Fibroids are non-cancerous tumors that develop in the uterus of women in their childbearing age. The uterus is an essential part of the reproductive system. The presence of fibroids will cause a lot of pain and discomfort for a woman, especially when the large tumors expand the uterus. Also, in some cases, these growths are likely to affect your chances of having a normal and healthy pregnancy. Myomectomy is a procedure that allows the removal of the fibroids while maintaining your uterus in a healthy state. If you suspect something is wrong in your womb, it would be wise to consult a gynecologist as soon as possible. Your gynecologist will diagnose and determine the most appropriate procedure if you need treatment. If you are in the Los Angeles area, get in touch with All Women’s Care for excellent gynecological services like the removal of Fibroids.
What are Fibroids?
Fibroids are tumors that often develop in the uterus of women in childbearing age. Fibroids can have different sizes, ranging from tiny invisible lumps to big ones that cause your uterus to expand. Also, you can develop a single fibroid or multiple tumors that expand your ribcage and feel heavy. However, it is crucial to understand that fibroids are not cancerous and do not increase your chances of developing cancer of the uterus. These tumors can develop on the walls of your uterus, while others can push outside into the pelvis.
Sometimes the development of fibroids does not produce any symptoms. Therefore, it will be difficult for some women to realize they have the problem. Making frequent visits to your gynecologist can improve the chances of early detection and treatment before the fibroids cause any issues to your uterus. Fibroids don’t develop on every woman. Some of the risk factors of fibroid development include:
- Fibroids develop in the uterus of women who are within the childbearing age. However, older women are more likely to develop this condition as compared to the younger ones.
- Even though any woman within the reproductive age can develop fibroids, the condition is more likely to develop in black women than in other races. Also, black women could get the tumors at a younger age, and these tumors may be significant with severe symptoms. Fibroids are known to disappear during menopause, but this might not happen for black women.
- Family history. Fibroids are one of the conditions that are passed through the genes. Therefore, if females in your family have a history of the disease, you are likely to develop the tumors. In this case, it would be wise to get regular checkups if your mother or sister has suffered from the condition.
- Obesity is the condition where you have excess fat in the body. A woman who is obese is more likely to develop fibroids at one time during their reproductive years. This is because obesity increases the rate of estrogen circulating in the body. An imbalance of estrogen that is exchanged within the uterine walls could then trigger the development of these tumors.
- No pregnancy history. If you have never been pregnant, you will be at a higher risk of developing this condition than those who have. It is vital to note that these tumors could grow in your uterus even during pregnancy.
- High blood pressure. High blood pressure is likely to cause injury to the smooth muscle cells, thus increasing the risk of fibroid development. Therefore, if you are suffering from hypertension or have a family history of the condition, you should have regular checks with your gynecologist.
Causes of Fibroids
Although the exact cause and content of fibroids are not known, some of these factors could cause the condition:
- The growth of uterine tissues is often stimulated by estrogen and progesterone during the menstrual cycle. An imbalance in these hormones, where estrogen is more than progesterone, could lead to tumor development. Since the release of hormones declines during menopause, the growths will tend to shrink at this point in a woman’s life.
- Genetic changes. Many fibroid tissues are known to contain materials that differ with the healthy uterine tissue in genetic makeup.
- Extracellular matrix. ECM is a substance that causes the cells to stick together. The presence of ECM in your body could make the fibroids more fibrous. This substance could also store growth factors and make biological changes in the cells of the uterine wall.
Sometimes fibroids will develop without any symptom and could only be detected during your regular gynecological checkups. However, in women who experience the symptoms, they can range from mild to severe. Common signs that accompany the development of these uterine growths are:
- Long-lasting menstrual periods
- Heavy bleeding during menstruation
- Pain and pressure in the pelvis
- Difficulty experienced when emptying the bladder.
- Constipation
It is wise to consult with a gynecologist if you experience severe pelvic pain that does not go away. Also, excessive bleeding during periods or between your cycles could indicate that you require immediate medical attention.
Apart from the pain and discomfort that is created by fibroids, the condition could have detrimental effects on your fertility. In most cases, the fibroids don’t prevent a woman from getting pregnant but can cause complications or even pregnancy loss. This is because larger tumors will take up more space in the uterus, restricting fetal growth. By maintaining a healthy lifestyle, you can reduce your risk of this condition. Also, regular visits to a specialist will ensure early detection and treatment to avoid severe effects.
Diagnosis of Fibroids
Often, fibroids are discovered during routine checks with the doctor. Also, if you have symptoms that resemble those of fibroids, the doctor could perform the following tests:
- Ultrasound. Performing an ultrasound is the most common method that is used to detect fibroids. The doctor will place a probe on your abdomen to scan and view the uterus and ovaries.
- MRI. An MRI is an imaging test that uses magnets and radio waves to produce images on your uterine walls. This will help identify the number and size of the uterine growths. Also, the MRI shows the tumor location, helping the doctor determine the best treatment applicable to your situation.
- Hysterosalpingogram. If you have trouble getting pregnant, the doctor will want to check your uterus and tubes for abnormalities or the fibroids.
