Effects Of Intramural Fibroids

Frequently Asked Questions

  1. QUESTION:
    I am suffering from uterine fibroids what are my options?
    I am seeing a gynocolgist and he is not sure wheather I am going through menopause for they might shrink?I don't really want surgery(no insurance)but one fibroid is poking into my bladder!Need 2nd opinion???Thanks

    • ANSWER:
      Treatment of Fibroids

      The most important question to ask is do the fibroids need to be treated at all. The vast majority of fibroids grow as a woman gets older, and tend to shrink after menopause. Obviously fibroids that are causing significant symptoms need treatment. While it is often easier to treat smaller fibroids than larger ones, most of the small ones never will need to be treated. So just because we can treat fibroids while they are small, it doesn't follow that we should treat them. And many women have successful pregnancies without removing the fibroids as long as they are not inside the uterine cavity. The location of the fibroids plays a strong influence on how to approach them.

      Treatment with medicines:

      There are not any currently available medicines that will permanently shrink fibroids. Often heavy bleeding can be decreased with birth control pills. There are a number of medications in the family of GnRH agonists, which induce a temporary chemical menopause. In the absence of estrogen myomas usually decrease in size. Unfortunately, the effect is temporary, and the fibroids rapidly go back to their pre-treatment size when the medication is discontinued. Mifepristone, better know as the 'French abortion pill, or RU-486, also may cause a decrease in size of myomas, and often stops abnormal uterine bleeding. It also has undesireable side effects. It's use is promising, but it is not currently available in the United States.

      Surgical treatment of Fibroids:

      There have been a number of procedures recently promoted for treatment of fibroids. Some are truly new. Others are being marketed as new in order to promote the sale of expensive instruments, without offering any real advantages. Many new procedures prove over time to be major advances; we may look back on others as not so wonderful. With any new procedure, it is important to look at studies published in peer-reviewed medical journals as well as promotional materials by a physician, clinic, or instrument manufacturer. Ask questions: how many of these procedures have been done in published studies; what is the outcome; how long have these patients been followed? In deciding whether any procedure is for you, you should look at advantages and disadvantages of all available options.

      Intracavitary Fibroids

      When a fibroid is inside the uterine cavity, it will almost always cause abnormal bleeding and cramping. If it is not currently causing problems, the odds are very high that it will. For this reason, I usually recommend that they be removed. These can usually be removed by using a special kind of hysteroscope, or resectoscope. The resectoscope is a telescope with a built-in loop that can cut through tissue. It has been used for years to treat enlargement of the male prostate gland, and has more recently been used inside the uterus. This is called hysteroscopic resection of myomas. In skilled hands most myomas inside the uterus can be removed in an outpatient setting. Click here to learn more about hysteroscopic resection of myomas.

      Submucous Fibroids

      Unlike intracavitary myomas, some of the fibroid is also in the wall of the uterus. Submucous myomas often cause abnormal bleeding. Many of these can also be treated by hysteroscopic resection. During the process of removing submucous myomas by this method the uterus contracts, and tends to push the portion of the myoma that is in the wall into the cavity of the uterus. The decision on which myomas should be treated by this method should be made by an experienced hysteroscopic surgeon. If heavy bleeding is the main reason for desiring treatment, and fertility is no longer desired, an endometrial ablation may also be done at the same time.

      Intramural and Pedunculated Fibroids

      Myomas that are in the wall of the uterus or on the outside of the uterus are not accessible to treatment through the cervix. If these need to be treated, there are essentially three types of procedures: remove the fibroid(s), destroy the fibroid(s), or remove the uterus. All of the surgical options available are variations on one of these themes. Some have been available for years. Others are very new and have had very little or no long term testing.

      Hysterectomy:

      Hysterectomy is the only procedure that comes with a guarantee: no more bleeding and no regrowth of fibroids. Like any alternative, there are advantages and disadvantages of having a hysterectomy. Click here to learn more about hysterectomy.

      Removal of the fibroid(s):

      This is also called myomectomy. Myomectomy, with one exception, means making an incision into the uterus and removing one or more fibroids. If the fibroid is on a stalk (pedunculated) it is not necessary to cut into the uterus to cut the stalk. Unless the fibroid is on the outside surface of the uterus, the uterus is repaired, usually with sutures. One of

  2. QUESTION:
    can someone tell me about subserosal fibroids? and the treatment to have them removed?
    I was told that i have 2 subserosal fiborids and they hurt i want them removed but i want to know really can i still have children after the trement?

    • ANSWER:
      Fibroids, also known as leiomyomas or just plain myomas, are benign, smooth muscle tumors that usually grow in the uterus (womb). They are the most common pelvic tumors in females. They can range in size anywhere from a few millimeters (the size of a sesame seed) to several centimeters (about an inch). Fibroids can occur in different locations in and on the uterus but very rarely on organs outside of the uterus.

