You may have uterine fibroids and not even know! Most of the time these harmless timorous growths show up on your uterus and are little cause for concern. But sometimes fibroids can grow large enough to cause discomfort that while still harmless can interfere with your life.

Uterine fibroids are usually too small to cause any problems and most women will not have any symptoms at all. Signs of fibroids are heavy menstrual periods and pelvic pressure or abdominal pain. If you have been feeling uncomfortable lately, ask yourself the following questions:

*Are my abdomen and/or pelvic region more tender than usual?
*Is my abdomen bloated?
*Am I experiencing constipation?
*Am I urinating more frequently than usual?
*Have I been having pain during intercourse?
*Are my periods heavier than usual? Am I changing tampons or pads more often, or every couple of hours?
*Am I soaking right through my tampons or pads?

If you have been having any of the above symptoms you should see your doctor. You will also want to tell your doctor if there is a history of uterine fibroids in your family. For women of African-American descent, your chances of developing fibroids are greater than for your Caucasian or Asian sisters although no one seems to really know why.

Diagnosing uterine fibroids
Your doctor will consider your symptoms and then perform two tests to determine if you have uterine fibroids. A pelvic exam may reveal fibroids if they are large enough for the doctor to feel by using his or her hand during the examination.

Some fibroids do not grow large enough to be felt, so your doctor will conduct an ultrasound exam. This simple non-invasive test involves using a machine to scan your internal organs. Fortunately an ultrasound is painless and does not involve using radiation in the way that an x-ray would.

Once your doctor has determined that you do have uterine fibroids, depending on their severity, there are several treatment options.

Uterine fibroid treatments

Uterine fibroid surgery
If your fibroids are causing a lot of pain or you are becoming anaemic due to heavy menstrual periods, your doctor may recommend surgery. There are three types of surgery to choose from and you will need to discuss which option is right for you based on the severity of your fibroids, whether you plan to have children, and what you are most at ease with.

*A myomectomy involves removing the fibroids without having to remove the uterus. This is far less invasive than a hysterectomy, but may not be suitable if the uterus has many fibroids or if the fibroid(s) have grown very large.

*A hysterectomy is more serious and means removing the uterus and the fibroids. For some women this is the most effective treatment for serious cases of fibroids but will impede any child-bearing. Plus if the ovaries are removed, immediate menopause occurs.

*A uterine fibroid emobilization (UFE) is a newer alternative where a radiologist uses a small x-ray tube to stop the flow of blood to the fibroid. This cuts off its life supply but does not require removing the fibroid. There is a risk the fibroids may grow back and you may not be comfortable undergoing a procedure that uses radiation, albeit in very small amounts.

Uterine fibroid drug therapy
Your fibroids may not require surgery or your doctor may prescribe certain drugs to facilitate any surgical procedures. These drugs shrink the size of the fibroids.

*Lupron is a common drug that is part of the GnRH agonists (Gonadotropin-releasing hormone) type that is used to decrease estrogen and progesterone production which in turn decreases the size of the fibroids. While taking these drugs you will experience menopause and many of the usual menopausal symptoms. Once you stop taking the drug, you period will return. These drugs are usually administered by monthly injections.

*Androgens are synthetic male hormones that slow or stop uterine fibroid growth and may provide relief from heavy periods and pelvic pain. But these drugs, such as danazol, tend to cause a lot of other unpleasant side effects that induce weight gain, facial hair growth, headaches, fatigue, hair loss, depression, and even blood clots and liver problems.

*Birth control hormones such as Depro Prover can be given in pill or patch form but will only help with the heavy menstrual bleeding and not the fibroids themselves. This is the least effective way to deal with uterine fibroids because the real problem of the fibroid growth is left untreated.

No one treatment is the best for all women and you may need to do some further research and talk to your doctor to determine what will be your best option. But the good news is that if your fibroids are affecting your life, there is help available and you can look forward to living discomfort and fibroid-free.

Some great info about uterine fibroids can be found at www.womenshealthmatters.ca

Menopause, Your Doctor, and You