A friend of mine has been experiencing a prolonged menstrual cycle for a couple of months. She mentioned that her monthly flow lasts longer than ten days and that she is also experiencing painful sexual intercourse. Being a woman over forty, I advised her to visit her PCP. My concern as a healthcare professional is that she could be dealing with uterine fibroids. Let me share my knowledge of what uterine fibroids are, their signs and symptoms, and the possible treatments.

Uterine fibroids, medically known as uterine leiomyomas, are non-cancerous growths of the uterus that often appear during childbearing years. They vary in size, ranging from tiny seedlings that are undetectable by the human eye to large masses that can alter and enlarge the uterus.

The signs and symptoms of fibroids can vary depending on their size, number, and location. Some women may experience:

1. Heavy menstrual bleeding
2. Prolonged menstrual periods (lasting more than a week)
3. Pelvic pain or pressure
4. Frequent urination
5. Difficulty emptying the bladder
6. Constipation
7. Backache or leg pains
8. Pain during sexual intercourse

Treatment options for fibroids depend on factors such as the severity of symptoms, the size and location of the fibroids, age, and plans for future pregnancies.

1. Watchful Waiting: A doctor may recommend monitoring without immediate treatment if fibroids are small and do not cause symptoms.
2. Medications: Hormonal medications like birth control pills, hormonal IUDs (intrauterine devices), or GnRH agonists may help to control heavy bleeding and reduce the size of fibroids.
3. Surgery:
   • Myomectomy: This surgery involves the removal of fibroids while leaving the uterus intact. It’s often recommended for women who want to become pregnant.
   • Hysterectomy: In more severe cases or when fertility is not a concern, a hysterectomy may be recommended, which involves the surgical removal of the uterus.
   • Minimally Invasive Procedures: Techniques like uterine artery embolization, MRI-guided focused ultrasound surgery (MRgFUS), and laparoscopic or robotic surgeries may also be options for some patients.
4. Endometrial Ablation: This procedure destroys the lining of the uterus and is used to control heavy menstrual bleeding caused by small fibroids.
5. Uterine Fibroid Embolization (UFE): This minimally invasive procedure blocks the blood supply to the fibroids, causing them to shrink.
6. Radiofrequency Ablation: This newer technique uses heat to destroy fibroid tissue.
7. Focused Ultrasound Surgery (FUS): This non-invasive procedure uses high-intensity ultrasound waves to destroy fibroids.

Treatment choice depends on individual circumstances and should be discussed with a healthcare provider. It is crucial to consider various factors such as medical history, current health condition, potential side effects, and the overall impact on one’s well-being. Seeking professional guidance ensures that the chosen treatment aligns with the individual’s unique needs and minimizes any potential risks.

I would love to hear your thoughts!