Otherwise known as leiomyomas, fibroids are common. As many as 50% of women will have fibroids. However, fibroids are generally not cancerous and may not cause any symptoms.
While some women learn they have fibroids incidentally as part of health screening or scan during pregnancy, others may discover their fibroids during investigation of their symptoms.
Common symptoms of fibroids include:
- Heavy and or prolonged menses
- Anaemia due to excessive blood loss from heavy menses
- Inability to conceive
- Feeling a hard bulge in the lower abdomen
As some fibroids have no symptoms, it is best to do your health checks regularly. Treatment of fibroids can range from simple medical treatment to the very latest innovative surgery. However, the treatment must be individualized based on symptoms, size and location of fibroids, age, need and desire of the patient to preserve fertility or the uterus.
Effective medical treatments for women with abnormal uterine bleeding associated with uterine fibroids can range from simple oral treatments like Tranexamic acid, oral contraceptives especially Qlaira or use of Mirena (levonorgestrel intrauterine system) to treat symptoms of heavy menstrual flow to the latest products like Esmya (progesterone receptor modulators) to shrink the fibroids.
The surgical option of hysterectomy (removal of the uterus) is the most effective treatment for symptomatic uterine fibroids. Hence, for women who have completed family or do not wish to preserve fertility, hysterectomy can be considered as this is the only option that will confer cure.
Myomectomy (surgical removal of only the fibroids) while conserving the uterus can be done for women who still wish to conceive. However, there is always a risk that new fibroids may grow in future as the uterus is still intact.
Operations to remove the uterus or the fibroids alone can be done via laparoscopy (keyhole), laparotomy (conventional open incision) or through the vagina / cervix (with no incision on the abdomen). However, the best and safest type operation differs from person to person based on the location, the size and the number of fibroids.