If you’re experiencing excessive bleeding, particularly long periods or pelvic pain, it may actually be the symptoms of fibroids - but how can they be treated?
‘Fibroids are benign (non-cancerous) tumours of muscle and tissue that grow inside, within, or on, the wall of the womb,’ explains Shirin Irani, consultant gynaecologist at Spire Parkway Hospital. ‘They’re fairly common, in fact it’s estimated that up to 30 to 40 per cent of women will have fibroids in various sizes, numbers and locations, and may not even know about it.’ Here’s the lowdown on what to look out for.
Why do women get fibriods?
‘The actual cause of fibroids is unknown, but it’s thought that they’re linked to the hormone oestrogen,’ says Shirin. They develop in women during childbearing years, and tend to shrink after the menopause when oestrogen levels are low. Women of African-Caribbean origin suffer with the condition more frequently, while obesity is also considered to be a risk factor.
What are fibroid symptoms?
‘In many cases, women will only realise they have fibroids when they’re picked up during an ultrasound scan, possibly for something else,’ explains Shirin. ‘Symptoms may also di er between women due to the location, size and how many a woman has.’ These are some of the signs that you may have fibroids.
- Painful periods
- Very heavy bleeding
- A feeling of fullness in the tummy
- Discomfort during sex
- Low backache and/or the need to go to the toilet dueto fibroids pressing on the bowel or bladder.
How do fibroids affect fertility? Five fast facts
1. It is still possible to conceive when you have fibroids, and often they’re first discovered on a pregnancy scan.
2. Intramural fibroids develop in the womb’s muscle wall. Subserosal fibroids grow on the outside of the womb, and submucosal fibroids develop under the womb’s lining.
3. Having fibroids doesn’t increase the risk of developing cancer.
4. If fibroids cause heavy blood loss, this can result in iron-deficiency anaemia, which will need to be treated.
5. A hysterectomy isn’t always necessary – there are several other options that can be tried first.
Fibroid treatment – what are the options?
‘The choice of treatment will depend on the size of the fibroids,’ says Shirin. They can be as small as the size of a pea, and because often these won’t cause symptoms they can be left and monitored to see if they grow. In other cases, fibroids can increase to the size of a melon, causing more severe symptoms and requiring treatment.
The importance of keeping fertility options open should also be considered when deciding to treat them. ‘Medication, surgery, blocking the blood supply by uterine artery embolisation, or a complete hysterectomy, are some of the options available,’ says Shirin. Chat to your GP ifyou are suffering with any symptoms that you think may be fibroids – they can refer you for a scan to confirm diagnosis and advise on a possible treatment plan.
Medical treatment: Tablets or injections can manipulate hormones to shrink fibroids or prevent them from growing. Fibroids can regrow after the treatment is stopped.
Myomectomy: This procedure removes the fibroids, but not the whole womb, so preserves fertility. There is a small risk of blood loss that could result in a hysterectomy.
Hysteroscopic resection: By inserting a telescope, called a hysteroscope, through the vagina and into the womb through the cervic, fibroids are removed surgically under anaesthetic.
Uterine artery embolisation: This is an alternative option to a hysterectomy or myomectomy and involces blocking the blood vessels that supply the fibroids, causing them to shrink.
MRI-guided treatment: Only suitable for certain types of fibroids, this focuses ultrasound waves or laser energy on the fibroids and destroys them.
‘I often fainted from the heavy bleeding’
For Louise Bryan, 41, fibroids impacted her everyday life
‘Until my fibroids were discovered,I assumed I was just unlucky to suffer from extremely heavy, painful periods. I would use a super-plus tampon along with the thickest night-time pad and yet I’d still leak through to my clothes. I permanently felt drained and as the fibroids grew I’d be on my hands and knees in agony and would rely on strong painkillers to function. I was losing so much blood with each period that I was severely anaemic to the extent that I began fainting regularly and had two blood transfusions. I was eventually referred to a specialist, who put me on a drug called Esmya –a treatment that shrinks fibroids and reduces bleeding.
This was life- changing. After a three-month course I felt amazing. I could go swimming and horse riding activities that I love but had been risky for a long time. But I was told that Esmya isn’t a long-term option, and that my fibroids wouldn’t disappear forever. After 18 months, my bleeding began to get much heavier again, so it was time to take action. I recently went into hospital for a hysteroscopic resection that removed a large fibroid. Hopefully, I can now look forward to a future without pain and bleeding.’