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What are fibroids?

Fibroids, or leiomyomas, are benign growths formed from muscle and fibrous tissue and situated either within the womb’s walls, on the womb’s outer surface, or inside its central cavity.

They can vary in size and severity. Some form independently as individual nodes, while others grow together in clusters, ranging from a fraction of a centimetre up to 20 centimetres or more in diameter. For reference, some are barely the size of a grain of rice, others are like large melons.

This vast disparity in size also means that fibroids can produce a broad range of symptoms. Some of them – the smaller ones – often do not cause any notable symptoms, while others have a serious negative impact on women’s health, causing pain, heavy bleeding and pressure symptoms.

What are the types of fibroids?

Fibroids are classified into different types according to their location and structure:

  • Intramural – this is the most common variety. They develop within the muscle walls of the womb.
  • Subserosal – these fibroids grow on the outer walls of the uterus and can extend out into the pelvis. They are at risk of getting very large, with much surrounding room to spread to.
  • Submucosal – these fibroids grow under the uterus’s mucus lining and can extend into the central cavity.
  • Pedunculated – the rarest form, these fibroids are almost like little mushrooms, with a stalk-like structure sticking out from the uterus and a larger growth on the end of it.

What are the symptoms of fibroids?

As mentioned above, the symptoms vary according to their size, number and location. It is worth noting that lots of women remain unaware of their fibroids and they are only eventually discovered during routine gynaecological examinations or other tests because they are symptomless.

Smaller fibroids are less likely to cause symptoms. But larger ones are more likely to lead to issues including:

  • Painful and/or heavy menstrual bleeding
  • Soreness and aching of the pelvis
  • Bleeding not connected to periods
  • Bloating and feeling full or swollen around the lower belly area
  • Frequent urination because of a fibroid exerting pressure on the bladder
  • Inability to fully empty the bladder when going to the toilet
  • Constipation
  • Pain during intercourse
  • Back pain

Since some cases are symptomless or mild, and others can be much more severe, it is important to take a symptom-based approach to fibroids treatment.

How are fibroids diagnosed?

Various methods can be used to diagnose cases of fibroids. They are often discovered during routine check-up examinations or investigations for other pathologies.

Specialists may also look at a patient’s medical history to assess their risk of fibroids and use a range of tests to confirm their presence, like:

  • Ultrasound: A device called a transducer is placed in the vagina and then emits sound waves to form a picture of the uterus, which can then be used to discern the presence of fibroids.
  • MRI: A non-invasive scan that forms a 2D image of the womb for analysis.
  • Hysteroscopy: A little telescope tube enters the uterus via the vagina to assess the cavity of the uterus and rule out the presence of submucosal fibroids.

Accurate and comprehensive diagnosis is necessary to treat fibroids most efficiently and effectively.

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What are the common causes of fibroids?

Experts are not 100% sure what causes fibroids. We do know that these growths seem to be intrinsically linked to the feminine hormone, oestrogen. This is why they are most likely to appear during a woman’s reproductive years and tend to fade during menopause when hormone levels decrease.

Certain risk factors may give you a higher chance of developing fibroids, such as:

  • Starting your periods at an early age
  • Being clinically overweight
  • Having a family history of fibroids
  • Lack of vitamin D
  • Fibroids are more prevalent in black women

About Mr Pandelis Athanasias – Fibroids Expert ✓

Mr Athanasias has extensive experience in treating fibroids and specialises in minimally invasive surgery, which aims to reduce symptoms with a short recovery time. We are committed to tailoring treatments to the individual patient’s needs, and if a treatment is not proven to be effective, we will endeavour to find an alternative solution.

Start your journey to better health by booking a consultation, today.

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Pregnancy and fibroids

As they typically grow in the same space that a foetus develops, it is easy to see how fibroids can potentially affect pregnancy. Depending on the location and size they can increase the risk of miscarriage or preterm labour.

There are also cases where expecting mothers with fibroids have additional pain and discomfort during pregnancy. However, it is important to note that most women with fibroids have no trouble delivering a healthy baby, and any fibroid symptoms during pregnancy can be managed without invasive treatment.

There are also questions concerning fibroids and fertility, and studies suggest that fibroids can sometimes make it harder to conceive. Yet many women with fibroids are still perfectly capable of getting pregnant without the need for treatment or surgery.