      Subserosal fibroids are located under the outer “skin” of the uterus (serosa) and do not grow into the muscular wall of the uterus (myometrium).

      What are the Available Treatment Options?

      Medication
      Medical management of fibroids is fairly limited and often used only to reduce symptoms until surgery is necessary. Currently two medical agents are used for the management of fibroids:

      * Depo-Provera, an intramuscular injection of long-acting progesterone (a commonly used birth control agent) has been used for the management of fibroids that cause heavy vaginal bleeding. Used over time, Depo-Provera stops menstruation (amenorrhea). This reduces the vaginal bleeding, but there are troublesome side-effects associated with this process including: weight gain, hair thinning, and irregular vaginal spotting. This medication is of little or no use in treating symptoms of fibroids other than those related to vaginal bleeding.

      * Depo-Lupron (Lupron) has also been used in the medical management of fibroids. It is given by injection. Lupron essentially creates a “medical menopause” by decreasing the amount of estrogen circulating in the bloodstream and causing the fibroids to shrink. Like Depo-Provera, Lupron also causes amenorrhea. When used for a short time (from 3 to 6 months), Lupron has proven beneficial in reducing fibroid size making them surgically more manageable. It also helps to reverse the anemia (low red blood cell count) caused by increased vaginal bleeding. However, Lupron cannot be used for more than 6 months, as over-usage leads to bone loss (osteoporosis) and significant increases in triglyceride (a fat molecule) and cholesterol levels.

      Surgery
      Surgery is needed when your symptoms cannot be managed using medication. The surgical procedures that are used are described below. The one that is right for you depends on multiple factors including your age, the symptoms and types of fibroids you have, and your desire for future child bearing.

      * Abdominal Myomectomy involves the removal of fibroids (pedunculated, subserosal or intramural) from the uterine surface or wall through an incision made in the abdomen. This procedure is indicated if you have symptomatic fibroids and plan to have children in the future. The risks of an abdominal myomectomy include significant blood loss, post-operative infection, accumulation of scar tissue (with possible detrimental effects on fertility), possible need for cesarean section with subsequent pregnancies, and possible growth of new fibroids.

      * Hysteroscopy and Submucus Resection is performed through the vagina for the treatment of symptomatic submucosal fibroids. The cervix is dilated and a small camera (hysteroscope) is passed through the cervix into the endometrial cavity. This camera allows the physician to see a submucosal fibroid directly. A small wire with a weak electrical current is then used to shave the fibroid from the endometrial cavity. The risks of this procedure include infection, uterine perforation, and possible growth of new fibroids with recurrence of symptoms.

      * Laparoscopic Removal of Fibroids and Myolysis involve placing a small telescope (laparoscope) through the naval to visualize subserosal and pedunculated fibroids. A laser or electrical wire is then used to remove or dissolve the fibroid. There are very few indications for this procedure. If your fibroids are small enough to be treated this way, then you should discuss with your physician whether your fibroids actually need to be treated at all.

      * Hysterectomy is the removal of the uterus with or without the removal of the cervix. Hysterectomy is the only definitive treatment for fibroids and can be used for all types. It can be performed in several ways. An abdominal hysterectomy involves removing the uterus through a surgical incision in the abdomen, while a vaginal hysterectomy is done by making an incision in the vagina. In a laparoscopic-assisted vaginal hysterectomy, a laparoscope, inserted through the navel, is used to aid in the removal of the uterus through the vagina. A hysterectomy is indicated if you have symptomatic fibroids that cannot be managed by other means and you are done with child bearing. The type of hysterectomy that should be done depends upon the size and location of your fibroids. The complications of a hysterectomy include bleeding and infection.

      Uterine artery embolization
      An alternative to medical management or surgical treatment of fibroids is uterine artery embolization. Embolizations are performed by cardiovascular interventional radiologists. Your gynecologist should be able to refer you to one. In this specialized test, a small tube (catheter) is placed into the blood vessels going to your uterus. These vessels are then blocked so that the blood flow to the fibroids is greatly decreased. This blocking causes the fibroids to shrink, improving your symptoms. This procedure is indicated if you have symptomatic fibroids and would like to preserve fertility. The complications of this procedure are rare but include internal swelling from ruptured blood vessels (hematomas) and infection.

