#5, Fall 2014
Uterine Fibroids

What are uterine fibroids?

Uterine fibroids are benign tumors arising from the muscle tissue of the uterus. They can be a single size or appear in multiple sizes and can grow over time. In very rare instances these tumors can be malignant.

Who commonly has  uterine fibroids?

Any women of reproductive age can get fibroids, however they are more common in women of African ancestry. The incidence of fibroids increases with age and tends to decrease during menopause.

What are the symptoms of uterine fibroids?

One in four women have uterine fibroids, however most are unaware as they have few or no symptoms.

In symptomatic cases, the most common complaints are heavy periods, general pressure or pain, pain during intercourse as well as infertility and miscarriages.Uterine fibroids are occasionally found during routine pelvic exams or during a gynecological workup.

How are uterine fibroids diagnosed?

The most effective method to detect uterine fibroids by is a pelvic ultrasound. This procedure enables doctors to accurately measure the fibroids and pinpoint their location. Other detection methods include:

         
 

TREATMENTS

Not every woman with uterine fibroids requires treatment. However, if a woman has significant heavy, irregular or painful periods, abdominal pressure from large fibroids, rapid increase in unterine size or difficulty becoming pregnant as a result of fibroids, then medical treatment is necessary.

Treatment can be broadly divided into three categories: 

1. Medical treatment

  • Birth control pills can be used to manage menstruation and pain.
  • Ulipristal, a relatively new drug, shrinks fibroids and controls bleeding.
  • Gonadotropin agonists are drugs which temporarily shrink fibroids. It is typically used before surgery to treat anemia and make surgery more easier.
  • A progestin releasing IUD can help control bleeding, however it will not treat the fibroids themselves (similar to the birth control pill option).

2. Surgical treatment

Minimally invasive surgery:

  • A hysteroscopy can remove fibroidsfrom inside the uterine cavity by transcervical approach.
  • A laparoscopic myomectomy removes fibroids without large incisions on the abdomen, using a video camera.

 

  

Conventional surgery:

  • An open myomectomy entails the removal of fibroids via abdominal incision
  • A hysterectomy involves the complete removal of the uterus either by laparoscopic or open surgery. Typically the ovaries can be preserved to prevent early menopause.

3. Other treatments

  • Uterine artery embolization blocks the blood supply to the fibroids causing them to shrink. This treatment is not recommended for women seeking to maintain fertility.

 

IN CONCLUSION

As you can see, uterine fibroids are very common but do not always require treatment. However, when treatment is necessary, it is important to establish one that is appropriate for the needs and circumstances of each patient.  

It is worth noting that conservative, non-invasive treatments that preserve fertility and avoid hysterectomy may result in up to a 20% chance of recurrence. Also keep in mind that fibroids are rarely treated after menopause unless they are determined to be growing.

 
     
 
       
         
       
         
Docteur Faez Faruqi
(the founder of Gynesys)

Both Fellow of the Royal College of Physicians and Surgeons of Canada and Fellow of the American Board of Obstetrics and Gynaecology, Dr. Faez Faruqi practises and teaches Gynaecology and Obstetrics at St. Mary’s Hospital in Montreal (affiliated with McGill University). He also heads the Gynaecology and Fertility Centre Gynesys that was launched in 2004 with great success.

If you have any questions about fertility issues or treatment options, we invite you to visit our website or contact us by
email.
Available periodically throughout the year, this guide is intended to accompany the modern woman on her journey to wellness and fulfillment. Each edition will have a specific focus guided by a single objective:
the health, well-being and beauty of today’s women.

© Gynesys - 2014