Fibroids

There are several types of fibroids, depending on where they’re located in the uterus, including:

• Submucosal fibroids: These fibroids are located just underneath the endometrium, or lining of the uterus, and protrude into the uterine cavity. Submucosal fibroids can vary in how much of the fibroid protrudes into the uterine cavity and how much is in the muscle of the uterus.
• Intramural fibroids: These fibroids are mostly found in the myometrium, or muscle tissue of the uterus. Depending on their size and location, these fibroids can also extend toward the uterine cavity and distort it, or protrude outside the uterus.
• Subserosal fibroids: These fibroids are located near the outside of the uterus. They can be partially in the myometrium or hanging off the outside of the uterus.

Fibroids’s symptoms can vary depending on the size, location, and number of fibroids you have. The most common symptoms associated with fibroids include:

• Abnormal bleeding
• Anemia
• Bladder pressure, or frequent urination
• Constipation
• Pelvic pain or pressure

Having fibroids can cause pregnancy complications such as difficulty getting pregnant and recurrent miscarriages. If women with fibroids do become pregnant, they might experience abdominal pain and light bleeding. Additionally, pregnancy causes a boost in hormones, which can influence fibroids to grow and crowd the fetus.

Fibroids often are identified through routine pelvic exams and imaging tests, such as an ultrasound, MRI, or CT scan, which can show the size and location of fibroids. We also can perform diagnostic procedures for even more in-depth examinations. These can include a:

• Diagnostic hysteroscopy: We’ll investigate the inside of the uterus with a thin tube that contains a video camera
• Hysterosonography:We combine a transvaginal ultrasound and a saline injection into the uterus to help identify fibroids
• Hysterosalpingography:Your doctor will use a dye to highlight the uterus and fallopian tubes on an X-ray

There is a wide range of treatment options for fibroids, depending on:

• The location and size of the fibroid(s)
• The symptoms you experience
• Your age
• Whether you plan to have children in the future

Medical Management

While they won’t completely eliminate fibroids, several medications can help you manage most symptoms. The most common include:

• Anti-estrogens:These medications, such as raloxifene, are used to help control heavy bleeding
• Birth control pills, which can reduce symptoms by regulating your hormones
• Danazol: This is a type of androgenic agent that helps correct anemia and can sometimes shrink fibroids by reducing the number of hormones that your ovaries produce
• Gonadotropin-releasing hormone agonists (GnRH agonists): This shot puts you in a temporary state of menopause, causing your fibroids to shrink. This typically is used to prepare you for surgery or to bridge you close to menopause
• Intrauterine devices (IUDs): These are tiny, T-shaped pieces of plastic that are placed into the uterus and can help relieve heavy bleeding and pelvic pain

Surgical Management

Surgery is another treatment option for fibroids. Our expert doctors combine the latest technology and practices to treat fibroids on an outpatient basis. Fibroids often are removed via a myomectomy, a technique in which we preserve the uterus while removing the fibroids, allowing women to remain fertile.

Other surgical techniques we use include:

• Uterine fibroid embolization/Uterine artery embolization (UFE/UAE): This technique blocks blood flow to the uterus and/or fibroid, leading to fibroids gradually shrinking
• MR-Guided Focused Ultrasound: This technique uses ultrasound energy to heat and destroy fibroids
• Hysterectomy: This technique involves removing the uterus with the fibroids. A hysterectomy provides women with the greatest chance of fibroids not returning