Heavy, Painful Periods? Could be Fibroids

Contributed by: Robert Pollard, MD | Gynecology

Let’s start with the good news: most fibroids — tumors that grow in the uterus, often affecting pre-menopausal women — are not cancer. (You may see them called leiomyomata, or myoma for short.) Some women have no symptoms, others suffer painful periods with heavy bleeding. Robert Pollard, MD, MetroHealth’s Director of Minimally Invasive Gynecological Surgery, helps explain the condition, symptoms, and possible treatments.

Many women with uterine fibroids have no symptoms. Their gynecologist may feel these growths during a regular pelvic exam or see them on a pelvic or vaginal ultrasound. For others, these tumors can cluster together or grow, sometimes as large as a grapefruit, and cause symptoms, including:

• Heavy menstrual bleeding
• Belly swelling, pressure or discomfort
• Painful period cramps
• Frequent urination, from bladder pressure
• Lower back pain
• Anemia, or low blood-iron levels

More concerning, fibroids can impact fertility, so be sure to ask your doctor about any symptoms you may have.

Some 70% of White women and over 80% of Black women will get uterine fibroids by age 50, according to the National Library of Medicine. Though rare, women can still get uterine fibroids after menopause.

They grow thanks to hormones: When estrogen levels are high during your period, that fuels fibroid growth. After menopause, there’s a big drop in estrogen levels, reducing the risk of fibroids.

Although uterine fibroids are one of the most common reasons women undergo hysterectomy, major surgery is not the only option. First, your provider may recommend hormonal contraceptives, such as the pill or certain types of intrauterine devices (IUD) that control the hormones that make fibroids grow. You may also take anti-inflammatory pain relievers for period pain. Healthcare providers may prescribe a drug called leuprolide to help shrink the fibroid before surgery, so it’s easier to remove.

MetroHealth is a high-volume surgery center for uterine fibroid care, and most surgeries can be done laparoscopically, which means just a few small incisions and no need for an overnight hospital stay. You might have:

• Myomectomy. This is surgery to remove only the uterine fibroid. It’s an option for women who want to keep their uterus and preserve their ability to have children.
• Hysterectomy. This is surgery to remove the uterus so fibroids can no longer grow. It’s an option for women who are done having children. MetroHealth also offers robotic-assisted hysterectomy. “The robot allows us to see better and potentially access areas that are harder to access otherwise,” says Dr. Pollard.
• Uterine fibroid embolization. An interventional radiologist performs this minimally invasive surgery using special imaging tools. Through a tiny cut at the top of your leg, they insert a catheter that sends tiny particles into your uterine artery. This blocks blood supply to fibroids.