I have fibroids – what are my treatment options?

Written by: Dr Paul Crowe
Published: | Updated: 15/01/2019
Edited by: Bronwen Griffiths

Do you suffer from fibroids? The chances are that you do, or you will as up to 40% of women aged 35 or older have fibroids. Fibroids can either be symptomless or can cause numerous menstrual problems, including heavy bleeding. Choosing your treatment can be overwhelming, but Dr Paul Crowe, a leading interventional radiologist with lots of experience in treating uterine fibroids lays out the A to Z in treatment options for this common condition.

Fibroids – what are they?

Fibroids are abnormal growths found on the muscle walls of the womb or uterus. Also known as uterine fibroids, these are the most common tumours found in the female genital tract. Although tumours, they are benign growths (non-cancerous) and do not always produce symptoms. However, when fibroids do cause symptoms, women can experience very heavy or painful periods.

Are fibroids common?

Uterine fibroids are very common, with those suffering from fibroids increasing in numbers with age until menopause. Around 20% to 40% of women aged 35 or older have uterine fibroids. They are also more common in some ethnic groups.

How can fibroids be treated?

Your specialist will discuss the different treatment options available with you, as the course of treatment chosen is unique to your circumstances.

Combination treatments:

  • often you will follow a combination of different treatments, particularly if you have different types of fibroid
  • for example, you might have embolisation, followed by medication or embolisation followed by surgery

Endometrial ablation:

  • this treats the uterine lining to reduce heavy menstrual bleeding (menorrhagia) made worse by fibroids

Hysterectomy:

  • either the whole uterus and cervix are removed, or the cervix and ovaries are left intact (subtotal hysterectomy)
  • this is more invasive, and usually recommended to women who have severe bleeding problems caused by their fibroids
  • recovery time is much longer

Medical treatment:

  • tablets or injections that manipulate hormones that affect fibroid growth can be taken
  • fibroids can return if this treatment method is discontinued

Myomectomy:

  • a surgical procedure that removes the fibroids
  • this procedure can be carried out hysteroscopically (through the cervix), laparoscopically (keyhole surgery) or as open surgery

MRI guided focused ultrasound (MRgFUS):

  • high intensity ultrasound waves onto the fibroids in an MRI scanner heat treats the and destroys them
  • this option is only appropriate in cases where the location and size of the fibroids is optimal

Uterine artery embolisation (UAE):

  • also known as uterine fibroid embolisation (UFE)
  • a mainstream treatment option that shrinks the fibroids by blocking their blood supply

How to choose your treatment?

After in-depth discussions and on the basis of your diagnosis, a gynaecologist and interventional radiologist will recommend the best course of action for the treatment of your fibroids. However, it is also best to research the options ahead of your appointment, so that you can ask as many informed questions as possible.

 

If you require fibroid treatment or would like to find out more, make an appointment with a specialist.

By Dr Paul Crowe
Interventional radiology

Dr Paul Crowe is a leading interventional radiologist based in both London and Birmingham. After graduating from Trinity College Medical School, Dublin in 1988 Dr Crowe went on to complete five years of specialist radiology and interventional radiology training. Following this Dr Crowe joined Birmingham Heartlands Hospital, part of University Hospitals Birmingham NHS Trust, where he has been a Consultant Interventional Radiologist since 1998.

With an extensive experience, both in the NHS and privately, Dr Crowe has influenced interventional radiology practices and set up new services. This includes being one of the first to offer uterine fibroid embolisation in the UK, a treatment he has now performed over 6000 times. In addition to carrying out interventional radiology treatment procedures, Dr Crowe undertakes diagnostic radiology scans, such as ultrasounds, MRI scans and CT scans. Dr Crowe's areas of expertise include embolisation of uterine fibroids, adenomyosis, pelvic congestion syndrome, varioceles, treating benign prostate enlargement and supporting cancer treatment services by providing venous access (portacath, Hickman line, PICC line).

Further to Dr Crowe's clinical achievements, he is also involved in research and speaks frequently at medical conferences. He has spoken on numerous occasions about uterine fibroid embolisation and has been the leading individual contributor to the UK Fibroid Embolisation Registry. He is co-founder of the Birmingham Fibroid Clinic and is also kept busy with various chairmanship positions for hospitals and his advisory capacity to the National Institute of Health and Care Excellence.

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