From an interview with
Gary Emerson, MD
McLeod OB/GYN Associates

When a woman experiences pelvic pain, she can be suffering from a number of issues. One of the most common problems is 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 which occur in about 25 percent of all women. They can happen at any age but are less common later in life. Fibroids are more prevalent prior to menopause and tend to shrink after menopause.

Fibroids 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. However, fibroids can be anywhere and any size. We’ve removed some growths 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 are pressing 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.

Treatment options for fibroids depend on a woman’s current stage of life. For women who desire fertility, we can take 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 causing them to 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 known as 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 to build their hemoglobin up to a normal level. And then, if fertility is not an issue, an easier, more complete procedure for a woman to have would be a hysterectomy.

ACTION YOU CAN TAKE

If you suffer symptoms of fibroids, see your Gynecologist to find out the treatment options. They can help you choose your next course of action, based on your age and stage in life.

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