Eric Schmit, DO, OB/GYN, and Olga Valieva, DO, OB/GYN, with Valley Women’s Healthcare explain what fibroids are and the various treatment options in this DocTalk video. A summary of the conversation can be found below the video.
What are uterine fibroids?
Uterine fibroids are growths that develop within the muscle tissue of the uterus. They are made of specific cells in the uterus that grow abnormally. While sometimes called tumors, they are usually not cancerous, and have a very low risk of becoming cancerous.
Who is more likely to have fibroids?
About 70 to 80% of women may develop fibroids. However, only about 25% of people with fibroids may experience symptoms. There’s an increased frequency of fibroids in certain cultures and ethnicities, particularly African American women, who have a two to three times higher risk of developing fibroids or larger fibroids.
What are the symptoms of fibroids?
The most common symptom of fibroids is heavy menstrual bleeding, which may be significantly heavier than normal. Other symptoms include pain, discomfort, and bulk symptoms, where the fibroids grow large enough to press on other organs. In some cases, fibroids can also cause infertility. These symptoms depend on the fibroid’s size and location in the uterus.
How are fibroids diagnosed?
Fibroids are typically diagnosed through imaging, with a pelvic ultrasound being the standard method. This ultrasound can be ordered by either a primary care physician or an OB/GYN and gives a clear view of the uterus and ovaries, helping to locate the fibroids. Sometimes, fibroids are found incidentally during a CT scan or an MRI for an unrelated issue.
What are the treatment options for fibroids?
Treatment options for fibroids vary depending on symptoms and patient preference. Observation (watchful monitoring) is one option, particularly if the patient doesn’t have symptoms. If they cause symptoms, medical treatments, mainly for bleeding, include hormonal therapies (like birth control pills, Depo Provera, Mirena IUD); medications to decrease hormones (like Lupron); and non-hormonal treatments (like tranexamic acid). Surgical options depend on whether future pregnancy is a consideration, with procedures ranging from myomectomy (removal of fibroids) to more extensive surgeries like hysterectomy (removal of the uterus).
How do you determine the best treatment options for patients?
The best treatment option is determined based on the patient’s future childbearing plans, the size and location of the fibroids, and individual patient preferences. The approach varies from minimally invasive (less complex) procedures to more significant surgeries based on the fibroid’s characteristics.
What fibroid treatment options does Valley Medical Center offer?
Valley Medical Center offers a range of medical and surgical treatment options for uterine fibroids. These include both medical management and surgical procedures, tailored to the patient’s needs. They also offer newer treatment options like Acessa, which uses radiofrequency ablation technology. This method is beneficial for shrinking fibroids with less pain, less blood loss, and quicker recovery compared to traditional surgeries. Dr. Schmit and Dr. Valieva, along with their team, have additional certification in minimally invasive gynecologic surgery, ensuring that patients receive care in the least invasive and most effective manner possible.
Understanding Our DocTalk Videos
The information shared in the video above represents the opinions of the individual healthcare provider(s) featured. Our DocTalk presenters will sometimes give a general overview including risks, symptoms, and treatments for the medical conditions they are addressing. Therefore, they may not cover specific details that would be available in other resources or in an appointment with a provider about your own healthcare conditions. Please also note that the written summary may not capture every detail contained in the video, and additional information might only be in the video format. Our goal is to inform, educate, and inspire healthier living. If you have any questions about the video content, please contact us HERE.
Why don’t these medical professionals also speak to a uterine fibroid embolization as an option of treatment? Shouldn’t all the options, not just the options provided directly by these practitioners, be given to patients?
Thank you for your question! It helped us realize that a small portion of the video content didn’t make it into the written overview. That said, if you watch the video, they do mention embolization around 4min and 38sec. At that time, they note, “If patients are not interested in what we call fertility-sparing procedures, then some of the options would include either an ablation procedure such as uterine artery embolization, one of the newer technologies which we’ll talk about in a second with radiofrequency ablation, or a hysterectomy.” We hope this helps!
I’d suggest you check the actual literature: There is no level 1 clinical evidence comparing the rates of fertility in women with fibroids who are untreated, vs embolization vs myomectomy.
According to Google Scholars:
– In the FEMME Randomized Control Trial (https://pubmed.ncbi.nlm.nih.gov/35435818/), the number of women who became pregnant after uterine artery embolization vs myomectomy was not statistically different.
– According to the American Journey of OBGyn (https://www.ajog.org/article/S0002-9378(21)00601-3/fulltext), out of 398 patients who had uterine embolization there was a 91% success rate in improvement of symptoms, and there were 148 pregnancies afterwards.
– In another randomized trial (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2700241/) the patients who had uterine embolization had a statistically shorter hospital stay and were twice as likely to be back to normal activity within 2 weeks.
I think we women need more unbiased marketing from hospitals to give us all the different treatment options out there…. my friend had embolization and had such a miraculous improvement, and I would want the same for my family.
I agree with Christine Cahill. The Treatment section only speaks from the perspective of Ob/Gyn. It is a disservice to patients to withhold information about Interventional Radiology uterine artery embolization which has proven to be a reliable alternative to the other therapies mentioned. Marketing should be consistent with their message. People browsing through the Women’s Health website first read the text b/c it takes less time.
Women’s health should included UAE/UFE in the text as well if they want to support a healthy exchange of information with their patients.
Thank you to everyone who has brought up the topic of fibroid embolization. It is a treatment our OBGYNs will discuss with patients. The information shared in the video and summary above represents the opinions of the healthcare providers featured. Our providers sometimes give a general overview including risks, symptoms, and treatments for the medical conditions they are addressing. Therefore, they may not cover specific details that would be available in more comprehensive resources or in an appointment with a provider about your own healthcare conditions.