Northwest Health Spring 2011

Women's Health

The Trouble With Fibroids

Fibroids can cause excessive bleeding, cramping, and more - but there's help.

Go to: Northwest Health Index

In 2009, Group Health member Debra Flores noticed that her periods were suddenly much heavier and lasted up to 20 days. Flores, who was in her late 40s, thought that the prolonged bleeding would stop and she'd hit menopause. But after a year, nothing had changed, except that she often felt dizzy, tired, and extremely weak.

"It really wore on my psyche," says Flores. "I'm normally a vivacious, outgoing person, but I became cranky and irritable."

She sought help from gynecologist Yolanda Richardson, MD, at Group Health Medical Centers downtown Tacoma location. Dr. Richardson diagnosed anemia from the excessive bleeding that was the result of uterine fibroids.

These non-cancerous growths occur in 20 to 40 percent of women. The tumors can range in size from smaller than a pea to larger than a cantaloupe. Most fibroids aren't troublesome and need no treatment. But sometimes they do cause problems in the form of heavy bleeding, cramping, fullness or pressure in the belly, the urge to urinate more often, low back pain, or pain during sex.

"We don't yet know why women get fibroids, but higher levels of estrogen affect them," says Dr. Richardson. "Symptoms can occur at any time but generally flare up during perimenopause (the 2- to 8-year period prior to menopause) when female hormones are fluctuating. Fibroids tend to shrink after menopause."

Treatment Options for Fibroids

If treatment for symptomatic fibroids is needed, women have several choices outlined in the chart below. They need to weigh their age, lifestyle, desire for future pregnancies, and whether they want to keep their uterus, says Dr. Richardson. Other factors that will help determine the best treatment selection are the size and location of the fibroids, as well as obstetrical history and severity of symptoms.

Group Health offers a shared decision-making video on treatment options for symptomatic fibroids. It's helpful to view this as part of a discussion with your physician about your options. You must be registered and have access to your personal online services to view the video: Videos About Treatment Options. Or contact Group Health's Resource Line to request a DVD copy.

Flores chose endometrial ablation, and says this option was right for her. "The procedure took care of my problem completely. When you're suffering from these symptoms, it's great to know that there is light at the end of the tunnel."

Name of procedure Type of procedure Description Recovery time* OK for future child-bearing?
Endometrial ablationFive-minute, outpatient. No incisionDestroys uterine lining; decreases menstrual bleedingA couple of daysNo
Uterine fibroid embolizationRadiationBlood flow to fibroids is blocked to shrink them; improvement within a few monthsOne to two weeksNo
MyomectomyLaparoscopic surgeryRemoves fibroids though they may regrowThree weeksYes
HysterectomyLaparoscopic surgeryUterus is removedFive to six weeksNo
Hormone therapyHormones administered orallySymptoms are relieved but return if therapy is stoppedN/AYes

*Recovery times vary



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