      Uterine fibroids can sometimes interfere with a healthy pregnancy. During pregnancy, uterine fibroids tend to grow to large sizes as they are triggered by your body�s increase in hormones. This can compromise the shape of your uterus and limit the amount of space that your baby has to grow. As a result, miscarriage or fetal malpresentations may occur. Uterine fibroids can also increase the chance of:

      * postpartum hemorrhaging
      * obstructed labor
      * stalled labor
      * cesarean section

  3. QUESTION:
    Question about Uterine Fibroids please?
    I was diagnosed with Intramural Fibroids, and I am 41, can one develop other kinds of uterine fibroids by time?
    I was told that we do not develop new ones after the age of 40, you may have complications from the ones that you already have.....

    • ANSWER:
      it depends on the size of the fibroid and its position if it is large or near the/or inside uterine cavity then it might effect pregnancy

  4. QUESTION:
    role of mirena in intramural fibroid?
    i am 45.i have intramural fibroid(2.5 cm ) in uterus.one gynacologist suggested mirena for me because i have severe dysmenorrhea.other dr said no.what to do

    • ANSWER:
      What I do (I am a woman too) I go to a 3rd doctor and if two have the same opinion I chose their advice. If none of them has the same, its a BIG problem. I suggest you do some reading about the Mirena and its side effects and decide after that.

      http://www.google.com/search?hl=en&rls=com.microsoft%3Aen-US&q=Mirena+side+effects

  5. QUESTION:
    Does anyone here used herbal medicine to shrink a uterine fibroid tumor (myoma)?
    the past weeks i been in terrible thoughts finding that i got 2 uterine fibroid growing (intramural type) abt 11cm and 8 cm...
    i consulted 3 specialist already and they told me that they cnt assure me that they will not remove my uterus.. im still single ,and menopause is still far away plus im desirous to have kids..
    upon research i found more advantages if my uterus will be removed. Now i have come across natural progesterone and other herbal things they sell in the internet.. Can you share me any of its effects if someone of you have use it .. PLEASE SERIOUS ANSWER ONLY.. u will help me a lot.. thnx

    • ANSWER:
      yeah but you still didn't answer my question on weather and whether.
      i asked you to give me a neumonic so i can remember them.
      but to answer you question no.

      do not remove your uterus. get a second opinion. if you want to gave 84 kidlets, please do not do that. i have never used herbal stuff like that but it does not hurt to try. give it a try first before you remove your woumb.

      i am ttc and i am using fertility blend and such stuff. so those are the only things i've tried. and i drink herbal teas.

      why can't they remove the fibroids and not the uterus though?

  6. QUESTION:
    i have to do mymactomy,for intramural fibriod,don,t know how much it will effect my fertility or uterous?

    • ANSWER:
      Make it absolutely clear, put it in writing in your chart, (it's called a living will, the chaplain at the hospital can help you) -this is to make sure that they do not preform a hysterectomy on you while you are under- they may open you up and see that they have to do something radical but if it is in your living will that they cannot take your uterus, ovaries ect, they can't not without being sued. Some docs would rather take the whole kit and caboodle that do the delicate work of removing the fibroids. I am not trying to scare you but trying to make you understand that you need to talk to your doc and make sure that you two are on the same page. http://www.myomectomy.net/ This looks like a great page to get you started. After you've healed up from the surgery have them give you an sonogram, an ultrasound or MRI to make sure there are no fibroids, adhesions or scar tissue, if everything looks clear, your fertility should be fine. Good luck.

  7. QUESTION:
    what are uterine fibroids? what are their side effects?

    • ANSWER:
      Fibroids are common, benign growths of womb (uterine) muscle. They are present in around 1/4-5 of white women and 1/2 black women. They are most common toward the end of the reproductive years. They exist sometimes singly, but most often are multiple and range in size from microscopic to filling the whole of the lower abdomen! They are more common in obese women and those who have no children, there probably is some genetic determinant and they are less common in smokers.

      Most fibroids do not cause symptoms, but overall symptomatic fibroids account for about one third of all hysterectomy operations.

      What are the Different Types of Uterine Fibroids?

      Fibroids are named depending upon where they lie. Those that are wholly within the muscle layer of the womb are called intramural fibroids. They typically give the uterus a globular feeling on examination (like early pregnancy). They increase overall blood flow to the uterus and if large can distort and enlargen the internal cavity, even if they don't encroach onto it.
      Subserosal fibroids are those that project out from the outer surface of the uterus. They can grow quite large, but do not typically affect the size of the womb cavity. They are more likely to produce pressure symptoms than heavy periods or infertility.

      Submucosal fibroids are the least common (5% of all fibroids). They project into the womb cavity and greatly disrupt its shape. They are the type most likely to cause fertility problems. Sometimes they grow into the uterus, filling it and even growing out of the cervix.

