Fibroids

One of the many things that grow inside a uterus and cause problems for some while others barely know about it in their life are FIBROIDS.I was recently diagnosed with multiple fibroids and cysts when my usual monthly periods became a little too unbearable.We got an ultrasound done which led to many other gynecologists doing the same thing for confirmation.

My fibroids are small but I have been told that my periods will be stopped for a couple of months and regular ultrasounds will be done to ensure that no fibroids are growing out of proportions or are getting benign or malignant,which again is done through a biopsy.I just thought I will write about a  bit of my journey as I spend this time scared.

I told a couple of my friends and they all had scary stories to tell about how some relative didn't take care of themselves and were finally diagnosed with cancer at a later stage and died from it.I had my share of panic attack yesterday night and after a proper informative chat with my husband,he calmed me down and as usual we decided we would embark on every journey or problem together and deal with it with the name of God on our lips.

First of all,I have been suffering from dysmenorrhea for a very long time.Some months are blessed especially after I got married ,things changed and I had many a wonderful painfree periods.I was diagnosed with mild endometriosis and multiple cysts and damaged tubes back in 2002.I had a laparotomy done which was a very horrible surgery to recover from,had to induce menopause for 6 months,spent money like water on good medications.I blew up like a giant air ball because of the recommended bed rest.Then came the phase when trying to concieve was driving me literally nuts and suicide seemed much better than not being able to get pregnant.We stopped all other medications for once and then last year 2012,I was admitted again because of sever pain from cysts.

No medicine was given as such but rather was told to wait and come for another check up to see if the cysts were there or not.Some had gone while was left behind .This year got admitted again.Thankfully a good doctor pointed out I should have been on treatment since last year for my endometriosis.Anyways,now she has given me duphaston tablets to be taken thrice a day for 21 days and next week I go for a ultrasoound. and she will recommend what else should be done.

I was researching info on fibroids so I'm better informed and know what my body is saying.I have had this feeling of in tense pressure on the lower abdomen and difficulty passing gas /wind and passing stool.This too is a symptom with fibroids as I researched.I had not told my doctor about it as I thought that was a different problem altogether.

Information: 

