Posted on Thu, 06 May 2010 09:54:08 by Columbus

ONE IN EVERY FOUR WOMEN ARE AFFECTED. HERE'S WHAT YOU NEED TO KNOW.

Thrive fibroid tumors - also called myomas or leiomyomas - are solid growths that can appear in or around the uterus. Almost all fibroids are non-cancerous (benign). They are extremely common, especially in women over 35 and in African-American women.

The number, size, and location of the growths determine their effect. In some women, fibroids cause no problems -- a woman might not even know she has them -- while in others they can cause heavy or irregular periods and painful cramps, as well as frequent urination. Other signs of fibroids include pain during intercourse and pressure or pain in the abdomen and lower back.

Generally, if a woman has fibroids, she'll have quite a few, though it's possible to have just one. Fibroids can range from the size of a pea to the size of a grapefruit. Their cause is unknown, but it's clear that estrogen stimulates their growth. That's why fibroids do not start growing until after puberty, when a woman's body starts to produce the hormone.

Fibroids normally grow fairly slowly, but they can quickly increase in size during pregnancy (they usually shrink after birth) or when a woman takes birth control pills. Unless a woman starts hormone replacement therapy, the growths should shrink when she reaches menopause and her body stops producing estrogen.

While they almost never become cancerous, fibroids can cause infertility. So if you do have them, it's important for your doctor to keep a close eye on them.

How do you know if you have them?

A doctor typically will be able to feel fibroids during a pelvic exam (if the growths are really big they can sometimes be felt through your abdomen). X-rays and ultrasounds are done to confirm a diagnosis.

What can you do?

If the fibroids aren't causing any problems, they might not need to be treated. However, if you want to have children, the growths - depending on their size and location - might need to be removed so they don't interfere with pregnancy. If they are causing painful symptoms or excessive bleeding, removal might also be necessary.

For women who want to get pregnant, and for many others, myomectomy - removing only the fibroid and leaving the uterus intact - is often the best treatment for the problem. There are a number of ways this can be done, again depending on the number, size, and location of growths. Myomectomy is a relatively new and somewhat complicated surgery. Possible side effects include decreased fertility because of scar tissue, as well as the chance that the fibroids might grow back because they could not be completely removed.

In some cases, where the fibroids are extremely large or are blocking bowel or urinary functioning, a hysterectomy might be needed. But if your doctor recommends such surgery, seek a second opinion. Sometimes a hysterectomy is recommended simply because it's a less complex procedure than a myomectomy.

If you are nearing menopause, you may want to delay any surgery, not take hormone replacement therapy, and see if the fibroids shrink (as they usually do) when estrogen production stops.

Myomectomy

Depending on your individual situation, this surgery can be done in a few different ways. Small fibroids can be removed in a quick, half-hour procedure where a hysteroscope-resectoscope is inserted through the vagina into the uterus and an electrical current is used to get rid of the growths.

Fibroids can also be removed using a laser attached to a small device, called a laparoscope, that is inserted through a small abdominal incision. The instrument also has a tiny camera that allows doctors to watch their work on a video screen as they destroy the tumors. In this procedure, drugs that block estrogen production, known as gonadotropin-releasing hormone (GnRH) agonists, such as Lupron, are usually given for a few months prior to surgery to shrink the fibroids. (Such medications are not used in place of surgery because they can have harmful side effects if taken for long periods of time. Also, the growths reappear as soon as the drugs are stopped.) The effects of this type of surgery on fertility are still not known, so it's generally not recommended for women who want to get pregnant.

Removing larger fibroids usually requires major surgery. While myomectomy can be done even with many large fibroids, blood is usually lost during the procedure and transfusions are often needed. (Autologous blood donation - storing your own blood ahead of time - is often recommended.) Because of the possible blood loss, many women choose hysterectomy instead.

Permanent Link | Comment | 430 hit(s) | Tags medicine fibroids myomas leiomyomas uterus myomectomy