Demystifying Uterine Fibroids - Detect and Treat Early for Best Results

Uterine fibroids are fairly common in women of reproductive age. Should you worry about it? Dr. Chantawat Sheanakul, a gynecologist at Bumrungrad International Hopsital who specializes in gynecologic oncology and microinvasive surgery, is here to answer all your questions about these women-specific tumors.

What you need to know about uterine fibroids

“Fibroids are—simply put—cells inside our bodies that grow larger than normal, causing a number of varying abnormalities. These fibroids are common; up to 60% of women can be found having fibroids. These benign growths can be found outside the uterus, within the uterine wall, or in the uterine cavity. Women with uterine fibroids may experience pain, abnormal bleeding, constipation or frequent urination.
As for the cause of uterine fibroids, there is no clear answer but the risk of endometriosis is hypothesized that the changing lifestyles of today’s women, who marry later and choose to have children later, leads to the collection of menstrual blood within the uterus. When a girl begins her period at 12 years old, as she ages, residual menstrual blood that is collected outside the uterus increases. 

Severity of uterine fibroids

“If we categorize the severity of uterine fibroids according to the symptoms demonstrated from low to high, we can begin with patients who have never experienced any abnormal symptoms, but during a pelvic exam, fibroids were discovered. If the fibroids are in the first stages of growth and are still small, I think the prognosis is excellent since early detection means early treatment. 
The next stage would mean larger fibroids that are putting pressure on nearby organs, such as the bladder, leading to a more frequent urge to urinate, but only a little urine being expelled, or the intestines, leading to constipation.  Bigger, more severe fibroids, might even been detectable by touch by the patient themselves, while endometriosis usually causes abnormally painful periods that warrant pain medication. This is probably the most severe symptom of endometriosis, along with excessive bleeding during menstruation or abdominal pain after sexual intercourse.”

Time for treatment

“In terms of treatment, when I have diagnosed a fibroid in the uterus, the first thing to do is develop a treatment plan. This will depend on a number of factors, such as the age of the patient and what treatment is most appropriate. For example, in a patient who is older and has entered menopause, the fibroids often shrink and disappear on their own. Others may need treatment. I would also inquire about the symptoms that the patient is experiencing, such as how much pain they are feeling, and I would check for the characteristics of the fibroids and the likelihood of further growth. Most importantly I would ask my patient if they are planning to have children. All of these factors will influence the diagnosis and appropriate treatment plan for each patient.”

Simple surgery

“If surgery is the best treatment then I have to consider what would be the best methods of surgery because there are many procedures for removing uterine fibroids. Abdominal surgery is one and usually causes visible scarring and a long recovery. Most patients considering this type of surgery worry about the scars that will occur. These days laparoscopic surgery is quite popular because surgical incisions are small, only 5 millimeters, and thus there is no scarring after surgery.  Another advantage of this type of surgery is minimal impact to other organ, reducing complications and the risk of infection. Recovery is quicker and the patient is able to return home and to their normal lives more quickly.
A question that I am asked often is, after surgery, what are the chances of recurrence? While the uterus remains, there is always the chance of fibroids returning since the uterus is the main factor in the occurrence of fibroids.” 

Early detection, early treatment

“As we know, unless uterine fibroids are large enough to be detectable through touch, there is no visual way to know that someone has fibroids. Thus, to detect any abnormalities of the uterus, an internal pelvic exam is necessary. Women should be checked once a year because the earlier a fibroid is found, the better the prognosis after treatment.”

Five Signs of Trouble

If you experience any of these, see your doctor immediately!
  1. Abnormally painful periods
  2. Abdominal pain that occurs even when you’re doing nothing
  3. Vaginal bleeding between periods
  4. Frequent urge to urinate, but little urine expelled
  5. Abnormal constipation

By Dr. Chantawat Sheanakul Gynecologic Oncology Women center Bumrungrad International Hospital, Bangkok, Thailand
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