Facts About Fibroids

What are fibroids?Fibroids are growths on the walls of the uterus. Sometimes, a fibroid is attached to the outside of the uterus by a stalk. Fibroids can be as small as a seed or a pea or as large as an orange or small melon. Although fibroids are called "tumors," they are not cancer. They are smooth muscle growths. About two of every 10 women who have not gone through menopause have fibroids. The technical term for a fibroid tumor is leiomyoma. What symptoms do fibroids cause? Fibroids may cause no symptoms at all, or they may cause pain or bleeding. Fibroids may make it hard to pass urine if they grow large enough to press on the bladder. They also may cause abdominal swelling, pain during intercourse, lower abdominal and pelvic discomfort or pain, and increased uterine cramping before and during menstrual periods. Fibroids also can make it hard for you to get pregnant. Sometimes fibroids can cause problems with pregnancy, labor or delivery, including miscarriage and premature birth. How are fibroids diagnosed? Usually, fibroids are found by abdominal or pelvic examination or pelvic ultrasound. Less frequently, magnetic resonance imaging (MRI) or computerized tomography (CT) scans are used. What happens to fibroids after menopause? Fibroids usually shrink substantially and symptoms may be significantly reduced. Larger fibroids may remain symptomatic if estrogen replacement therapy is used. How are fibroids treated?If you have fibroids, you may have several treatments from which to choose. The choice depends on how big the fibroids are, where they are, and whether you are pregnant or want to become pregnant. Watchful waiting may be all the treatment you need if your fibroid is small and you do not have any symptoms. You will need regular visits to your doctor for a pelvic exam to monitor the growth of the fibroid. Non-surgical treatments for fibroids include hormones and pain relief medicines. Surgical treatments for fibroids include hysterectomy and myomectomy. Hysterectomy is usually recommended when the fibroids are causing symptoms, when they have grown rapidly or when the fibroids are large (as large as a grapefruit). Myomectomy is an operation to remove a fibroid tumor without taking out the uterus. The growths may come back after a myomectomy, and repeat surgery may be necessary. If you are considering a myomectomy, be sure to ask the doctor how likely it is that new fibroids might grow after the surgery. You also should ask your doctor how much experience he or she has in doing this procedure. Not all gynecologists have been trained to perform myomectomies. Another option is laser surgery, which usually is an outpatient procedure. With laser surgery, the doctor uses a high-intensity light to remove small fibroids. Depending on the location of the fibroid, it may be possible to remove it during a laparoscopy. Or, the doctor may put a thin tube called a hysteroscope with a laser through the vagina and into the uterus. The tube may have a small scraper to scrape away the fibroid from the wall of the uterus. Fibroids Treatment Treatment for fibroids can range from no treatment at all to surgery. Unless fibroids are causing excessive bleeding, discomfort or bladder problems, treatment usually isn't necessary. If you have fibroids, you should be evaluated periodically to review symptoms, and to monitor the fibroid and uterus size with abdominal and pelvic examinations. If you don't have symptoms, routine pelvic ultrasounds have very little benefit. Fibroids are likely to grow each year until menopause, but this isn't an indication that you need treatment, unless the change is accompanied by disabling symptoms. The following are treatment options for fibroids: Medications Currently, the medications available for fibroids can temporarily improve symptoms but do not make the fibroids go away. For women with heavy bleeding, it is worth trying medication before undergoing a surgical procedure. Women with pressure symptoms caused by large fibroids won't benefit from any medicines currently available. There are several promising new drugs on the horizon that will treat the fibroids themselves, not just the symptoms. Contraceptive Pills and Progestational Agents Women with heavy menstrual periods and fibroids are often prescribed hormonal medications to try to reduce bleeding and regulate the menstrual cycle. These medications will not shrink fibroids or make them grow at a faster rate. If the medication has not improved your bleeding after three months, consult your doctor. Women over the age of 35 who smoke should not use oral contraceptives. GnRH Agonists (Lupron) GnRH agonists are a class of medications that temporarily shrink fibroids and stop heavy bleeding by blocking production of the female hormone, estrogen. Lupron is the most well known of these drugs. Although Lupron can improve fibroid symptoms, it causes unpleasant menopausal symptoms such as hot flashes. Long-term use can cause bone loss. Lupron is recommended only for very specific cases. It may be recommended if you have heavy bleeding and serious anemia, and would need a blood transfusion during fibroid surgery. If you take Lupron for two to three months before surgery, your periods may temporarily stop and eliminate the need for a blood transfusion. Lupron also may be recommended if you have very large fibroids — greater than 10 to 12 centimeters — prior to fibroid surgery. Lupron should not be used solely to shrink fibroids unless surgery is planned, because fibroids will re-grow to their original size as soon as you stop taking Lupron. Intrauterine Devices (IUD) Although IUDs are typically used to prevent pregnancy, they have other benefits as well. An IUD that releases a small amount of hormone into the uterine cavity can decrease bleeding caused by fibroids. An IUD can be inserted during a routine office appointment. Myomectomy A myomectomy is an operation to remove fibroids while preserving the uterus. For women who have fibroid symptoms and want to have children in the future, myomectomy is the best treatment option. Myomectomy is very effective, but fibroids can re-grow. The younger you are and the more fibroids you have at the time of myomectomy, the more likely you are to develop fibroids again in the future. Women nearing menopause are the least likely to have recurring problems from fibroids after a myomectomy. A myomectomy can be performed several different ways. Depending on the size, number and location of your fibroids, you may be eligible for an abdominal myomectomy, a laparoscopic myomectomy or a hysteroscopic myomectomy. Abdominal Myomectomy — During this operation, an incision is made through the skin on the lower abdomen (a "bikini cut"). The fibroids are removed from the wall of the uterus, and the uterine muscle is sewn back together using several layers of stitches. You will be asleep for the procedure. Most women spend two nights in the hospital and four to six weeks recovering at home. Laparoscopic Myomectomy — In a laparascopic myomectomy, four one-centimeter incisions are made in the lower abdomen: one at the belly button, one below the