The Facts About Fibroids: Q&A with Miss Moneli Golara

Q: I was found to have fibroids – does that mean I have cancer?

Most definitely not!

Fibroids are benign (non-cancerous) growths arising from the uterus (womb).  They are incredibly common, such that about 40% of women over the age of 30yrs are found to have these. They are muscular/fibrotic lumps that grow in different parts of the uterus and it really depends on how big they are and where they are located.

Fibroids grow under the influence of hormones and so can shrink after the menopause, unless you use HRT which can stop the shrinkage.

Q: Can fibroids stop me from having a baby?

In the majority of cases, fibroids do not interfere with pregnancy and it is common for women to discover them in a first pregnancy scan!

However, imagine the uterus as a room, with a cavity, walls and a roof. It really depends on where the fibroids are located. If they are occupying the ‘room’ (i.e. cavity) or if they are greater than 5cm in the wall, then they may cause difficulty with conceiving or increase the incidence of miscarriage, especially if they are in the cavity. In that situation, they need to be dealt with and treated.

Q: Do fibroids cause heavy bleeding?

Yes, that is one of the main symptoms of fibroids.  They may cause abnormally heavy periods resulting in anaemia, low iron levels and therefore tiredness and an inability to undertake day to day activities. They may also cause pressure symptoms such as pain, backache and bloated-ness if they are very large.

Q: Do I need a Hysterectomy if I have fibroids?

In most cases, fibroids can be left well alone without any treatment. If the fibroids are causing heavy bleeding then there are certain treatments that you can take to control the bleeding. These can be tablets, hormonal and non-hormonal, or the Mirena coil which can help lighten the periods.

If however the fibroids are in the cavity, then it is best to remove them. The procedure to undertake this is done through the vagina and cervix and does not need open surgery, so recovery is much quicker. This is called Hysteroscopic Resection of Fibroids. This needs a quick general anaesthetic and a trained surgeon can resect the fibroid.  You will be home the same day and recover after 1-2 days.  Patients will experience some immediate relief from heavy periods.

If the fibroids are very big and interfering with fertility, then the procedure to remove them would involve open surgery and is called a Myomectomy. Your surgeon may give you some treatment (injection or tablets) before surgery to induce a temporary menopause – this helps fibroids shrink beforehand and makes surgery safer.

In extreme cases, if the fibroids are extensive or very big, then the only option remaining may be a Hysterectomy. However, there are newer techniques which can be used to shrink the fibroid without the need of surgery, over a period of 6 months by blocking the blood supply to the fibroids. (Fibroid Embolisation). This needs to be discussed with your specialist and an MRI scan would have to be done first.

Miss Moneli Golara is a Consultant Gynaecologist at Highgate Private Hospital specialising in fibroids (fibroid embolisation), menstrual problems, keyhole surgery, contraception and hormone replacement therapy, gynaecological problems in teenagers and other general gynaecological conditions.