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Mature Women's Centre Victoria General Hospital

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Common Diseases of the Uterus

How do I know if my menstrual bleeding is excessive?

If you experience periods that last more than a week, or are so heavy you have to change your tampon or pad every hour or double your protection, you probably have excessive bleeding.

What can I do about my excessive menstrual bleeding?

There is a lot that can be done, so you should definitely bring to your doctor's attention any bleeding that is disturbing to you. Ask your doctor for an evaluation to determine if you have fibroids, since that can be a cause of excessive bleeding. If you do have fibroids, you may be eligible to participate in the FAST trial.

What is a fibroid?

Uterine fibroids are growths of smooth muscle cells that form a tough mass or ball in and around the wall of the uterus. Fibroids are often referred to as "benign" (non-cancerous) growths or tumors. Fibroids vary in size, with some being micrscopic and others large enough to fill the abdomen.

Illustration of Fibroid

How do I know whether the bleeding is due to fibroids or something else?

There are several possible reasons for excessive menstrual bleeding. Your physician may be able to tell you if you have fibroids in a routine pelvic exam or with common imaging tests like ultrasound or MRI scans that look at the inside of the uterus.

Does having a fibroid mean I have cancer?

Although fibroids are often referred to as "tumors" or "masses," they are not cancer.

What causes fibroids?

It is not clearly understood what actually causes fibroids, but the female hormone estrogen in known to help them grow. Fibroids occur most frequently during childbearing years, and then usually shrink after menopause. Fibroids are very common; they may affect 30-40% of women over age 30 and occur 2-3 times more often in women of African descent.

What are my treatment options?

Not all fibroids cause symptoms. If your physician finds that one or more fibroids are the cause of your abnormal bleeding, several treatment options may be considered based on your medical evaluation. Ask your physician about all the potential options so you will be comfortable with your decision. Some of these options include:

Hysterectomy

Surgical removal of the uterus performed in the hospital, usually under general anesthesia. Once a hysterectomy has been performed, fibroids cannot come back but future pregnancy is no longer possible, and recovery time may require several weeks depending on how the hysterectomy is performed.

Myomectomy

Surgical removal of the fibroid itself, leaving the uterus in place. Fertility is preserved, since the uterus remains in place but there is some risk that the fibroids may grow back.

Uterine Artery Embolization (UAE)

This is a less invasive procedure in which small particles are inserted into a major artery in order to block the blood supply to the fibroids. Over time, the fibroids eventually shrink and their symptoms may go away. Unlike myomectomy, UAE is not currently recommended for women who desire to get pregnant in the future.

Related article:

City tests new procedure to avoid hysterectomy surgery

Winnipeg Free Press

Friday, January 9, 2009