Fibroids and Fertility
Fibroids are a type of non-cancerous growth that are often discovered in a person’s uterus during a pelvic exam. Structurally, they come in a variety of shapes and sizes, but they are generally harmless. In fact they usually do not present any symptoms and a person could have fibroids and not know it. Having said that, their presence could affect a pregnancy, as well, cause medical complications. The good news is that there are treatment options for fibroids. So let us get into a little more detail about these growths, how they are detected, and as indicated, how they can be treated.
What Are Fibroids?
Medically, other words used to refer to fibroids are myomas, or leiomyomas. They are not typically disruptive to a person’s daily life, but at times, medical intervention may be required to manage them. We shall get into the various treatments for these soon enough. For now, let us talk about the types of fibroids and what their characteristics are.
Fibroids are categorized according to how they develop and grow in the uterus. They have been classified into three main categories:.
Intramural Fibroids
Intramural fibroids, just as the name suggests, grow within or between (intra) the wall (mural) of the uterus. This means they are neither on the inner surface, nor the outer surface of the uterine wall.
Submucosal Fibroids
This type of fibroid grows into the uterine wall. The fibroid itself does not grow directly on the uterine wall, but rather, develops atop a stalk which then extends into the uterus.
Subserosal Fibroids
This type of fibroid grows in a similar way to the submucosal type, atop a stalk. The difference is the direction that the stalk takes. In this case, the stalk extends outward from the uterus.
The stalk on which submucosal and subserosal fibroids develop classifies them as pedunculated.
Signs of Fibroids
As we mentioned earlier, for the most part, fibroids do not have any symptoms. However, sometimes, they can present symptoms. Some of the symptoms associated with the presence of fibroids are outlined below:
Menstruation Irregularities
In a typical period, it is normal to have some discomfort at times. When fibroids are present and symptomatic, they can cause a person to experience very heavy periods that are accompanied by pain. As well, the periods could come more frequently than usual, or for a longer duration of time than is expected.
Pain in the Pelvic Area or the Abdomen
When a person has fibroids, they may experience pain or some strong pressure in the pelvic region when they are having sex. Again, they could experience pain in their abdominal region or their lower back. Another form of pain could be from the sudden death of a fibroid, particularly if the fibroid had grown large. This type of pain is sudden and very severe, but it is a rare occurrence.
Interference of Bowel and Bladder Function
Fibroids can cause interference in the regular function of the bowels or the bladder because of their location in the pelvis. They can make it difficult to make bowel movements, at times even causing constipation. They can also make it challenging to pass urine, or cause a person to urinate with a lot more frequency.
Physical Changes
As earlier mentioned, fibroids grow in various shapes and to various sizes. A fibroid can grow so large that it causes a person to have an irregular protrusion on the abdomen. They can even be positioned in a way such as to make a person appear to be pregnant when they are not.
Causes of Fibroids
Fibroids do not have a specific cause that medicare practitioners can pinpoint to. As well, it is not clear as to whether it is a singular factor or a combination of factors that cause them to develop. What is known with certainty is that the hormone estrogen can trigger the rapid growth of small growths located within the uterus. This means that in the same way it facilitates the growth of a baby in the womb, it can also cause abnormal tissues to spread rather quickly.
Consequently, and perhaps coming as no surprise then, females who are within their reproductive years have a higher likelihood of developing fibroids than those who are past menopause, or are prepubescent. This is because of the hormonal fluctuations that their bodies undergo in the course of their menstrual cycles. Outside of this, there are factors such as genetics and a person’s lifestyle that could cause them to develop fibroids at a point in their life. As well, if a person has obesity, high blood pressure, or has a family history of fibroids, their likelihood of developing fibroids is higher.
Treatment of Fibroids
All of that being said, the good news is that there are treatments available in the management of fibroids which include ultrasound therapy, medication, hormone therapy and surgery. Often the first line of treatment would be non-surgical, unless the fibroids are very many or too large. When medical intervention is required, fibroids are usually treated using prescription medication or surgical procedures. Of note is that the typical modes of medical intervention do not cause infertility, therefore it is possible to still build a family after treatment of fibroids.
Nonsurgical Options
Non-surgical treatment options are typically used on smaller fibroids, or fibroids with milder symptoms. These treatments comprise either prescribed medicine, or prescribed hormones and have been observed to be effective in managing these smaller types of fibroids.
Hormone-based Treatments
The way that hormone-based treatment works on fibroids is that it targets the actual fibroids to shrink them, resulting in the alleviation of the symptoms they were causing. Gonadotropin-releasing hormone agonists, or GnRHa, is the key hormone used for this. GnRHA reduces the estrogen in the body, which slows down the growth of the fibroids, or reverses their growth altogether. Sometimes, this method of shrinking the fibroids is used as a pre-surgical protocol, which then increases the likelihood that they will be successfully removed. However, using GnRHa in the long-term has side-effects that can be serious and unpleasant.
Medication-based Treatments
When fibroids are particularly problematic, the typical course of treatment is prescribing contraceptive pills because they reduce the size of the endometrium. When the endometrium is not as thick, then a person does not experience the excessive bleeding that would otherwise continue lt if the endometrium is not controlled.
Uterine Fibroid Embolization
Embolization is a process that both shrinks and damages the fibroid, because it cuts off the blood supplying its growth.
Ultrasound-based Treatment
WIth this type of treatment, unlike a medical imaging procedure, the ultrasound waves are higher energy and focused, like a laser beam, allowing a healthcare provider to target and destroy the fibroids without damaging the surrounding tissue.
Surgery
When the treatment option necessitates a surgical procedure, apart from the size of the fibroids, healthcare providers take into consideration the health of the patient, their age, as well as if they have any plans for building a family in the future. This is because all surgery by nature comes with some risk. Below are surgical options that are commonly used in managing fibroids:
Hysteroscopic Myomectomy
A myomectomy is the term used to refer to the surgical removal of fibroids. A hysteroscopic myomectomy is done using an instrument called a hysteroscope. It is inserted through the cervix into the uterus, and a small surgical tool used to burn away the fibroid. This procedure is typically done on small fibroids that are problematic, and can be done as an outpatient procedure.
Laparoscopic Myomectomy
A laparoscopy is a surgical procedure that is done by making small incisions around a surgical site, which allow a surgeon to insert surgical tools through. The surgery is conducted with the aid of a camera and a monitor which allows the surgeon to view the surgery as they perform it. Larger fibroids usually call for this treatment, but they can at times be too large to pass through laparoscopic incisions. When that is the case, an open surgery may be required.
Full Hysterectomy
A hysterectomy is a surgical procedure that removes the uterus in its entirety from the body. As such, it can only be done in extreme cases, when the fibroids create a situation whereby a person cannot function normally in their daily routine. Several factors are put into consideration beforehand, the foremost being the family building plans of a patient, as pregnancy will no longer be an option. As well, the patient will no longer experience menstruation. For this procedure a patient will be sedated to prevent discomfort.
Summing It Up
Fibroids are not cancerous, and neither are they harmful. When they become problematic, it is possible to get treatment. However, if you have concerns or queries about fibroids, feel free to contact Fertility Associates of Memphis. We are happy to assist you in finding the proper medical care for fibroid-related or fertility issues.
Seek emergency care immediately if you experience lightheadedness, weakness, and fatigue with severe vaginal bleeding as it could be indicative of severe fibroid-related complications.