Symptoms and treatment of uterine fibroids

Uterine fibroids are benign tumors that appear in the uterus. According to Dr. Julio Álvarez Bernardi , Head of the Gynecological Oncology Department at the Women's Unit, up to 70% of women will develop fibroids at some point in their lives, although the prevalence is influenced by factors such as age and race.

Thus, while some fibroids are very small, others are large enough to deform the uterus. Similarly, some uterine fibroids have very few symptoms and are detected incidentally during routine checkups, while others can cause bothersome symptoms. The difference between them generally lies in their size and location within the uterine cavity.

Main symptoms of uterine fibroids

Abnormal menstrual bleeding: menorrhagia (menstruation with very heavy and long-lasting bleeding), metrorrhagia (when bleeding occurs between menstrual periods) or when the period is very prolonged.

Pelvic pain, back and leg pain, discomfort during sexual intercourse, pressure in the pelvic area…

Pressure on the urinary and digestive systems, which can lead to problems such as increased urinary frequency, difficulty urinating, constipation, and more.

Anemia, derived from increased menstrual bleeding.

Reproductive problems, as uterine fibroids can cause infertility, miscarriages, pregnancy risks, premature births, and more.

How is it diagnosed

As we mentioned, there are several indicators that can raise suspicion of a uterine fibroid. One of them is abnormal uterine bleeding , or when, during an examination, palpation reveals that the uterus has increased in size.

Therefore, a vaginal and abdominal ultrasound will be performed to confirm the presence of uterine fibroids and, in turn, their location, size and vascularization.

In addition, if necessary, an MRI will be performed for a more precise diagnosis, especially in cases of large or highly vascularized fibroids. There is also the option of performing a hysteroscopy through the vagina for cases of submucosal fibroids, which are those that grow into the uterus.

Finally, the definitive diagnosis will be obtained through a biopsy and pathological study in cases where surgical treatment is required.

Types of treatments for uterine fibroids

Uterine fibroids can be treated in different ways, although we could distinguish two main types of treatments: medical treatments and surgical treatments.

Medical treatments

When uterine fibroids are small and do not cause serious symptoms, medical treatments can be used to alleviate symptoms and even reduce their size . These options include:

Antihormonal medications, whose function is to block the action of gonadotropin-releasing hormone, which promotes growth, are also used before surgery to reduce size, as Dr. Álvarez Bernardi explains.

Non-hormonal symptomatic treatments. These reduce symptoms but do not change their severity. These include iron-based treatments, anti-inflammatory drugs, and more.

Symptomatic hormonal treatments. The use of contraceptives (the pill, IUD, etc.) and progestins can help control bleeding.

surgical treatments

When uterine fibroids cause severe symptoms , medical treatments are ineffective, or an ultrasound suggests signs of malignancy, they must be removed and analyzed in a laboratory . In some cases, only the removal of the fibroid(s) is necessary, while in others, a hysterectomy to remove the uterus is required.

Thus, we now have a much safer surgical procedure for the patient with a faster recovery: Minimally Invasive Surgery , in which Dr. Julio Álvarez Bernardi specializes . This technique allows for the removal of fibroids through small incisions or even through natural body orifices. Among the Minimally Invasive Surgery techniques for the treatment of uterine fibroids are:

Laparoscopy: fibroids are removed through small incisions in the abdomen, less than 1 cm in size.

Hysteroscopy: This involves removing fibroids located inside the uterus without making incisions, using an endoscope through the vagina and cervical canal.

v-NOTES Surgery: a highly innovative technique that allows the use of natural orifices in the body, such as the vagina, to perform surgeries such as myomectomy or hysterectomy. This technique significantly reduces postoperative pain and the risk of infection, and accelerates the recovery process.

Furthermore, in some cases, depending on the type of fibroid, a more traditional surgery may be necessary . This is an abdominal myomectomy , which involves the removal of large, multiple, or fibroids in complicated locations. A minimally invasive approach, such as a mini-laparotomy, is recommended. This involves a small, transverse incision of about 8 cm above the pubic bone and can be combined with laparoscopy.

Other treatments

In addition to medical and surgical treatments, other alternatives exist for treating uterine fibroids, such as uterine artery embolization , which involves blocking blood flow to the fibroids to reduce their size; or radiofrequency ablation and MRI-guided focused ultrasound , which precisely remove fibroids. However, these treatments have limitations, as the doctor explains, since there is no definitive diagnosis by biopsy, and absolute safety for the patient has not been demonstrated.

For this reason, the type of treatment for uterine fibroids will be chosen on a personalized and individual basis , taking into account the type of fibroid, the symptoms, and the patient's desire to have children. In any case, the most important thing is to have regular checkups to detect them early.

You can find more information about uterine fibroids, their symptoms and treatments in this article published on the Ruber International Hospital website.

If you found this article interesting and would like to consult with a clinical psychologist, the Women's Unit at Ruber International Hospital has a specialized department in this area. You can request more information by calling 91 387 51 72/73/74 or schedule an in-person appointment with top specialists.

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Symptoms and treatment of uterine fibroids