Written by: Dr. Kira Balkcom, MD, FACOG
Board certified Gynecologist at Springfield Gynecology
Springfield Hospital

Fibroids are growths in the uterus. They are made up of muscle, just like the uterus itself. They form when one muscle cell in the uterus divides and the resulting cells divide, and so on and so forth, until there is a new ball of smooth muscle where the one cell used to be. This sounds suspiciously like cancer—cells dividing unchecked—but fibroid cancer is actually very rare. The cells stay confined to their ball and do not invade into other areas the way that a cancer would. Uterus cells need to have the ability to divide when the uterus grows in pregnancy, so fibroids are a common error coming from a normal process. In fact, we think that 70-80% of women have fibroids.  If the ball stays very small, you typically never know that it was there. If many balls form, the ball/s grow large, or the balls happen to be on the inside wall of the uterus, then they can start to cause trouble. Trouble in this context can look like heavy bleeding, pelvic pain or pressure, back pain, having to urinate more frequently, trouble moving the bowels, pain with intercourse, and/or feeling bloated or too full after a meal.

When women have these symptoms, we usually start with a physical exam and pelvic ultrasound to assess for fibroids. If there are symptomatic fibroids, there are now actually quite a few treatment options available. It’s not just hysterectomy or suffer anymore. Certainly, we do perform hysterectomies in women who have fibroids and hysterectomy is appropriate, but we typically start with medical management if possible. Many women will do well with hormonal birth control, which helps with their bleeding and cramping. There are also medications that work to reduce hormone production that can help to shrink fibroids because high levels of hormones (higher than birth control levels) feed fibroids. There is a medication that does not affect hormones but decreases bleeding when taken during a period as well.

There are also now multiple minimally invasive surgical options available for fibroid treatment. Fibroids that are on the inside uterine wall can often be removed under sedation and without incisions using a small camera and the Myosure device. At Springfield Gynecology, we also have the Acessa^TM device, which is a special tool that uses ultrasound and radiofrequency energy to essentially seek and destroy fibroids that are in the walls or on the outside of the uterus. This stops the fibroids from getting any bigger and causes them to shrink and no longer impact periods. This is all accomplished with just a few small incisions on the belly. Recovery is typically less than 2 weeks with Acessa^TM and only a couple days with Myosure, compared to 4-6 weeks following a hysterectomy.

If you have fibroids that are affecting your quality of life, there are options. Gynecologists with training in fibroid treatment can help you find the option that is right for you.   To schedule a consult, please call 802-885-7561.       ###