Heavy menstrual bleeding is considered
'excessive menstrual bleeding which interferes with a women’s
physical, social, emotional and/or material quality of life '
It is estimated to effect 20 > 50% of menstruating women in Australia.
A common cause of Heavy Menstrual Bleeding is often found to be a Fibroid or cluster of fibroids
So What are Fibroids?
Fibroids are benign growths which form in and around your uterus.
They can occur singularly or in groups and vary dramatically in size from the size of a tiny seed to the size of a cantaloupe.
In very rare instances (less than<1%) a very large Fibroid has the possibility of becoming cancerous
There are 3 types of Fibroids:
Growth within the wall of the uterus
Grow on the outside of the wall of the uterus
Can cause heavy bleeding, extended bleed and painful period
Grow just within the inner lining of the uterus (endometrium)
Sometimes causing heavy, long and painful period
Who is at risk of developing them?
Fibroids are very common in women aged 20 and older.
They grow at varying rates until the onset of menopause, when they tend to decrease in size.
By the age of 40, about 40 per cent of Australian women have one or more fibroids and by the age of 50, up to 70 per cent have had fibroids.
Although Fibroids themselves are not harmful they can cause a range of health complications including;
Problems urinating & defecating
Miscarriage or premature delivery
The most common conditions is anaemia (a reduction in your red blood cells). This occurs if your fibroids cause an excessive loss of menstrual blood. Anaemia can lead to breathlessness, paleness, and feelings of fatigue.
Difficulty with toilet habits:
Other complications include bladder and bowel problems. These occur when large fibroids cause your uterus to bulge and press against your pelvic organs, causing feelings of fullness or discomfort, constipation or an increased need to urinate.
Fibroids can compromise your fertility if they interfere with the implantation of a fertilized egg – the egg may try to implant on top of a fibroid or have difficulty implanting because the fibroids have changed the shape of your uterus.
Fibroids that place pressure on the placenta can reduce placental blood flow, causing a higher risk of miscarriage and premature delivery.
Fibroids situated in the lower part of your uterus can affect delivery if they obstruct the baby as it moves down your birth canal.
What causes Fibroids?
The exact nature as to why Fibroids develop is still unknown.
It is thought that they probably have partly a genetic and partly an environmental cause.
They generally don't appear until after women ovulate for the first time and they tend to decrease in size after women undergo menopause.
As a result, researchers believe the sex hormones oestrogen and progesterone affect their development and growth.
Factors that increase your risk:
Family history of Fibroids
Early onset of Menstruation
Age (your risk of developing fibroids increases in your late reproductive years)
Having never been pregnant
Polycystic ovarian syndrome (PCOS)
Hypertension (high blood pressure)
How do you know if you have fibroids?
Many women who have fibroids experience no symptoms and can go through life without even knowing they have them.
Quite Often fibroids are detected incidentally during a routine gynaecological exam or while a pelvic ultrasound or surgical procedure is being performed for another condition.
While many women will have no symptoms, when symptoms present, fibroids can cause the following:
- Heavy periods
- Prolonged periods
- Bleeding, or spotting between periods
- Pain or a feeling of pressure in the pelvic area
- Period pain
- Pain in the lower back;
- Pain during sex;
- Constipation or difficult bowel movements;
- Difficulty urinating or frequent urination.
Often the symptoms are the same as women who have Adenomyosis, or Endometriosis.
If you experience any other these symptoms it is best to see your regular doctor/ GP whom can investigate things further or refer you to a gynaecologist
Diagnosis of Fibroids is usually done using an ultrasound, or an MRI.
They can also be diagnosed via surgical intervention with a laparoscopy and hysteroscopy Performed by a gynaecologist.
The treatment depends on the size, number & location.
- if the fibroids are not causing any symptoms & are not large the conditon can be monitored over time for any changes
-a combination of hormones or other medication can be used to shrink the fibroids before surgery.
-the fibroids are removed through the cervix using a hysteroscope, which is inserted into the vagina to examine the cervix and inside the uterus
‘keyhole surgery’. A thin tube is inserted through the abdomen to remove the fibroids.
Open surgery “Myomectomy”
Larger fibroids need to be removed through a cut in the abdomen.
MRI directed ultrasound technique
– the new technique uses MRI to locate and monitor the fibroids and ultrasound waves are used to destroy the fibroid tissue.
– under local anaesthetic ultrasound is used to guide Fine, sand-like particles, through a fine tube, into the artery to block the blood supply to the fibroid.
The fibroid slowly dies and symptoms generally subside over a few months.
the surgical removal of some, or all, of the uterus.