- Hysterosonogram. If you are experiencing heavy bleeding during your menstrual periods, the doctor may use this procedure to check for intracavitary fibroids. The process is carried out by placing a catheter in your ultrasound to inject water while taking images.
- Hysteroscopy. Hysteroscopy is used as both detection and fibroid removal procedures. When you present symptoms that suggest an abnormality in your uterus, the doctor will pass the instrument light through your vagina to observe your uterus. Smaller tumors that are detected during the procedure can be removed.
Reproductive health and childbearing is an essential part of many women. Fibroids can be very unsettling and cause a lot of pain for you. Fortunately, the condition is treatable with both medications and surgeries. Since most tumors will shrink as age advances, the doctor could recommend some observations if you have no symptoms. However, tumors with severe symptoms may need more treatment depending on the following factors:
- The severity and type of symptoms you are experiencing affects treatment. Fibroids that bring about severe symptoms may require more extensive treatment
- Your age
- Your childbearing goals. If you wish to continue childbearing, the doctor may want to perform a procedure that does not damage your uterus
- Size and number of tumors in your uterus - The growths developing in the womb vary in size and quantity from one person to another. These two factors are likely to affect the type of treatment best suited for your situation
- Status of your health - The treatment procedures to get rid of uterine fibroids are carried out with a consideration of your overall health and other conditions you may have. This is to help ensure that other conditions are not worsened by the drugs you take or the procedures you undergo
Myomectomy
Myomectomy is a surgical procedure that is used to remove uterine fibroids. During this procedure, the doctor’s aim at ensuring that they remove the tumors, relieve your symptoms, and maintain the uterus in its healthy state. With competent medical treatment, myomectomy will improve your symptoms such as pain, pelvic pressure, and excessive bleeding. Your doctor could recommend this procedure if the fibroids’ symptoms are troubling you and could affect your fertility.
Also, your interest in keeping your uterus and bearing children could compel the doctor to use this procedure as a treatment for your condition. Myomectomy is a surgical procedure, and you need to prepare for the process by fasting for the recommended hours before surgery. If you are taking any type of medication, you should consult with the doctor for some days before surgery.
Different types of myomectomy are performed based on your condition. Depending on the particular procedure you are set to undergo, you can receive general anesthesia, which keeps you unconscious throughout the surgery. Alternatively, you can get monitored anesthesia, which makes you feel as if you are fully asleep and cannot remember what happened.
The duration that you will spend in the hospital under observation depends on the extent and outcome of your procedure.
Approaches to Myomectomy
There are several ways through which a myomectomy is performed depending on the location and number of tumors in your uterus. The three conventional approaches to myomectomy include:
- Hysteroscopy myomectomy. If you have small tumors bulging into your womb, the surgeon may recommend this procedure for fibroid removal. The hysteroscopy will follow a process where a lightened instrument gets inserted through your vagina and cervix. The clear salt liquid is used to expand the uterus, and a wire shaves the pieces of the growth. Sometimes this procedure can be repeated multiple times when the fibroids are larger.
- Abdominal myomectomy. In this procedure, the surgeon cuts your abdomen to get to the uterus and remove the tumors. An incision could either be vertical based on the size and nature of your uterus.
- Robotic Myomectomy. Robotic myomectomy is a procedure in which small incisions made on the abdomen are used to access and remove fibroids. This procedure is often minimally invasive, and you suffer less bleeding. Removal of fibroids through the robotic procedure has a similar outcome to laparoscopic myomectomy.
In some cases, fibroids need to be cut into small pieces and removed through small incisions. However, when the fibroids are large, more significant incisions are used to remove the tumors without cutting them.
Risk Associated with Myomectomy
Myomectomy is a safe procedure that presents a lower rate of complications. However, you may experience the following after the surgery:
- Excessive bleeding. Most women who suffer from fibroids may already be anemic because of excessive loss of blood from heavy menstrual bleeding. Therefore, this will increase your risk of blood-related complications after undergoing fibroids removal surgery. However, before the surgery, your doctor may recommend the use of blood-booster or block blood flow during the procedure.
- The development of scar tissue is a common occurrence. Incisions that are made during the fibroid removal could create adhesions which leave behind scar tissues. The size of the scar depends on the type of myomectomy used. An abdominal myomectomy is likely to result in more scars as compared to other procedures.
- Pregnancy and birth complications. Myomectomy is a fibroid treatment procedure aimed to maintain your uterus for future childbearing. However, as a result of the incisions made to the uterus, the organ could rupture during childbirth. If you have undergone the procedure, your gynecologist may recommend a cesarean section birth in the pregnancies following the process.
- Hysterectomy. This is a procedure that prompts the removal of your uterus. If there is excess bleeding during a myomectomy, the surgeon could remove your uterus. However, since myomectomy is a less invasive procedure, excessive bleeding is rare.
- The spread of cancerous materials. In rare cases, a cancerous growth could be mistaken for fibroids. In an attempt to remove them, the materials can be transferred to other parts of the uterus, thus spreading cancer.
