The Trouble With Fibroids
By KJ Fields
Fibroids can cause excessive bleeding, cramping, and more - but there's help.
In 2009, Group Health member Debra Flores noticed that her periods were suddenly much heavier and lasted up to 20 days. Flores, who was in her late 40s, thought that the prolonged bleeding would stop and she'd hit menopause. But after a year, nothing had changed, except that she often felt dizzy, tired, and extremely weak.
"It really wore on my psyche," says Flores. "I'm normally a vivacious, outgoing person, but I became cranky and irritable."
She sought help from gynecologist Yolanda Richardson, MD, at Group Health Medical Centers downtown Tacoma location. Dr. Richardson diagnosed anemia from the excessive bleeding that was the result of uterine fibroids.
These non-cancerous growths occur in 20 to 40 percent of women. The tumors can range in size from smaller than a pea to larger than a cantaloupe. Most fibroids aren't troublesome and need no treatment. But sometimes they do cause problems in the form of heavy bleeding, cramping, fullness or pressure in the belly, the urge to urinate more often, low back pain, or pain during sex.
"We don't yet know why women get fibroids, but higher levels of estrogen affect them," says Dr. Richardson. "Symptoms can occur at any time but generally flare up during perimenopause (the 2- to 8-year period prior to menopause) when female hormones are fluctuating. Fibroids tend to shrink after menopause."
Treatment Options for Fibroids
If treatment for symptomatic fibroids is needed, women have several choices outlined in the chart below. They need to weigh their age, lifestyle, desire for future pregnancies, and whether they want to keep their uterus, says Dr. Richardson. Other factors that will help determine the best treatment selection are the size and location of the fibroids, as well as obstetrical history and severity of symptoms.
Group Health offers a shared decision-making video on treatment options for symptomatic fibroids. It's helpful to view this as part of a discussion with your physician about your options. You must be registered and have access to your personal online services to view the video: Videos About Treatment Options. Or contact Group Health's Resource Line to request a DVD copy.
Flores chose endometrial ablation, and says this option was right for her. "The procedure took care of my problem completely. When you're suffering from these symptoms, it's great to know that there is light at the end of the tunnel."
|Name of procedure||Type of procedure||Description||Recovery time*||OK for future child-bearing?|
|Endometrial ablation||Five-minute, outpatient. No incision||Destroys uterine lining; decreases menstrual bleeding||A couple of days||No|
|Uterine fibroid embolization||Radiation||Blood flow to fibroids is blocked to shrink them; improvement within a few months||One to two weeks||No|
|Myomectomy||Laparoscopic surgery||Removes fibroids though they may regrow||Three weeks||Yes|
|Hysterectomy||Laparoscopic surgery||Uterus is removed||Five to six weeks||No|
|Hormone therapy||Hormones administered orally||Symptoms are relieved but return if therapy is stopped||N/A||Yes|
*Recovery times vary