cause painful, heavy periods, they may lead to anaemia, and can even affect your ability to have a healthy baby. You might be surprised to learn they’re more common than you think. Around four in 10 women over the age of 40 have fibroids, but many won’t know.

Description: Fibroids often cause painful

Fibroids often cause painful

What are fibroids?

Fibroids, or myomas, are benign tumors that can form in and around the uterus. There are three main types: the most common is an intramural fibroid, which grows in the wall of the uterus; a submucosal fibroid grows in the lining of the uterus, or endometrium; while a subserosal fibroid grows on the outside of the wall of the uterus.

Although it is not known exactly why fibroids occur, the sex hormones oestrogen and progesterone are believed to play a key role in their development, so they only grow in women of reproductive age.

 “The majority of women with fibroids have small ones, and never know about it,” says Dr Elizabeth Farrell, a gynaecologist and founder of the Jean Hailes Foundation. “They are often discovered if a woman has an ultrasound exam for something else.”

Description: if you are pregnant, having fibroids means there’s a higher risk of miscarriage

If you are pregnant, having fibroids means there’s a higher risk of miscarriage

But for those women who have symptoms, it can mean heavy, long and painful periods, spotting between periods, painful sex, a feeling of pressure in the back, bowel and bladder, frequent urination and swelling in the lower abdomen. In rare cases, fibroids can obstruct the bladder completely.

Farrell says that fibroids symptoms should be investigated in case of other conditions and possible complications, including anaemia from excessive menstrual blood loss. Also, if you are pregnant, having fibroids means there’s a higher risk of miscarriage or premature delivery due to a reduced blood flow to the placenta, and reduced space for the developing baby.

“Fertility can also be compromised as fibroids can interfere with the implantation of the fertilized egg,” says Farrell. “This depends on how big the fibroids are, their shape, and where they are situated.”

What are my treatment options?

Fibroids are diagnosed using an ultrasound examination of the uterus, and there are several treatment options.

If the fibroids are small and without symptoms, they can be monitored over time. Drug therapy using hormones can be used to shrink larger fibroids before surgical removal.

When it comes to surgery, the least invasive option is hysteroscopy, where the fibroids are removed through the cervix using a hysteroscope.

Uterine arterial embolisation can be used to treat large fibroids. Under a local anaesthetic, a fine tube is passed through an artery supplying the fibroids with blood, and sand-like particles are injected into the artery to block the blood supply. The fibroid slowly dies, and symptoms ease over time. This approach is best for women who have completed their families, as risks include premature infertility and adverse pregnancy outcomes, says Dr Melisa Buttini, a consultant gynaecologist from The Wesley Hospital in Brisbane.

Women who are concerned about protecting their fertility can choose abdominal surgery for large fibroids. This could either be done by “keyhole” surgery, where a thin tube is inserted through the abdomen, or by abdominal surgery, where the fibroids are accessed through a large incision.

A hysterectomy is the “final solution” for fibroids, and only suits women who have finished having babies, says Buttini.

New procedures

The MyoSure tissue removal system has recently been introduced in Australia. It removes submucosal fibroids via the cervix without having to cut the uterus or damage the lining. This is especially important if you want to have children. Associate Professor Jason Abbott, a gynaecologist and laparoscopic surgeon at Sydney’s Royal Hospital for Women, says: “The MyoSure is a mechanized intra-uterine machine that cuts the fibroid and removes it from the cavity. It is suitable for those fibroids that are completely contained within the cavity, or where there is minimal inclusion of it into the wall of the uterus.”

A relatively new non-surgical treatment uses ultrasound-guided focused magnetic resonance imaging to destroy the fibroids. “But this is offered in only a few places in Australia, and has not been fully evaluated yet,” says Abbott.

Besides being expensive, the procedure is also not without risks, such as burns to the skin, bowel and bones from “stray” heat.

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