Fibroids

Understanding and Treating Fibroids at Dr. Ezwana Clinic, Led by Consultant Obstetrician & Gynecologist Dr. Ezwana Elias

At Dr. Ezwana Clinic, under the expert guidance of Consultant Obstetrician & Gynecologist Dr. Ezwana Elias, we provide comprehensive care for a wide range of uterine conditions, including uterine fibroids. Fibroids, also known as leiomyomas or myomas, are non-cancerous growths that develop in the muscular wall of the uterus. These growths are very common and can vary significantly in size, from being so small they are undetectable to becoming large masses that can alter the size and shape of the uterus. Fibroids can grow inside the uterine cavity (submucosal), within the wall of the uterus (intramural), or on the outer surface of the uterus (subserosal).

It’s important to know that fibroids are incredibly common, affecting as many as 4 out of 5 women at some point in their lives. Many women who have fibroids may never experience any symptoms and only discover them incidentally during a routine pelvic exam or an ultrasound performed for another reason.

Are Fibroids a Cause for Concern Regarding Cancer?

Reassuringly, uterine fibroids are not cancerous and do not increase your risk of developing uterine cancer. The development of cancer in the muscle wall of the uterus, called leiomyosarcoma, is extremely rare, occurring in less than 0.3% of uterine growths. However, if a fibroid appears to be growing rapidly, especially in a woman who has gone through menopause, it is important to have it evaluated by a doctor to rule out any potential concerns.

What Causes Fibroids to Develop?

While the exact cause of uterine fibroids remains unknown, several factors are believed to play a significant role in their development and growth:

• Hormones: Fibroids are known to be sensitive to the hormones estrogen and progesterone, which are produced by the ovaries. They tend to grow during a woman’s reproductive years when hormone levels are higher and often shrink after menopause when hormone levels decline.
• Genetics: There is evidence to suggest that genetics may play a role in the development of fibroids. Women with a family history of fibroids, such as a mother, sister, or aunt who has had them, have an increased risk of developing fibroids themselves.
• Reproductive History: Fibroids have a tendency to grow during pregnancy, likely due to the increased levels of estrogen and progesterone. They often shrink back down in size after childbirth.

Recognizing the Symptoms of Fibroids

While many women with fibroids experience no symptoms at all, others may develop a variety of symptoms depending on the size, location, and number of fibroids. Some common symptoms of uterine fibroids include:

• Heavy or Prolonged Menstrual Bleeding: This is one of the most frequent symptoms, often leading to anemia.
• Pelvic Pain or Pressure: Fibroids can cause a dull ache or a feeling of heaviness or pressure in the pelvic area.
• Frequent Urination: If a fibroid grows and presses on the bladder, it can reduce bladder capacity and lead to the need to urinate more frequently.
• Difficulty Getting Pregnant: In some cases, fibroids can interfere with fertility by distorting the shape of the uterus or blocking the fallopian tubes.

Fibroids are more likely to cause noticeable symptoms if they are large, if there are multiple fibroids, or if they are located inside the uterine cavity (submucosal fibroids).

How Are Fibroids Diagnosed at Dr. Ezwana Clinic?

At Dr. Ezwana Clinic, a doctor may suspect the presence of fibroids during a routine pelvic examination if your uterus feels enlarged or has an irregular shape. However, the most common and effective way to confirm the diagnosis of uterine fibroids is through a pelvic ultrasound. This imaging technique uses sound waves to create detailed pictures of the uterus and surrounding pelvic organs, allowing us to clearly visualize the size, number, and location of any fibroids present.

Treatment Options for Fibroids at Dr. Ezwana Clinic

Not all uterine fibroids require treatment. If fibroids are small, not causing any symptoms, and not affecting fertility, Dr. Ezwana Elias may recommend monitoring them with regular check-ups and pelvic ultrasounds to ensure they are not growing significantly.

However, if fibroids are causing bothersome symptoms such as pain, heavy bleeding, or are interfering with fertility, several treatment options are available at Dr. Ezwana Clinic:

1️⃣ Medications to Manage Symptoms

While there is currently no medication that can permanently shrink or completely remove fibroids, some medications can help to effectively manage the associated symptoms:

• NSAIDs (e.g., Mefenamic Acid): Nonsteroidal anti-inflammatory drugs can help to reduce menstrual cramps and the amount of bleeding during your period.
• Hormonal Birth Control (Pills, Patches, IUDs): Hormonal contraceptives can help to regulate your menstrual cycle and reduce heavy bleeding associated with fibroids.
• GnRH Agonists (Injections or Nasal Spray): Gonadotropin-releasing hormone (GnRH) agonists can temporarily shrink fibroids by inducing a state of reversible menopause. However, these medications are typically not used as a long-term solution due to potential side effects such as bone thinning.

2️⃣ Surgical Treatment for Fibroids

Surgery is currently the only way to completely remove uterine fibroids. Dr. Ezwana Elias may recommend surgery if:

• Heavy bleeding caused by fibroids does not improve with medication.
• Pelvic pain or pressure from fibroids is significantly affecting your daily life.
• Fibroids are believed to be interfering with your ability to conceive or carry a pregnancy to term.

There are different surgical approaches to removing fibroids:

• Myomectomy – Removing Fibroids While Keeping the Uterus: A myomectomy is a surgical procedure that removes fibroids from the uterus while leaving the uterus intact. This is often the preferred option for women who plan to have children in the future. Myomectomies can be performed in several ways:

  • Hysteroscopic Myomectomy: Fibroids that are located inside the uterine cavity can often be removed using a hysteroscope, a thin, lighted instrument inserted through the vagina and cervix, requiring no abdominal incisions.
  • Laparoscopic Myomectomy: This minimally invasive keyhole surgery involves making small incisions in the abdomen through which specialized instruments and a camera are inserted to remove the fibroids. This approach typically results in faster recovery times.
  • Open Myomectomy: For very large or multiple fibroids, an open myomectomy may be necessary, which involves a larger incision in the abdomen to access and remove the fibroids.

• Hysterectomy – A Permanent Solution for Fibroids: A hysterectomy is a surgical procedure that involves the complete removal of the uterus. This provides a definitive cure for fibroid-related bleeding and pain and is an option for women who:

  • No longer wish to have children.
  • Have severe fibroid symptoms that do not improve with other treatments.
  • Desire a permanent solution to their fibroid problems. Hysterectomy can also be performed in different ways:
  • Laparoscopic (Keyhole) Hysterectomy: A minimally invasive approach using small abdominal incisions for faster recovery.
  • Vaginal Hysterectomy: The uterus is removed through the vagina, leaving no visible abdominal scars.
  • Open Hysterectomy: A traditional approach involving a larger abdominal incision.

Choosing the Right Treatment at Dr. Ezwana Elias’ clinic

At Dr. Ezwana Elias’ clinic, we understand that every woman’s situation is unique. During a consultation, Dr. Ezwana Elias will:

• Assess your individual symptoms, fertility goals, and medical history.
• Recommend the best treatment approach tailored to your specific needs and preferences.
• Provide expert care using the latest and most effective techniques, including minimally invasive options whenever appropriate.

If you are experiencing symptoms that you believe may be related to uterine fibroids, we encourage you to schedule an appointment with Dr. Ezwana Elias today to discuss your concerns and explore the available treatment options.