bikini line near the pubic hair, and one near each hip. The abdominal cavity is filled with carbon dioxide gas. A thin, lighted telescope is placed through an incision so the doctors can see the ovaries, fallopian tubes and uterus. Long instruments, inserted through the other incisions, are used to remove the fibroids. The uterine muscle is then sewn back together, the gas is released and the skin incisions are closed. You will be asleep for the procedure. The recovery is shorter than for an abdominal myomectomy — typically, women spend one night in the hospital and two to four weeks recovering at home. Hysteroscopic Myomectomy — Only women with submucosal fibroids — fibroids that expand from the uterine wall into the uterine cavity — are eligible for this type of myomectomy. Fibroids located within the uterine wall cannot be removed with this technique. During the procedure, you will lie on your back with your feet in gynecology stirrups. You will most likely be asleep for the procedure. A speculum is placed in the vagina and a long, slender telescope is placed through the cervix into the uterine cavity. The uterine cavity is filled with fluid to lift apart the walls of the uterus. Instruments passed through the hysteroscope are used to shave off the submucosal fibroids. This is an out-patient procedure, and you may go home after several hours of observation in the recovery room. Most women spend one to four days resting at home to recover. Read more about myomectomy. Hysterectomy Hysterectomy is a major surgical procedure in which the uterus is removed. Many women choose hysterectomy to definitively resolve their fibroid symptoms. After hysterectomy, menstrual bleeding stops, pelvic pressure is relieved, frequent urination improves and new fibroids cannot grow. A woman can no longer become pregnant after a hysterectomy. The ovaries are not necessarily removed during a hysterectomy. Generally, if a woman is in menopause or close to menopause, the ovaries are removed. The ovaries may also be removed if they look abnormal or if the patient wants to decrease her chance of developing ovarian cancer later in life. In pre-menopausal women, removal of the ovaries can cause hot flashes, vaginal dryness and other symptoms. You should discuss the pros and cons of ovarian removal with your doctor. There are several hyterectomy surgical approaches: a vaginal hysterectomy, an abdominal hysterectomy and a laparoscopic hysterectomy. The choice of procedure will depend on the size of the uterus and several other factors. Vaginal Hysterectomy — A vaginal hysterectomy is performed by removing the uterus through the vagina, rather than through an incision on the abdomen. To be eligible for a vaginal hysterectomy, your uterus cannot be too large. You will be asleep for the procedure. Most women stay two nights in the hospital. The recovery involves significant pain for 24 hours and mild pain for 10 days. Full recovery usually takes four weeks. Abdominal Hysterectomy — In an abdominal hysterectomy, the uterus is removed through a horizontal incision on the lower abdomen, called a "bikini cut." If the uterus is very large or if there is a scar from an earlier operation, it may be necessary to make a vertical incision instead. A total abdominal hysterectomy means removing the uterus and the cervix. Women who have had abnormal pap smears are usually encouraged to have their cervix removed. A subtotal or supra-cervical hysterectomy means removing only the upper part of the uterus. Women who retain their cervix may have less bladder leakage and vaginal relaxation later in life; however, this has not been scientifically proven. Women who have had a supra-cervical hysterectomy will continue to need periodic pap smears. In addition, some women will have monthly spotting or light bleeding if endometrial glands are still embedded in the cervical tissue. You will be asleep during the procedure. Most women spend three nights in the hospital and six weeks recovering at home. Some women experience a complication that results in a longer recovery time. Laparoscopic Hysterectomy — This is a new procedure in which the uterus is removed through very small incisions on the lower abdomen. The cervix remains in place. Women with large fibroids or a large uterus may not be candidates for a laparoscopic hysterectomy. In the procedure, four one-centimeter incisions are made in the lower abdomen: one at the belly button, one below the bikini line near the pubic hair, and one near each hip. The abdominal cavity is filled with carbon dioxide gas. A thin, lighted telescope is placed through an incision so the doctors can see the ovaries, fallopian tubes and uterus. Long instruments, inserted through the other incisions, are used to remove the uterus. A special instrument is used to cut the uterus into smaller segments for removal through the small incisions. At the end of the procedure, the gas is released and the skin incisions are closed. You will be asleep during the procedure. Most women spend one night in the hospital and two to four weeks recovering at home. Read more about hysterectomy. Uterine Artery Embolization (UAE) Uterine artery embolization is a relatively new procedure and an alternative to open surgery for fibroids. Embolization is a technique that blocks the blood flow to the fibroid or fibroids, causing them to shrink and die. This also often decreases menstrual bleeding and symptoms of pain, pressure, urinary frequency or constipation. UAE is performed in a radiology suite rather than an operating room, by an interventional radiologist. An intravenous (IV) line will be placed before beginning the procedure, and you will be sedated. You will remain awake, but sleepy, throughout the procedure. A needle is placed in an artery in your leg, at the groin crease. A small catheter is then placed into the artery and X-rays are taken of the arteries — a test called anarteriogram — that supply the fibroids. The catheter is then used to select these arteries and slowly inject particles called polyvinyl alcohol, which are the size of a sand grain. The particles block the flow of blood. After the left and right uterine arteries are embolized, another arteriogram is performed to confirm the procedure is complete. Afterward, you must rest in bed for six hours, lying flat with your leg straight. The amount of pain patients experience varies. The most significant pain usually occurs immediately following the procedure and over the next six hours. Patients usually stay overnight in the hospital, so we can monitor the arterial access site and provide adequate pain control. You will be discharged the next morning. Most women can return to full activity in a week. When blood flow to the fibroid is blocked, the fibroid gets no oxygen and will begin to die. This process happens over days to months. During this time the fibroid shrinks by about 40 to 50 percent and the uterus by about 30 to 40 percent. Our experience and the scientific literature suggest that symptoms will improve in 80 to 90 percent of patients. For some, UAE is ineffective. Serious complications occur in less then four percent of patients.