      Fibroid Symptoms

      The most common complaints of women with fibroids are pressure symptoms and heavy periods. An enlarged womb will place pressure on the bladder giving increased urinary symptoms (eg. frequency), and can cause back ache, lower abdominal discomfort and pain on intercourse. Fibroids can cause very heavy periods, leading to iron-deficiency anaemia. They don't cause disturbance to the menstrual cycle itself - typically the bleeding is regular but much heavier than usual. The periods may be more painful than usual (called secondary dysmenorrhoea).

      It is estimated that fertility problems are one of the presenting features in about 1/4 of women with fibroids. There is a well-established relationship between the presence of fibroids and lower fertility or childlessness. When compared to other causes of infertility, however, they are a relatively uncommon cause, being implicated in only 3% of couples. It may be that a delay in having children (whether voluntary or involuntary) predisposes to the development of fibroids and this is more often an association rather than a causative feature.

      How are Fibroids Investigated?

      Often they are discovered on pelvic examination, where the uterus feels larger than expected with hard round lumps felt arising from the surface. Ultrasound scan can tell where the fibroids are located and give an idea of their size. Sometimes they are detected on laparoscopy (looking into the abdomen with a small telescope) or hysteroscopy (looking into the uterus with a fine telescope). Hysteroscopy is particularly useful for seeing the submucous fibroids and assessing how much of the uterine cavity is involved.

      What are Fibroid Treatment Options?

      If the fibroids aren't causing any symptoms and are relatively small (less than equivalent to a 14-week pregnancy) then it is quite reasonable to just observe them in the first instance. It is important to repeat a scan or examination in 6 months time to rule out rapid growth (something which would prompt removal). Women who are near the menopause will often not need surgery as they will shrink once the level of the hormone oestrogen declines.

      If fertility is desired or for other reasons hysterectomy is not wished, a myomectomy can be performed. This is still major surgery, where the fibroids are individually removed and the uterus reconstructed. It has the advantage of preserving fertility and is most useful where there are one or two large fibroids. A woman must understand that haemorrhage from the operation can sometimes be significant and occasionally a hysterectomy must be performed to control bleeding. Within 20 years of myomectomy, about 1 in 4 women will undergo hysterectomy most often for recurrent symptomatic fibroids.

      Hysterectomy is the definitive treatment for symptomatic fibroids. Most often this will need to be carried out via an abdominal incision, though a skilled vaginal surgeon may be able to perform a vaginal hysterectomy following medical treatment to shrink the fibroids before the operation. Most abdominal operations will be carried out via a low 'bikini-line' incision, but if the uterus is large, an 'up-and-down' vertical incision may be needed.

      Submucosal fibroids which project into the uterine cavity may be removed by passing a telescope into the womb from down below and chipping away at the surface with a hot wire loop (hysteroscopic resection). This is a day-case procedure avoiding major surgery, but completion may require more than one operation.

      Another option which is being developed in some areas is uterine artery embolisation. This involves a radiologist passing a very thin catheter into a blood vessel in the groin and guiding it toward one of the arteries that lead to the fibroid. The small artery is blocked off leading to shrinkage of the fibroid. Long term results of success of this treatment is not yet available and very few women have become pregnant afterwards. At present it is not widely available, but further information can be found on Dr WJ Walkers information pages.

      What About Medical Treatment?

      Medical or tablet treatment has a limited role in managing fibroids. There are drugs which can be used to reduce the symptoms - such as pain-killers or those which can reduce the amount of blood loss each cycle. Blood loss may be reduced by the use of the contraceptive pill. Previous reports of growth of fibroids in response to the pill probably relate to older, high dosage formulations, and use of the birth control pill may be protective against their development.

      There are some treatments that can shrink fibroids, but they have the side effect of making a woman effectively menopausal, by switching off the ovary's production of hormones. If this is continued for more than 6 months, there are risks of bone-thinning oesteoporosis & heart disease, as well as the other uncomfortable symptoms of hot flushes, vaginal dryness and psychological symptoms. This treatment is most useful prior to surgery as discussed above. Alternatively it may be considered in a woman near to the menopause who is keen to avoid an operation.

      What is the Success Rate After Surgery Other Than Hysterectomy?

      In women undergoing myomectomy for infertility, a large review of the published data found a pregnancy rate of 40-60%, the majority conceiving in the first year after treatment. Where myomectomy is performed for heavy periods, an 80% success rate is reported. Fibroid recurrence rate at 10 years was 27% in a 1991 review of 622 patients.

      Hysteroscopic resection is a more recently developed procedure and long-term follow-up of large numbers of women is not available yet. Studies published so far demonstrate an 80-90% success rate for surgery performed for heavy periods, with around 17% requiring a second operation in the following 10 years (similar to myomectomy). Pregnancy rates following resection of submucous fibroids where this is the only cause of infertility are high, at 60-70%.