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Fibroids treatment options

Non-surgical treatments

Surgery is not always required to treat fibroids, nor is it necessarily the most appropriate or effective solution in all cases. We provide multiple non-invasive fibroid treatment methods to relieve and comfort our patients.

Medication

Prescription medications will not erase fibroids but can help shrink them or impede their growth. They work by regulating hormone levels and can prove helpful in smaller fibroids but are less effective on big ones.

Levonorgestrel intrauterine system (LNG-IUS)

A T-shape device is placed into the womb. It releases a hormone called levonorgestrel, which makes the lining along the uterus walls less thick and viscous. This results in lighter menstrual bleeding and eased fibroid-related symptoms.

Gn-RH agonists

Gn-RH agonists are drugs that restrict the body’s production of sex hormones (like oestrogen). With lower oestrogen levels, fibroids should stop growing and may start to shrink or fade away. This may, however, bring menopause-like side effects, such as hot flushes.

Contraception

Various methods of contraception that impact hormone levels may prove helpful in managing fibroids. The pill, for example, can ease symptoms like heavy bleeding, while an intra-uterine system or coil may have similar effects, though neither of these methods will remove or shrink the growths.

New hormonal medication

New medications are available that reduce the level of hormones released by the ovaries. The fibroids will then shrink and the symptoms can improve. The medication can be prescribed indefinitely if needed.

Surgical treatment – fibroid removal

In many cases, where fibroids are large and cause a lot of pain, discomfort, or other negative effects, surgery may be the best or only logical treatment option. We offer various surgical procedures to deal with fibroids of different locations and of varying sizes.

Laparoscopic myomectomy

A few small incisions are made on the abdomen so that surgical instruments can pass through in order to remove fibroids and repair the uterus.

Open myomectomy

When dealing with very large or numerous fibroids the best way to remove them is via a bigger scar (like a bikini line scar). The steps of the procedure are the same as during keyhole surgery (laparoscopic myomectomy).

Open or laparoscopic hysterectomy

Closer to the menopause, if the woman completed her family or when dealing simultaneously with other conditions removal of the uterus together with the fibroids might be the ideal treatment option. The operation can be either performed via keyhole surgery or a bigger scar.

Hysteroscopic resection

An incision-less option, this involves the use of a hysteroscope (a narrow tube telescope) inserted into the vagina, along with tiny surgical instruments to operate on the womb from within.

Hysteroscopic morcellation

Another procedure that does not involve any incisions. A hysteroscope passes through the vagina into the uterus, and a morcellator (a type of surgical instrument) cuts away the fibroids from within.

Uterine artery embolisation (fibroid embolisation)

Blood supply to the fibroids is cut off without impacting the uterus supply. Subsequently, the fibroids gradually shrink.

Fibroids treatment UK

Experience the best fibroid treatment with highly skilled specialists and tailored treatment plans, at our London clinic.

FAQ

Will I have scars after the surgery?

Keyhole surgery is performed via 3 or 4 tiny scars (largest 12mm/half inch). If open surgery is necessary a lower transverse scar (like a caesarean scar) will be required.

Hysteroscopic removal of submucosal fibroids does not involve any scars as the procedure is performed via the cervix.

Do I need fibroid treatment?

If your fibroids are causing you pain, heavy bleeding, discomfort, or other symptoms or affecting your chances of getting pregnant, fibroids treatment may be the logical route to follow. For others in symptomless cases, there may be no need for treatment because fibroids often shrink away on their own as you age.

Timely diagnosis and personalised expert care according to your individual needs and wishes is the key to successful treatment of uterine fibroids.

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    10 Knaresborough Pl,
    Kensington, London,SW5 0TG

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    Chelsea Bridge Road
    London, SW1W 8RH

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    801 London Road, North Cheam
    Sutton, Surrey, SM3 9DW

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    53 Parkside, London
    SW19 5NX

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    184 Coombe Lane West
    Kingston upon Thames, KT2 7EG

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Mr Panayi’s Secretary:

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Tel: 07990781826

Fax: 0208 082 5560

amy@londonwomenscentre.co.uk

Mr Athanasias’ Secretary:

Angela Hughes

Tel: 07731522542

Fax: 0203 725 9935

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