27 / 124
role,” she says. “It is also suggested
that fibroids may enlarge with
estrogen therapy (such as
oral contraceptives) or with
pregnancy.” Their growth seems
to depend on regular estrogen
stimulation, showing up only
rarely before age 20 and shrinking
after menopause.
SYMPTOMS
More than 50 percent of fibroids
are asymptomatic. “Symptoms of
uterine fibroids depend on the
location and the size of the tumor,”
stresses Dr. Dmitrieva. She adds
that the most common symptoms
include pronged menstrual
periods, intermenstrual bleeding,
heavy menstrual bleeding with
clots, lower abdominal pains,
pelvic pain and pressure, backache
and leg pains. There may also be
pressure on the bladder, which
leads to frequent urination, urinary
incontinence, or urine retention,
pressure on the bowel, which leads
to constipation or bloating, and/or
an enlarged abdomen. “However,
most women with fibroids are
asymptomatic; with only 10 to
20 percent of patients require
treatment,” she tells.
TREATMENT
Medications for uterine fibroids
are used to target hormones
that regulate the menstrual
cycle, and while they do not
eliminate fibroids, they may
shrink them. These cause estrogen
and progesterone levels to fall,
menstruation to stop, fibroids to
shrink and thereby anemia often
improves. Myomectomy, says Dr.
Dmitrieva, is a surgical procedure
when the surgeon removes the
fibroids, leaving the uterus in
place. Endometrial ablation is
a treatment that involves the
removal of the lining of the uterus,
either ending menstruation or
reducing menstrual flow.
IF YOU HAVE FIBROIDS
• Keep your follow-up
appointments so that your
doctor can check your fibroids
regularly.
• Take your ir
on supplement if
one has been recommended.
This will prevent anemia. It is
also helpful to eat a diet rich
in iron in addition to the iron
supplement.
• If your period cramps are
uncomfortable, over the-counter
Ibuprofen can be very effective
in relieving the cramps. You
should always take Ibuprofen
with some food on your stomach
to avoid stomach irritation.
DIAGNOSIS OF
FIBROIDS
Doctors usually detect
uterine fibroids during
a pelvic examination.
Ultrasound examination
helps to localize the
tumor and to check the
size. Fibroids do not
have to be removed
unless they are causing
symptoms such as
heavy periods, irregular
bleeding, or severe
cramps with periods. In
addition, sometimes the
size alone causes enough
discomfort so that
removal is necessary.
Once women go through
menopause, fibroids do
not usually cause any
further problems.
WHEN TO
CALL YOUR DOCTOR
• If periods become heavier,
either heavier flow or more
or larger clots.
• If you have irregular periods
or bleeding.
• If the ibuprofen does not
relieve enough of the cramps
and there is still severe pain.
• If you feel that the fibroids
are suddenly larger, or the
mass causes discomfort.
25
Jan/Feb 2016