      Fibroids and Pregnancy

      One study published in 1993 looked at 12,500 pregnancies where just under 500 women had fibroids detected during pregnancy. 88% of them were single fibroids. There was an increased risk of bleeding, pain during pregnancy and threatened premature delivery. These were more common when the size of the fibroid measured 200cm3 volume or greater and when the location of the fibroid was under the placenta. There was no increased risk of early delivery, or caesarean section. Other studies, however, do report an increased risk of early delivery.

      As others have found, if attempt is made to remove the fibroids at the time of caesarean section, bleeding can be profuse and in the series above hysterectomy was needed in 1/3 of cases where this was attempted. Most people have reported a tendency towards increase in fibroid size during pregnancy and then shrinking again afterwards, but a 1988 study followed women with serial scans during pregnancy and 80% remained the same size (20% growing).

      If the fibroid is located low in the uterus, it may obstruct labour increasing the risk of caesarean section, but one at the top is less likely to do so. Most don't need removal afterwards, and since it wasn't causing you any problems before, there is little reason to suspect it will do after pregnancy. If it remained large (increasing the womb size to greater than a 12-week pregnancy) then you may be offered treatment (usually surgery - myomectomy, or fibroid removal), though increasingly we are not operating on the ones that aren't causing any problems.

      Pain from fibroids occurs because of something called 'red degeneration'. Pain-killers are all that's needed, and to exclude other causes of pain during pregnancy.

      Cancerous Change in Fibroids

      This is something that can happen, but is extremely rare. It is thought to happen in about 0.1%, from published studies. Many cases of fibroids are not diagnosed, so this figure must be an overestimation. It is 10 times more common in a woman in her 60's than one in her 40's and usually causes symptoms. Rapid enlargement of a fibroid in a post-menopausal woman would arise suspicion and prompt surgical removal. As mentioned above, fibroids are common - most women know someone who has them, yet most gynaecologists would see cancerous change once or twice in their lifetime practice.

  8. QUESTION:
    had a scan still worried?
    i have just been for an ultrasound scan im 6 wks pregnant because i am losing a slight brown discharge.luckily they found a heart beat and everything looks ok, but wat they did find as well was a fibroid at the fundus of the uterus. will this effect my pregnancy in any way and am i at any more risk then usall of misscarage?

    • ANSWER:
      Leiomyomas are benign tumors of the uterus.
      Most leiomyomas occur in the fundus and body of the uterus; only 3% occur in the cervix. The fibroids may be solitary, multiple, or diffuse.
      Most fibroids (95%) are intramural; they are located in the middle of the myometrium. Subserosal, or exophytic, fibroids are located in the subserosal layer and tend to cause a focal bulge in the exterior surface of the uterus. They can become pedunculated. Rarely, they occur in the broad ligament. Submucosal, or subendometrial, fibroids are the least common. They distort the overlying endometrium and can become extruded or pedunculated (ie, fibroid polyp) in the endometrial canal.
      Clinical Details
      Most women with fibroids are asymptomatic. Only 10-20% of patients require treatment.
      Symptoms of fibroids are related to the location, size, and number of the tumors. Symptoms may include the following:
      Bleeding: Menorrhagia, with an increased amount and duration of flow, is the most common symptom. Menorrhagia may result in severe anemia and can be life threatening, although this is rare. Menorrhagia usually results from the erosion of a submucosal fibroid into the endometrial cavity. Rarely, dilated veins on the surface of a subserosal pedunculated fibroid can cause sudden massive intraperitoneal bleeding.
      Pain: Women may experience abdominal cramping. Pain usually is felt during menstruation. Less often, pain occurs intermenstrually.
      Pressure: Urinary frequency, urgency, and/or incontinence result from pressure on the bladder. Constipation, difficult defecation, or rectal pain results from pressure on the colon. Abdominal cramping results from pressure on the small bowel. Generalized pelvic and/or lower abdominal discomfort may be present.
      Other: Rare cases of secondary polycythemia, cured with hysterectomy, are reported. Infertility and/or complications of pregnancy may occur. Submucosal fibroids may affect fertility (see Mortality/Morbidity). An exophytic fibroid can twist on its pedicle, resulting in necrosis and pain.
      Leiomyomas arise from the overgrowth of smooth muscle and connective tissue in the uterus. A genetic predisposition exists. Histologically, a monoclonal proliferation of smooth muscle cells occurs
      Evidence of an apparent hormonal dependency includes the following:
      Both estrogen and progestin receptors are present in fibroids.
      Elevated estrogen levels may cause fibroid enlargement. During the first trimester of pregnancy, 15-30% of fibroids may enlarge then shrink in puerperium. Some fibroids may decrease in size during pregnancy.
      Fibroids shrink after menopause. Some regrowth may occur with hormonal therapy.
      Frequency United States
      Leiomyoma is the most frequently diagnosed gynecologic tumor and occurs in 20-50% of women older than 30 years.
      Mortality/Morbidity
      Rarely, uterine leiomyoma may undergo malignant degeneration to become a sarcoma. The true incidence of malignant transformation is difficult to determine because leiomyomas are common, whereas malignant leiomyosarcomas are rare and can arise de novo. The incidence of malignant degeneration is less than 1.0% and has been estimated to be as low as 0.2%.
      Infertility may occur as a result of narrowing of the isthmic portion of the fallopian tube or as a result of interference with implantation, especially inference caused by submucosal fibroids.
      Complications during pregnancy include spontaneous abortion, intrauterine growth retardation, preterm labor, uterine dyskinesia or inertia during labor, obstruction of the birth canal, postpartum hemorrhage, and hydronephrosis.
      Race Leiomyomas occur more commonly in black women than white women, with a black-to-white ratio of 3-9:1. A genetic predisposition exists.

