Vim & Vigor - Fall 2019 - PARRISH - 17

thicken and shed with each menstrual
cycle. But the cells that lead to fibroids
seem to be extra-responsive to hormones, and it's this overgrowth of muscle cells that causes the benign tumor
to form. "They could be caused by an
overreaction to scarring, but we aren't
100 percent sure," Zelmanovich says.
3 Fibroids aren't cancerous.
Leiomyomas are always benign. But in
some cases, a leiomyosarcoma, or cancerous tumor, may develop in the uterus.
According to the Sarcoma Foundation,
leiomyosarcoma is extremely rare, affecting only 6 in 1 million women each year.
Simply having fibroids does not increase
your risk for it-nor are you more likely
to get other gynecological cancers.
3 Symptoms may vary-or not
exist at all. Women with fibroids may
experience heavy bleeding with menstruation or bleeding between periods.
Excessive bleeding can lead to anemia,
which may be one reason for treating fibroids. Other symptoms include
constipation or frequent urination (if
the fibroid is pressing on the rectum or
bladder), painful sex and difficulty getting pregnant. "Symptoms will depend
on the size and location of the fibroid,"
Zelmanovich says.
3 African-American women are
affected more severely. The Journal
of Women's Health reports that black
women are three times more likely
than white women to develop fibroids.
They're also more likely to get them
at a younger age; the reasons why are
largely unknown.
3If you choose treatment, there are
many options. Doctors treat fibroids
if they affect a woman's quality of life.
Most of the time, the recommendation
will be watchful waiting; your doctor can
monitor the size of the fibroid at your
annual exams, typically with a transvaginal ultrasound. If you do opt for
treatment, the method you choose will
depend on a variety of factors, like your
age, whether you want to have children
and the nature of your symptoms.

Treatment options include:
Oral contraceptives. Birth control
pills don't shrink fibroids, but they can
improve the symptoms. "Birth control
pills thin the endometrial lining, which
will lessen bleeding," Zelmanovich says.
Hormonal intrauterine devices (IUDs)
can serve the same purpose.
Drugs to suppress hormones. Also
known by brand names like Lupron and
Synarel, gonadotropin-releasing hormone
agonists can shrink fibroids by stopping
the production of certain hormones. But
it's considered unsafe to take GnRH agonists for longer than nine months, and
the fibroids will return once the drug is
stopped. For this reason, women typically use these drugs to either shrink
tumors before having surgery or solve
the issue temporarily if they are close
to menopause.
Myomectomy. This type of surgery
removes only the fibroids but leaves
the uterus and other organs, making it
a good option for women who want to
get pregnant someday. It can be done
through a large incision in the abdomen (sometimes called "open surgery"),
laparoscopically using tiny incisions, or
through the vagina, using a thin, flexible
tube called a hysteroscope.
Embolization. This minimally invasive procedure involves injecting small
gel particles to cut off the fibroids'
blood supply. Because embolization also

APPOINTMENTS

Support for Women
with Fibroids
Parrish Medical Group offers a
variety of resources and treatments for women with fibroids.
Visit parrishmedgroup.com to
view the physician directory for
a list of OB-GYN providers.

might affect the uterus, it is not recommended for women who wish to have a
future pregnancy.
Hysterectomy. This surgery refers
to the removal of the uterus and makes
future pregnancies impossible; it can
also lead to early menopause in younger
women. "It's usually only performed
when it's the last solution available,"
Zelmanovich says. ■

6 Questions
Your Doctor
Might Ask
Whether you choose treatment or
watchful waiting for fibroids, your
doctor can use this information to
help determine a plan.
1. How close to menopause are
you? You may find that your fibroids
shrink after you stop getting your
period regularly.
2. How bothersome are your
symptoms? Doctors will consider
your quality of life. For example, are
you developing anemia, missing work
because of painful periods or suffering
from digestive distress?
3. Are you willing to try a hormonal
medication? If so, you can consider
birth control pills, a hormonal intrauterine device or injections of a medication
like Depo-Provera.
4. Are you having difficulty conceiving? Your doctor may recommend
a myomectomy to remove fibroids and
possibly improve your chances.
5. Even if you're not attempting
to conceive, do you want to have
children in the future? Women who
haven't ruled out pregnancy won't
be candidates for certain surgical
procedures.
6. Are you willing to undergo surgery? Surgery comes with its own risks,
such as infection, but operations done
laparoscopically or through the vagina
usually have shorter recovery times.

FALL 2019

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Vim & Vigor - Fall 2019 - PARRISH

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