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ASK THE DOCTOR: Uterine fibroids explained |
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Written by DR. KATIA LAREMONT, M.D.
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 Q. : I’ve been diagnosed with uterine fibroids. What are they, and how are they treated?
–Rose C., Fort Lauderdale
A. : Uterine fibroids are benign growths in the uterus that originate from a muscle cell. They are typically diagnosed by a pelvic ultrasound. Treatment largely depends on what symptoms you are experiencing and your fertility desires. In women who are not experiencing symptoms, management involves monitoring with routine pelvic exams and repeat ultrasound to ensure that rapid change in their growth has not occurred. A rapid change in growth is a sign that the fibroids may be cancerous, but this is rare—only 1 percent of cases.
Other symptoms fibroids may produce include vaginal bleeding, pelvic pressure or discomfort, back pain and fertility problems. In the case of the latter, myomectomy is an excellent option. This procedure involves making an incision in the uterus and removing the fibroid (s) to relieve a woman’s symptoms and improve her chances of conceiving.
It may be done through traditional surgery, laparoscopy or hysteroscopy (inserting instruments through the vagina and uterus to remove fibroids.) With laparoscopy and hysteroscopy, there are limitations to the size and number of fibroids which may be removed. These two particular procedures are ideally suited for women with a limited number of small fibroids. Women with symptomatic, multiple, large fibroids are best treated with traditional surgery. This may be accomplished with a myomectomy or a hysterectomy: removal of the uterus.
Medications can be prescribed in some women to provide temporary relief of symptoms. These medications may include birth control pills, progestin injections and lupron, a medication which temporarily shrinks the fibroid(s). If you are experiencing heavy periods or bleeding you should have your blood count checked to make sure you are not anemic. Anemia can be treated with iron supplements.
In the past few years, newer, less invasive methods have been developed for the treatment of fibroids.
These methods include uterine artery embolization and MRI guided ultrasound ablation of fibroids. In uterine artery embolization, small particles are introduced into the blood vessels which feed the fibroids, causing these vessels to cease function. Without functioning blood vessels to feed them, the fibroids are unable to grow, and thus shrink. Many women may experience up to a 30% reduction in the size of their fibroids with this procedure. Some women may experience a larger amount of shrinkage of their fibroids; others less.
Ultrasound ablation of fibroids is a procedure wherein the fibroids are destroyed by ultrasound waves using MRI guidance. This is a very expensive procedure and may require more than one treatment. Unlike uterine artery embolization, many insurance companies do not cover ultrasound ablation. A typical treatment may cost several thousand dollars.
In summary, by working closely with your doctor, you will be able to decide which of these treatments is ideal for you.
Dr. Katia Laremont, M.D. is medical director of Planned Parenthood of South Palm Beach & Broward Counties, Inc. overseeing four health centers in Broward County and one in Boca Raton. Planned Parenthood is dedicated to providing medically accurate information and affordable health care. For questions on this or other topics on women’s health, contact Dr. Laremont at the Planned Parenthood Boca Raton Health Center: 561-368-l023 or
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