Shweta Rai, 27, was made aware of the presence of fibroids during a routine ultrasound as part of a preventive health check-up. Anxious, she came in for a consultation hoping for fibroid treatment without surgery.
“Most fibroids don’t cause symptoms and you may not even know about the presence of fibroids until an ultrasound detects them”, says Dr Rinku Sengupta, Consultant Obstetrician – Gynecologist at Sitaram Bhartia Hospital in South Delhi.
During their consultation, Dr Rinku explains, “Fibroids are benign tumours that can grow in or around the uterus during the reproductive age. They are thought to be associated with the hormone estrogen that is produced by the ovaries.”
Shweta wanted to know what should be her next step.
Dr Rinku asked her whether she noticed anything out of the ordinary with her menstrual cycle or any of the other symptoms of fibroids.
What are the signs and symptoms of fibroid?
The doctor continued, “Most fibroids do not cause any problem and may remain without symptoms. In certain cases however the fibroids may cause changes in your menstrual pattern.”
The signs and symptoms of some symptomatic fibroids are as follows:
- Heavy bleeding or prolonged menstrual periods
- Pelvic pain
- Urge to urinate
- Backache or pain in leg
Shweta recalled her menstrual flow and duration were fine and she hadn’t experienced any of the other symptoms as well.
Dr Rinku says, “If you aren’t experiencing any of these symptoms, you don’t need any treatment as of now.”
Shweta was relieved to hear that but wanted to know in which situations fibroids treatment without surgery is possible and when is treatment required.
When is fibroid treatment without surgery possible?
Fibroid treatment without surgery or conservative treatment is usually possible in certain cases such as:
- when the fibroids are located on the outer wall or
- the fibroids are less than 5 cm
The doctor went on to answer when fibroid treatment is needed.
When do you require treatment for fibroids?
The doctor highlighted, “Treatment for fibroids is only suggested when fibroids are bigger than 6 cm or cause heavy bleeding. Otherwise, they are usually harmless as they grow slowly and tend to shrink after menopause.”
The type of treatment depends on symptoms and concerns which may vary from person to person.
Shweta felt calmer after learning this but wished to know treatment options available to her if needed in future.
What is the most common treatment for fibroids?
The most common treatments for fibroids without surgery are:
Dr Rinku cautioned, “If you experience heavy menstrual flow or pelvic pain in the future, you may be suggested medicines that help regulate menstrual cycles or lessen the pain.”
Some of these medicines may create a temporary postmenopausal i.e. a menopause-like state which may help shrink fibroids but medications do not make fibroids go away.
- Uterine Fibroid Embolisation (UFE):
The doctor explains, “Uterine Fibroid Embolisation (UFE) is a way of fibroid treatment without surgery. The intent of the procedure is to block the blood flow to the fibroids so as to reduce the size of the fibroid and remove the symptoms.”
“The procedure is not suitable for all fibroids and neither is it widely available in all hospitals. The success rate of the embolisation is also low.”
The available surgical options are:
- Minimally-invasive surgery (MIS):
She continues, “A fibroid may be removed surgically (laparoscopically) with a small incision through the abdomen or through the uterus with a hysteroscope.”
The type of procedure will depend on the location of fibroid in the uterus. Both these procedures are usually associated with a quick recovery, shorter hospital stay and less pain compared to traditional open surgery.
- Open Surgery:
Dr Rinku further explains, “Open surgery may be considered if you have multiple, large or deep fibroids which are inside the uterine cavity that may be difficult to remove through laparoscopy.”
A hysterectomy or removal of the uterus is a permanent solution for fibroids but since it ends your ability to reproduce that should be carefully thought out before and chosen.
Dr Rinku concludes by saying, “Fibroids may not need treatment in most cases especially if they don’t exhibit any symptoms or pose any threats.”
“In cases where surgery may be required, the options should be carefully considered and discussed with your doctor.”
The consultation put Shweta’s mind at ease and she shared, “When I was first diagnosed, I was anxious and scared. But after the consultation, I feel much more at ease!”
Shweta felt more confident knowing that she didn’t require any treatment as of now and vowed to be punctual with her follow-ups and ultrasounds.
This blog post has been written with editorial inputs from Dr Rinku Sengupta, Consultant and Head Maternity Program, who has over 24 years of experience. Dr Rinku is known for her expertise in vaginal birth after cesarean. She also actively conducts and participates in seminars for the medical community to improve awareness on how normal delivery after cesarean can be encouraged in a public and private setting.
MBBS, Lady Hardinge Medical College, University of Delhi (1991); MD, Obstetrics & Gynaecology, University College of Medical Sciences, University of Delhi (1997)
Come in for a consultation with Dr. Rinku. Please call on +91 9871001458 to schedule a free consultation.