  9. QUESTION:
    What is Fibriod? whether it can be cured by homeopathy medieines without side effects?

    • ANSWER:
      Fibroids are the most common growths in a woman's reproductive system. Many women with fibroids have no symptoms at all, while others have symptoms ranging from heavy bleeding and pain to incontinence or infertility.
      Fibroids are tumours that grow in the uterus (womb). They are benign, which means they are not cancerous, and are made up of muscle fibre. Fibroids can be as small as a pea and can grow as large as a melon. It is estimated that 20-50% of women have, or will have, fibroids at some time in their lives. They are rare in women under the age of 20, most common in women in their 30s and 40s, and tend to shrink after the menopause.

      l

      Although the exact cause of fibroids is unknown, they seem to be influenced by oestrogen. This would explain why they appear during a woman's middle years (when oestrogen levels are high) and stop growing after the menopause (when oestrogen levels drop).

      According to US studies, fibroids occur up to nine times more often in black women than in white women, and tend to appear earlier*. The reason for this is unclear. Also women who weigh over 70kg may be more likely to have fibroids. This is thought to be due to higher levels of oestrogen in heavier women.

      In the past, the contraceptive pill was thought to increase the risk of fibroids, but that was when the pill contained higher levels of oestrogen than it does today. Some studies suggest that the newer combined pill (oestrogen and progestogen) and the mini pill (progestogen only) may actually help prevent or slow the growth of fibroids.

      Types of fibroids

      Fibroids are categorised by where they grow in the uterus

      Intramural — these grow in the wall of the womb and are the most common type of fibroid.

      Subserous—- these fibroids grow from the outer layer of the womb wall and sometimes grow on stalks (called pedunculated fibroids). Subserous fibroids can grow to be very large.

      Submucous — submucous fibroids develop in the muscle underneath the inner lining of the womb. They grow into the womb and can also grow on stalks which, if long enough, can hang through the cervix.

      Cervical — cervical fibroids grow in the wall of the cervix (neck of the womb) and are difficult to remove without damaging the surrounding area.

      If you have fibroids, you may have one or many. You may also have one type of fibroid or a number of different types.

      Fibroids — prevention

      As the cause of fibroids is still unknown, there are no clear guidelines for preventing them. However, there are some things you could do that may help reduce your risk:

      * Keep your weight in check. This will minimise oestrogen levels in your body.
      * Eat green vegetables and fruit, and avoid red meat. An Italian study found that women who eat little meat but a lot of green vegetables and fruit seem to be less likely to develop fibroids than women who eat a lot of red meat and few vegetables.
      * Some studies suggest the combined pill may protect against fibroids by keeping hormone levels from peaking and falling. The pill comes with its own set of side effects, however, so talk to your doctor about whether it�s right for you.

      Drug treatments � GnRH analogues

      A group of drugs, called GnRH analogues, reduce oestrogen levels in your body and, as a result, cause fibroids to shrink. Studies have shown that when taken for six months, GnRH analogues can reduce the size of fibroids by up to 50%. They also stop menstrual bleeding and pelvic pain. But GnRH analogues should not be taken for more than six months in total and there are a number of side effects. These include menopause-like symptoms such as hot flushes, vaginal dryness and bone loss (osteoporosis).

      Once you stop taking the drugs, fibroids begin to grow again.Your periods should also return within a few weeks, although some women may no longer ovulate after treatment.

      GnRH analogues are most commonly used to reduce the size of fibroids before surgery. In some cases, doctors may recommend them as a temporary treatment for women who are nearing the menopause, when fibroids should begin to shrink naturally.

      Surgical and non-surgical procedures

      The main treatments for fibroids are:

      * Myomectomy (removing fibroids individually, leaving the womb intact)
      * Hysterectomy (removing the womb entirely)
      * Uterine artery embolisation (blocking the blood supply to the fibroids)

      These are discussed in detail below.

