When a woman experiences pelvic pain, she can be suffering from a number of issues. One of the most common is a growth called fibroids, as explained by McLeod OB/GYN Gary Emerson, MD:
Here’s a summary of Dr. Emerson’s comments:
Fibroids are benign muscular growths of the uterus. They occur in about 25 percent of all women. They can occur at any age but are less likely to occur later in life. They usually occur prior to menopause and after menopause they usually start to shrink. They require estrogen to grow and, as women go through menopause, their estrogen levels preventing fibroids from growing anymore.
They can be in the muscular wall of the uterus, in the lining of the uterus or under the surface of the uterus. The position of the fibroids dictates a woman’s symptoms. The more common presentation is the submucosal, the intrauterine kind, which cause heavy bleeding with the menstrual cycle. Yet, fibroids can be anywhere and any size. We’ve taken them out of women as a large as a basketball or as small as a marble.
When fibroids grow large, they can cause problems, such as urinary frequency and urgency. If they’re pressed on the bladder, they can cause incontinence. They can cause difficult or painful bowel movements. Sometimes, they can increase a woman’s abdominal girth. You may notice that a woman’s clothes are fitting tighter. But the biggest problems with fibroids are pain and bleeding.
Fibroids treatment options depend on where a woman is at in her life. For women, who desire fertility, we can use measures to shrink the fibroids. There’s a medicine called Depot Lupron, which lowers a woman’s estrogen levels, hindering the growth of these fibroids and makes them shrink. We can try to preserve fertility by removing the fibroids surgically with a myomectomy. We leave the uterus in place but just remove the smooth muscle tumors, the fibroids themselves. There’s an interventional radiology procedure, uterine artery embolization, where they identify the blood flow going to a specific fibroid. They put an embolic agent in to obstruct the blood flow to the fibroid, which subsequently shrinks and dies. It’s fairly effective, but does have some side effects.
All procedures have potential side effects. The issues with a myomectomy are, obviously, it’s surgery. The uterine artery embolization occasionally obstructs blood flow, where the fibroid dies and can become infected. The Lupron, because it temporarily puts a woman in menopause, can cause hot flashes and night sweats. Women, who are bleeding heavily from the fibroids especially if they’re anemic, will get Depot Lupron try to build their hemoglobin up to a normal level. And then, if fertility is not an issue, an easier, more complete procedure is a hysterectomy.