Fibroids and Fertility

Fibroids are harmless, non-cancerous growths that usually occur in the uterus, and are often detected during routine pelvic exams. They also come in various shapes and sizes. 

Fibroids do not typically cause infertility, but they can affect pregnancy, and may sometimes cause medical complications that have serious side effects. 

That being said, let us discuss the symptoms of fibroid and discover the treatment options that are currently available.

What Are Fibroids?

Fibroids are also called leiomyomas, or myomas are benign uterine growths that typically do not interfere with a person’s health. There are some that may require medical interventions such as surgery, hormone therapy, medications, or ultrasound therapy.

There are three categories of fibroids characterized by their mode of growth:

• Intramural fibroids tend to develop inside the muscle tissue of the uterine wall.
• Submucosal fibroids on the other hand grow extending inward into the uterus.
• Subserosal fibroids typically grow extending outward of the uterus.

Submucosal and subserosal fibroids are classified as pedunculated, which means that the fibroid itself grows on a stalk, into the uterus or the area surrounding the uterus.

Signs of Fibroids

Fibroids are usually asymptomatic, meaning that people who have fibroids sometimes may never know they do. Some fibroids do cause symptoms which include: 

Irregularities in periods

Painful, heavy, longer or more frequent periods could be as a result of the presence of fibroids.

Pelvic or Abdominal Pain

Pain or pressure during intercourse in the pelvic region, as well as lower back and abdominal pain, could be indicative of the presence of fibroids. A fibroid can also grow very large and then suddenly die, which can cause sudden and severe pain in the abdomen. This however is a rare occurrence.

Difficulty with Bowel and Bladder Function

Difficulties with bowel movements such as constipation, frequent urination, or difficulty in passing urine may also be because of fibroids.

Physical Changes

Sometimes, a fibroid can grow so large that it distorts the natural form of the abdomen, making a person look pregnant.

Causes of Fibroids

The exact causes of fibroids are yet unknown, and whether it is one or multiple factors that trigger their development remains to be discovered. However estrogen is known to cause small growths in the uterus to become large rather quickly, which leads to an uncontrolled spreading of abnormal tissues.

Therefore females of reproductive age are more likely to develop fibroids than prepubescent or post menopausal females. 

Other factors such as lifestyle and genetics also contribute to the development of fibroids. For example, women of color develop fibroids at a higher rate and often require treatment, but there is no research available to explain why this is so.

People with high blood pressure, obesity, or whose family medical history includes fibroids are at a higher risk, including those who consume a lot of red meat. 

Treatment of Fibroids

When medical intervention is required, fibroids are usually treated using prescription medication or surgical procedures. Medical intervention usually is necessitated by required pain, bleeding, or other concerning symptoms. Medical intervention does not typically result in infertility as a side effect.

Nonsurgical Options

These are usually medicine-based and hormone-based treatments which have been effective in treating smaller fibroids, and fibroids that have milder symptoms.

Hormone-based Treatments

Hormone-based treatments typically shrink the fibroids and alleviate their symptoms. The main hormone used for this treatment is gonadotropin-releasing hormone agonists (GnRHa). 

GnRHa medications are used for short-term treatment and work by reducing estrogen in the body, which slows down or even reverses the growth of the fibroids.

These treatments are particularly useful as part of a pre-surgical protocol, which increase the chances of successfully removing the fibroids. Long-term use of GnRHa medication has both serious and undesirable side effects. 

Medication-based Treatments

The most common form of medicine-based treatment is prescription oral contraceptive pills, which work by reducing the size of the endometrium. This in turn reduces the excessive bleeding caused by problematic fibroids.

Uterine Fibroid embolization

This procedure cuts off the blood supply to the fibroid using a small catheter inserted close to the fibroid itself causing both damages and shrinkage to the fibroid.

Ultrasound-based treatment

Focused, high-energy sound waves are used to destroy the fibroids without causing any damage to the tissue in the surrounding area. In this way the fibroids are eradicated.

Surgery

Surgical options are conducted based on several factors such as the size of the fibroids, as well, the age, health, and future family planning of the patient are taken into account. Some surgical options are:

Hysteroscopic Myomectomy 

This procedure is done on small but problematic fibroids. It is a brief procedure that can be performed as a one-day outpatient process. 

A hysteroscope is inserted into the uterus through the cervix and is used to locate the fibroids. A small surgical instrument is then used to cut or burn away the growth.

Laparoscopic Myomectomy

This procedure is used to treat largee fibroids, and is similar to the hysteroscopic procedure. However if the fibroids are larger than the heterotopic procedure allows for,  incisions are made in the lower abdomen for a laparoscopic procedure, which allows the fibroids to be easily removed. 

Full Hysterectomy

This patient is sedated to prevent discomfort during the procedure. This procedure takes the full uterus out of an individual’s body. This definitively takes care of the fibroid problem, but it also means that after the procedure, a person will no longer have a menstrual cycle, or become pregnant.

Due to its drastic effects, it is usually done under very unique circumstances; where debilitating fibroids recur, and at the same time, the individual in question does not intend on having children in the future.

Summing It Up

Fibroids are benign growths that occur in the uterus and are typically harmless, but they can sometimes cause other problems that require medical intervention. 

If you are concerned about fibroids or need help in finding the best course of treatment for fibroid-related issues, contact Reproductive Partners Medical Group. We offer a wide range of reproductive health services at our various locations across the country.

Frequently Asked Questions (FAQS)

Can Fibroids Affect My Pregnancy?

Many people with fibroids do not experience fibroid-related complications during pregnancy. However in the course of pregnancy, sometimes fibroid-related complications may crop up depending on their size and number.

What Complications Can Arise from Fibroids in Pregnancy?

There are several complications that fibroids can cause in pregnancy including higher risks of spontaneous miscarriage, preterm labor, placenta abruption, malpresentation, labor dystocia, cesarean delivery, and postpartum hemorrhage.

When Should I See a Doctor?

You should see your doctor when you experience a sudden onset of fibroid-related symptoms; if existing symptoms disrupt your daily life; or if you experience a sharp and sudden pain in your abdomen, that does not go away even after taking pain medication.

Seek immediate emergency care if you experience severe vaginal bleeding with  lightheadedness, fatigue, and weakness, as it could mean you have severe complications related to fibroids.