In an attempt to avoid some of these complications, your doctor could recommend:
- Iron supplementation. You may need to boost your blood before the surgery if you are already at risk of anemia from excessive bleeding during your menstrual periods. By receiving supplementation with iron and other vitamins, the risk of anemia will get lower.
- Hormonal Treatment. Anemia is one of the most severe side effects of myomectomy. This condition can be managed by interrupting the menstrual flow. Your doctor may give you a gonadotropin-releasing hormone to block estrogen production and stop menstruation.
- Shrinking the tumors is a viable option. Large growths will require a more invasive procedure, which, in return, is a risk for complications. Shrinking of the fibroids allows the surgeon to use less invasive procedures and eliminate the possible risks. Doctors often use gonadotropin-releasing hormone therapy to shrink the fibroids. However, not all women are allowed to receive this therapy, and the doctor may have to carry out more tests before administering it.
The Outcome of the Surgery
After removal of fibroids using myomectomy, the following outcomes could be noticed:
- Relief of your symptoms. After a successful myomectomy, most women will report some of the most irritable symptoms like pain and excessive bleeding.
- Improvement of fertility. Fibroids are known to affect your ability to carry a healthy and full pregnancy when left untreated. Myomectomy removes these tumors while ensuring that your uterus is left healthy. Therefore, it is common that your fertility will improve after the procedure. Getting pregnant after the removal of fibroids reduces the chances or recurrence.
If some tumors are not detected, or the removal is not completed, the fibroids may grow back with more severe symptoms. Therefore, it is essential to ensure that you consult a doctor who is experienced in this field.
Other Treatment Options for Fibroids
Fibroids are tumors that develop gradually and have a possibility of disappearing during menopause. Depending on the size and number of tumors detected, treatment ranges from medication to surgeries such as myomectomy. Medicines that are used to treat fibroids aim at regulating the hormones to treat symptoms such as pelvic pressure and pain. However, this medication does not get rid of the tumors but attempts to shrink them. Alternative treatment procedures include:
- An intrauterine device that releases progesterone is used. This will help in preventing excessive bleeding that is associated with the tumors. Also, the use of other contraceptives could inhibit the menstrual period and help avoid excessive blood loss and pelvic pressure.
- Tranexamic acid. This is a medication taken during menstrual periods to regulate bleeding. Some of these medications relieve the most uncomfortable symptoms before fibroid removal procedures are carried out.
- GnRH therapy. The use of gonadotropin-releasing hormones will block estrogen and progesterone production, which stimulates the menstrual period. By doing so, you are put into temporary menopause. The reduction of these hormones in your body shrinks the growths and reduces the occurrence of anemia. Most doctors will attempt to shrink the fibroids before resulting in a surgical procedure.
- Uterine artery embolism. Artery embolism is an image-guided procedure where the blood supply to the fibroid is cut down. This will cause the tumors to shrink from lack of blood and relieve the symptoms that accompany the condition. During the fibroid artery embolism procedure, a catheter will be introduced to divert the blood supply.
- Radiofrequency ablation. For this procedure, radiofrequency is used to shrink or destroy the fibroids and the blood vessels that feed them. After the doctor locates the tumor’s position, small needles are injected into the fibroid mass to heat up and destroy when the growth is destroyed its structure changes and allows it to shrink over time.
- Endometrial ablation. The treatment involves the destruction of your uterine walls using electric current. The procedure is aimed at ending your menstrual flow. However, it is crucial to understand that after an endometrial ablation, it is difficult for you to get pregnant. You will need to use a contraceptive method to avoid an ectopic pregnancy.
- Hysterectomy is an invasive surgical procedure where your doctor removes the whole uterus as a result of fibroids. This procedure is the only proven method that can completely get rid of the fibroids. However, the procedure is more prone to complications. If you are hoping to bear children, hysterectomy is not an option for the treatment of fibroids.
Unless the surgeon completely removes your uterus, you are likely to experience recurring episodes of fibroid tumors. This is because some fragments from the growth may remain in your body and continue growing. The development of fibroids could take a toll on your reproductive health. Apart from the pain that comes as a symptom of the tumors, the treatment could be quite stressful and may bring unfortunate side effects. Getting proper medical care should be your priority if you have symptoms that resemble those of this condition. Your gynecologist should be reliable and experienced in dealing with gynecological procedures and surgeries.
Get Professional Help from an Experienced Los Angeles Gynecologist Near Me
Your reproductive system is a very delicate part of your body. Fibroids are tumors that could develop any time within your reproductive years. The growth in your uterus can vary in size, and their effect depends on their size. In extreme cases, fibroids are likely to affect your fertility and create complications during pregnancy. Fortunately, through myomectomy, these tumors could be removed while maintaining the health of your reproductive system. You cannot entrust just anyone with your reproductive system. You will want an environment that makes you comfortable during treatment. If you have fibroids, we invite you to visit All Women’s Care for proper diagnosis and treatment. Call us today at 213-250-9461 if you are in the Los Angeles area.