Uterine fibroids are a common cause of pelvic pain
Your uterus is lined with smooth muscle cells designed to help you deliver babies. Sometimes these cells can grow out of control for no clear reason, causing you to develop a mass on the wall of your uterus called a uterine fibroid. Uterine fibroids are very common and affect between 30 to 77 percent of woman in their lifetimes. Though they are considered tumors, uterine fibroids are not cancerous in 99 percent of cases.
Uterine fibroids can be so small they can’t be detected, or they can be as large as an orange. Doctors most often find fibroids during a normal physical exam when they press on the uterus. If you’re having symptoms, your doctor may also want to do an ultrasound or X-ray to look for uterine fibroids.
What are the symptoms of uterine fibroids?
Some women may never have symptoms of uterine fibroids. Others, however, may have severe symptoms that impact their daily lives. Symptoms may include:
- Long or heavy periods
- Bleeding between periods
- Pelvic pain or low back pain
- Frequent urination
- Pain during sex
Do all uterine fibroids need to be treated?
If you don’t have symptoms or only have mild symptoms, your doctor may suggest that your fibroids not be treated at all. Your fibroids might stop growing or even shrink as you age. Your doctor will just keep an eye on your fibroids to make sure your symptoms don’t get worse and your fibroids don’t grow.
Depending on your individual needs and health, your doctor may suggest one of many treatment options. If you only have minor pain, pain medicines may be enough to manage occasional pelvic pain. Other medicines can help lower the amount of hormones in your body, which helps shrink fibroids and reduce symptoms. You could also have a procedure or surgery to remove uterine fibroids.
What procedures are used to treat uterine fibroids?
Minimally invasive procedures such as uterine artery embolization can treat uterine fibroids with fewer risks than other surgeries. The procedure only takes one to two hours and is performed while you are under anesthesia.
During uterine artery embolization, your doctor uses a dye to see which blood vessels are giving blood to the tumor and helping it grow. The doctor then uses a very small incision in your groin to guide a tiny tube into the blood vessel and fill it with plastic particles that block blood flow. Without blood flow, the uterine fibroids shrink and die over time.
After a uterine artery embolization, you might stay in the hospital overnight. You can usually return to normal activities within two weeks. Ninety percent of women see relief from heavy bleeding, while 85 percent have less pain. Because your uterus is still intact, you can become pregnant after this procedure.
One of the newest procedures to remove fibroids is called focused ultrasound. This procedure is outpatient, meaning you can go home after the procedure, and it also doesn’t require incisions. The procedure uses focused sound waves to make heat that burns away fibroids.
What surgeries are used to treat uterine fibroids?
Your doctor can perform surgery, called a myomectomy, to remove just the uterine fibroid. This surgery leaves the uterus intact so you can become pregnant in the future.
Your doctor can usually perform this procedure using a few small incisions (laparoscopic myomectomy) or by inserting specialized tools through the cervix (hysteroscopic myomectomy). However, for some women, the uterine fibroid will need to be removed through a larger incision in the abdomen.
When there are a lot of fibroids or the fibroids are large, doctors may suggest a hysterectomy to remove the entire uterus. Uterine fibroids are the most common reason for hysterectomies in premenopausal women. This procedure is not recommended for women who want to get pregnant in the future.
Hysterectomies are now performed laparoscopically, meaning the doctor only makes a few small incisions and then uses special tools to remove the uterus. Laparoscopic procedures have fewer risks and a faster recovery time than traditional open hysterectomies that use a large incision. Doctors can also remove the uterus through the vagina in laparoscopic assisted vaginal hysterectomy, which results in fewer scars and less pain.