Living With Uterine Fibroids
Uterine fibroids are abnormal growths in your uterus. They are an extremely common condition among women, especially starting in your 30s, 40s, and going into menopause. While it can be scary to have a “growth” in your uterus, fibroids are very rarely cancerous, and many women never have symptoms.
However, for women who have fibroid symptoms such as pelvic pain, painful periods, painful intercourse and heavy uncontrollable bleeding, many feel compelled to or are encouraged to turn to invasive treatments, like hysterectomies, a procedure that removes their entire uterus.
In keeping with the mission of Innovative Women's HealthCare Solutions, we started The Fibroid and Reproductive Care Center to further educate our patients on all available options- and there are many NON-HYSTERECTOMY OPTIONS available!
The team at Innovative Women’s HealthCare Solutions, with offices in Smyrna and Midtown Atlanta, Georgia, use a combination of traditional and alternative treatments, customizing your fibroid treatment plan to fit your risk category, lifestyle and clinical picture. Best of all, we provide all of the minimally-invasive fibroid treatments in our in-office surgical suite, saving you time, money and offering a safer, sterile environment, minimizing the exposures to COVID-19 that can occur in a crowded hospital setting.
We believe in protecting and preserving your reproductive health and offering innovative solutions to manage your gynecological issues using minimally invasive treatments.
Dr. Melinda Miller-Thrasher’s recently released book entitled The Innovative Women's Guide to Managing Fibroids Without Hysterectomy is a testament to her passion for this ongoing issue.
Understanding uterine fibroids
Your uterus, or womb, plays a vital role in your body. Not only does it support pregnancy and childbirth, but it also provides structural integrity to your bowel, bladder, pelvic organs, and pelvic bones.
Your uterus also has a complex network of blood vessels and nerves, which directs blood flow throughout your pelvis and external genitalia, which is involved in sexual response.
There are three main types of fibroids, including:
- Submucosal: growing in your uterine cavity
- Intramural: growing within the uterine wall
- Subserosal: growing outside your uterus
No one knows what triggers these abnormal growths to develop in your uterus, but they’re often genetic and linked to the hormones estrogen and progesterone. Your chances of having fibroids may also be higher if you’re overweight, frequently eat red meat but minimal vegetables, or are African American. Dr Miller-Thrasher also counsels her patients regarding certain vitamins, supplements and additives that may impact the growth of fibroids such as vitamin D and phthalates. Her emphasis on these nontraditional factors that impact fibroids distinguishes her from her peers
When uterine fibroids cause symptoms
Up to 80% of women have uterine fibroids by the time they turn 50. You can have a single growth or several, and they can range in size from a tiny seed to the size of a grapefruit, or even bigger. And unfortunately, some fibroids (especially large growths) can cause a variety of uncomfortable symptoms.
Common symptoms of uterine fibroids include:
- Heavy menstrual bleeding
- Painful periods
- Pelvic pain or fullness
- An enlarged lower abdomen
- Lower back pain
- Painful sexual intercourse
- Urinary Frequency or Incontinence from pressing on your bladder
- Constipation or Bloating from pressing on your intestines
Although fibroids rarely cause infertility, they almost uniformly grow during pregnancy and are associated with an increased risk of miscarriage, preterm labor, preterm rupture of membranes, and preterm delivery. Additionally, depending on the location of the fibroid, your chances of needing a cesarean section increases as well.
Diagnosing Fibroids
After a thorough history and physical exam, which typically will include a pelvic exam, you will more than likely have to undergo a pelvic and/or transvaginal ultrasound. This is a noninvasive procedure that looks closely at your uterus, tubes and ovaries from outside your pelvis or by using a probe that goes into the vagina. This procedure will give details like the size, number and location of your fibroids.
Treating uterine fibroids
We often see patients who say that hysterectomy was the only choice discussed by their provider. This is absolutely wrong and unacceptable. It is my opinion that unless malignancy is suspected, a woman should have the choice to keep her uterus, regardless of age, menopausal status and number of children you already have. This procedure removes your uterus and sometimes other reproductive organs, like your ovaries or cervix.
While this treatment can provide effective relief from fibroid symptoms, approximately 90% of hysterectomies are unnecessary. At Innovative Women's Healthcare, we pride ourselves on offering numerous minimally-invasive treatments to help relieve your uterine fibroids symptoms while still preserving your reproductive health.
Medications
We recommend a variety of medications to address specific fibroid symptoms. In some cases, they might include:
- Over-the-counter or prescription pain relievers
- Iron supplements to avoid anemia from blood loss
- Low-dose birth controls, like The Pill, or IUDs, and medications such as Depo-Provera, Lysteda and Oriahnn
Lupron is a medication specifically formulated to treat fibroids known as gonadotropin-releasing hormone agonists (GnRH-a). These drugs can shrink fibroids and eliminate heavy bleeding.
Hysteroscopy
This minimally invasive procedure involves passing a small instrument, or hysteroscope, with a light and camera through your vagina and into your uterus. We use this treatment device to both diagnose fibroids as well as remove them.
We perform hysteroscopy in our office under local or using gentle IV sedation administered by an experienced anesthesia team. During your procedure, we fill your uterus with fluid or gas to improve visibility in the area. Then, we guide the hysteroscope into your uterus to locate and capture images of your fibroids.
To remove your fibroids, we use a suction morcellator. This device lets us cut and remove tissue at the same time, so we can remove your fibroid faster, with less risk, no incisions, and absolutely no downtime. This procedure will not negatively impact your fertility. As a matter of fact, removing fibroids or polyps from inside the uterus allows the uterus to be more receptive to the developing embryo. After having hysteroscopy, you may experience cramping and discomfort for a few days, but you can manage the symptoms with over-the-counter medications.
Endometrial ablation
This treatment involves removing or destroying your uterine lining to stop heavy and menstrual bleeding. We might recommend this technique if you are done having children because it can affect your fertility.
We use a variety of techniques to perform endometrial ablation, including:
- Laser ablation
- Radiofrequency
- Thermal balloon ablation
- Electrical cauterization using special electrodes
- Microwave ablation
- Cryoablation (freezing)
We perform this 15-20 minute procedure using local anesthesia or sedation. You can go home right after your appointment. After the procedure, you might experience some minor vaginal bleeding, discharge, or cramping for a week or two. These are just a few of the minimally-invasive procedures offered to our patients. There are several other highly-effective treatment options, including uterine fibroid embolization. The Fibroid and Reproductive Care Center at Innovative will facilitate consultations for these other diagnostic and therapeutic options.
To learn more about living with uterine fibroids, and how we can help treat it using minimally invasive methods, call or schedule an appointment online. The Innovative Women’s Guide to Managing Fibroids Without Hysterectomy is available through Amazon or at The Fibroid and Reproductive Care Center at Innovative Women’s HealthCare Solutions.
With your Uterus In Mind,
Melinda Miller-Thrasher, MD, FACOG