What should women know about uterine fibroids? Ask The Doctor

We’re committed to keeping women of all walks of life healthy, thriving and well-cared for, and by the age of 50, as many as 70 to 80 percent of women may have fibroids,” says Robert Mayson, MD, RWJBarnabas Health Medical Group. Here Dr. Mayson shares a quick guide to uterine fibroids.

What are Fibroids? Fibroids are noncancerous growths in the uterus. There are several types, defined by their location. Intramural fibroids are contained within the uterine wall. Submucosal fibroids protrude into the uterine cavity. Pedunculated fibroids are attached to the outside of the uterine wall by a stalk. What mainly determines whether fibroids will cause symptoms are their size and location. “Location is what matters most,” explains Dr. Mayson, “Submucosal fibroids are usually the ones that cause the most problems.”

Symptoms can include heavy menstrual bleeding (which can be severe enough to cause anemia); pelvic pain, pressure or bloating; increased urinary frequency and constipation.

In very rare cases, fibroids can be dangerous if they grow so large that the uterus expands and compresses blood vessels and other structures in the pelvis. Fibroids may stay the same size, grow larger or even shrink over time.

“Once a woman reaches menopause, fibroids tend to shrink,” says Dr. Mayson. “We don’t know if it’s estrogen, progesterone or a combination of the two hormones that cause fibroids to grow.”

Many women will only find out they have fibroids during a routine pelvic examination or on unrelated imaging.

Options for treatment

1. Observation: A doctor may decide to monitor the growths by doing repeat imaging every few months to assure they’re not increasing in size or number.

If symptoms are mild, a woman may not need any treatment or may be able to manage discomfort with over-the-counter pain relievers like ibuprofen.

2. Prescription Medications: There are new prescription medications available that can reduce the heavy bleeding associated with fibroids. “But these medications can only be used up to 24 months because there’s a risk of bone loss and other side effects with longer use,” says Dr. Mayson.

3. Uterine Fibroid Embolization (UFE): “This is a procedure done by an interventional radiologist,” says Dr. Mayson. “The radiologist places a catheter in the patient’s groin. Using CT scan guidance, they guide the catheter to the blood vessels that supply the fibroids. They put a substance into the feeding blood vessels to decrease the fibroid’s blood supply.”

4. Hysteroscopic Fibroid Resection (also called Hysteroscopic Myomectomy): “This is a procedure that’s done without any incisions,” explains Dr. Mayson. “A camera is inserted into the uterus through the vagina, and fibroids within the cavity of the uterus, or partially in the cavity, can be removed.”

5. Myomectomy: “This is a surgery to remove just the fibroids,” says Dr. Mayson. “It can be done through an open surgical approach or laparoscopically.” This procedure is mainly recommended for women who want to retain their fertility. Patients need to understand that the risk of new fibroids forming may be as high as 60 percent.

6. Hysterectomy: “This surgery— removal of the uterus—is the only definitive management for symptomatic fibroids. Once you have your uterus removed, you’ll never have another fibroid or associated bleeding,” says Dr. Mayson. The surgery can usually be done minimally invasively with only tiny incisions. About 600,000 hysterectomies are done in the U.S.A. each year, and the most common reason for the surgery is fibroids.

Which treatment, if any, is right for you is something you need to discuss with your doctor. Visit rwjbh.org/WomensHealth or call 888-724-7123 to learn more about the women’s healthcare team.

Go to rwjbh.org/WomensHealth or call 888-724-7123 to find the nearest hospital near you and learn more about our women’s healthcare team. Use your smartphone camera to hover over the QR code to learn more now.

Coming up this month at RWJU Hospital Hamilton

For more information, call (609) 584-5900. To register for a program or for schedule changes go to rwjbh.org/ events.

WEDNESDAY, MAY 3

Colon Cancer Isn’t Just a 50+ Disease. 6 to 7 p.m. Join Meera Yogarajah, MD, Board Certified in Hematology and Oncology, for a discussion about colon cancer and the importance of recognizing symptoms, early screenings and interventions.

THURSDAY, MAY 11

Stroke: Every Second Counts. 1 to 2 p.m. Learn the signs stroke and what increases your risk for having a stroke. Connie Moceri, MSN, RN, A-GNP-C, Director of Disease Management and Stroke Coordinator with knowledge and tools to reduce stroke risk.

THURSDAY, MAY 18

Woman’s Situational Awareness and Self Defense. Also May 25 and June 1. 6:30 to 8 p.m. This three part series will cover situational awareness, de-escalating conflict and escaping basic holds as well as vulnerable points on the human body in which to strike effectively. It is expected that participants engage in all three classes. Anthony Jackson, of Dao Concepts is a US Veteran Tai-Chi instructor and self-defense educator. $50 for the series of 3 classes.

Better Health Programs

Registration required for all programs. Must be a Better Health Member. Call (609) 584-5900 or go to rwjbh.org/events.

WEDNESDAY, MAY 3

Let’s Talk, a Senior Social Group. Also Wednesdays May 10, 17, 24, 31 and June 7. 10 to 11 a.m. Ongoing gathering in a collaborative setting to exchange thoughts, feelings and experiences among peers. This is a safe zone designed to be welcoming of all attendees. A partnership between RWJ University Hospital Hamilton and the PsycHealth Associates here in Hamilton.

MONDAY, MAY 8

My Aching Joints–Advancements in Arthritis Treatment and Joint Replacement with Dr. Michael Duch, Lunch & Learn. Noon to 1:30 p.m. Joining us for the first-time is Michael R. Duch, MD, Orthopedics. Interactive program about advancements in arthritis treatments and when joint replacement might be the best option.

FRIDAY, MAY 19

No Place Like Home, Lunch & Learn & More! Noon to 3 p.m. Living out our life at home should not be just a dream. Sheli Monnachio, Angelione Mobility expert, will speak about changes to safeguard your surroundings for comfort and safety with a focus on remaining in your home.