      There is also a new procedure that is not included in the treatment chart because it is still undergoing trials. The procedure involves inserting four specially designed needles through the abdomen. Magnetic resonance imaging (MRI) is then used to guide the needles directly to the fibroid. The MRI is also used to monitor the effects on normal tissue around the fibroid in order to prevent any damage during the procedure. Once in place, the needles release laser energy into the centre of the fibroid, burning its tissue and halting its growth. Results so far suggest this procedure is effective in reducing symptoms and fibroid size, is minimally invasive and is without complications. These are, however, only the first set of results. More research and longer follow-up is needed to fully understand the benefits, risks and long-term effects.

      I had to undergo surgery as there is no medication (allopathic or homeopathic) that really helps.

  10. QUESTION:
    What are fybroids??
    31 WEEKS PREGNANT AND HAVE BEEN TOLD I HAVE SMALL FYBROIDS BUT THEY ARE NOT GROWING.... WILL THEY DISSAPEAR??!!

    • ANSWER:
      Fibroids are the most common growths in a woman's reproductive system. Many women with fibroids have no symptoms at all, while others have symptoms ranging from heavy bleeding and pain to incontinence or infertility. These information pages explain what fibroids are, how they can affect your health and what your options are for treatment. For more information on heavy bleeding or hysterectomy, visit our pages on these topics.

      What are fibroids?

      Fibroids are tumours that grow in the uterus (womb). They are benign, which means they are not cancerous, and are made up of muscle fibre. Fibroids can be as small as a pea and can grow as large as a melon. It is estimated that 20-50% of women have, or will have, fibroids at some time in their lives. They are rare in women under the age of 20, most common in women in their 30s and 40s, and tend to shrink after the menopause.

      Although the exact cause of fibroids is unknown, they seem to be influenced by oestrogen. This would explain why they appear during a woman's middle years (when oestrogen levels are high) and stop growing after the menopause (when oestrogen levels drop).

      According to US studies, fibroids occur up to nine times more often in black women than in white women, and tend to appear earlier*. The reason for this is unclear. Also women who weigh over 70kg may be more likely to have fibroids. This is thought to be due to higher levels of oestrogen in heavier women.

      In the past, the contraceptive pill was thought to increase the risk of fibroids, but that was when the pill contained higher levels of oestrogen than it does today. Some studies suggest that the newer combined pill (oestrogen and progestogen) and the mini pill (progestogen only) may actually help prevent or slow the growth of fibroids.

      Types of fibroids

      Fibroids are categorised by where they grow in the uterus (see illustration -->):

      Intramural — these grow in the wall of the womb and are the most common type of fibroid.

      Subserous—- these fibroids grow from the outer layer of the womb wall and sometimes grow on stalks (called pedunculated fibroids). Subserous fibroids can grow to be very large.

      Submucous — submucous fibroids develop in the muscle underneath the inner lining of the womb. They grow into the womb and can also grow on stalks which, if long enough, can hang through the cervix.

      Cervical — cervical fibroids grow in the wall of the cervix (neck of the womb) and are difficult to remove without damaging the surrounding area.

      If you have fibroids, you may have one or many. You may also have one type of fibroid or a number of different types.

      Fibroids — prevention

      As the cause of fibroids is still unknown, there are no clear guidelines for preventing them. However, there are some things you could do that may help reduce your risk:
      Keep your weight in check. This will minimise oestrogen levels in your body.
      Eat green vegetables and fruit, and avoid red meat. An Italian study found that women who eat little meat but a lot of green vegetables and fruit seem to be less likely to develop fibroids than women who eat a lot of red meat and few vegetables.
      Some studies suggest the combined pill may protect against fibroids by keeping hormone levels from peaking and falling. The pill comes with its own set of side effects, however, so talk to your doctor about whether it’s right for you.

      Fibroids — Symptoms

      It is estimated that 75% of women with fibroids do not have symptoms, therefore many women don't know they have fibroids. Whether or not you have symptoms depends on the size of the fibroids and where they are in your womb. This also affects the types of symptoms you are likely to have. For example, a small fibroid in the wall of your womb probably won't cause any problems, whereas a large fibroid growing outward from your womb might press against your bladder, causing bladder problems.

      The most common symptom of fibroids is heavy menstrual bleeding. Other symptoms include abdominal pain or pressure, changes in bladder and bowel patterns and, in some cases, infertility.

      Heavy menstrual bleeding (menorrhagia)

      Heavy bleeding may involve flooding (a sudden gush of blood), long periods or passing large clots of blood. Heavy bleeding is not always due to fibroids, but when it is, it is usually associated with fibroids that grow into the womb (submucous). Although it is unclear exactly why fibroids cause bleeding, it may be that they stretch the lining of the womb, creating more lining to be shed during a period.

      Heavy bleeding can be distressing and can make every day activities difficult. You will need to use extra sanitary protection and will probably need to change towels or tampons frequently. Some women with heavy bleeding feel they need to stay near a toilet during their periods. This can greatly restrict activity and may be frustrating or tiring.

      Anaemia (iron deficiency)

      Some women with fibroids and heavy bleeding develop anaemia as a result of blood loss. Anaemia can make you feel weak, dizzy and tired. If blood tests show that you have anaemia, ask your doctor about supplements or changes in your diet that might help. Foods such as liver, leafy green vegetables, dried fruit and even red wine can help boost your iron levels.

      Pain and pressure

      Some women with fibroids experience painful periods, dull aches in their thighs, back pain or constant pressure in the abdominal area that feels like bloating or fullness.

      Pain during your period may be due to large clots of blood pushing through your cervix. Cramps could also be caused by the womb trying to force out a submucous fibroid that is growing on a stalk in the cavity of the womb.

      Large fibroids can make the womb big and bulky, which can lead to lower back pain or pelvic discomfort. Some women with fibroids feel a dull ache in their thighs or develop varicose veins in their legs. This happens when fibroids become so large they press on nerves and blood vessels that extend to the legs.

      Occasionally, fibroids can cause sudden severe pain in the pelvic area or lower back. This may be due to a fibroid on a stalk (pedunculated) that has become twisted. This kinks the blood vessels in the stalk and cuts off the blood supply to the fibroid. If you feel sudden severe pain and also have a fever or feel sick, you should see your doctor. The fibroid may need to be removed or your doctor may recommend bed rest and painkillers until the pain stops on its own.

      Pain during sex

      Fibroids that press on the cervix or hang through the cervix into the vagina can make penetrative sex painful and can also cause bleeding during sex.

      Bladder and bowel symptoms

      Large subserous fibroids (on the outer part of the womb) can press on your bladder or bowel, leading to one or more of the following symptoms:
      Bladder
      frequent need to urinate
      leaking or dribbling urine
      urgent need to urinate, often passing only a small amount
      difficulty or inability to pass urine – this is very serious and you should tell your doctor as you may need urgent care. A tube, called a catheter, will be put into your bladder to empty it
      cystitis caused by trapped urine that becomes infected
      Bowel
      constipation
      haemorrhoids (piles)

      Fibroids and pregnancy

      Most fibroids do not get in the way of a pregnancy. They may cause discomfort, but they generally do not cause any other problems. Some fibroids in certain areas, however, can make conception difficult or lead to miscarriage. Fibroids may press against, or block the entrance to, the fallopian tubes, thus preventing the egg from reaching the uterus. Submucous fibroids that grow inwards into the womb are thought to cause recurrent miscarriage.

      A fibroid can also interfere with labour and birth if it blocks the passage to the birth canal. If this is the case, your doctor may recommend a Caesarean section. Fibroids may increase your risk of bleeding heavily after birth, and can increase the time it takes for your womb to return to its normal size.

      Just as fibroids can affect pregnancy, pregnancy can affect fibroids. It is thought that fibroids grow during pregnancy because of higher levels of oestrogen, but there is little evidence to support this. Another effect of pregnancy on fibroids is something called 'red degeneration.' This is when a fibroid’s blood supply is cut off, causing it to turn red and die. It can also happen outside of pregnancy but it usually occurs in the middle weeks of a pregnancy. Red degeneration can cause intense abdominal pains and contractions of the womb, which could lead to early labour or miscarriage. If you feel these symptoms, tell your doctor. The pain and contractions usually stop on their own but your doctor may give you drugs to ease the pain and stop the contractions more quickly.

      Fibroids are never removed during a pregnancy because of the risk of haemorrhage (bleeding).

      How to find out if you have fibroids

      Because there are often no symptoms, you may only find out you have fibroids when you go for an internal examination. If you have symptoms and think you might have fibroids, see your doctor. You may be referred to a gynaecologist who should be able to diagnose whether you have fibroids or another condition. The doctor will give you a vaginal examination to feel your uterus for lumps or bulges.

      If your doctor says you do have fibroids, ask if there is more than one, where they are and how large they are. This will help you better understand your symptoms and decide what action to take, if any. Your doctor may want to confirm a fibroid diagnosis with additional tests:

      Ultrasound scan

      An ultrasound uses sound waves to get an image of your internal organs. This can help determine if the lumps are fibroids or another type of tumour. It can also provide more detailed information about the size and location of fibroids.

      You may be given an abdo

effects of intramural fibroids