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Women's Health

Women’s Health Issues – Uterine Fibroids & Infertility

What Are Uterine Fibroids?

Uterine fibroids are noncancerous tumors that grow in or on the uterus. Fibroid tumors affect approximately 20-40% of women over the age 35 and are much more prevalent among African-American women than women of other races. Fibroids can range from the size of a golf ball to the size of a cantaloupe. Physicians generally measure them by comparing them to the size of the uterus during pregnancy; large fibroids may cause the uterus to grow to the size of a six- or seven-month pregnancy.

Signs & Symptoms of Uterine Fibroids

Of the 600,000 hysterectomies performed every year in the U.S., one-third are due to fibroids. Women may develop a single large fibroid or a cluster of smaller ones. Because fibroids are sensitive to hormonal changes, symptoms may appear cyclically. With estrogen at higher levels before the onset of menopause, fibroid size and symptoms may increase at that time. At the onset of menopause, the accompanying decrease in estrogen may cause fibroids to shrink. Women on hormone replacement therapy may experience an increase in the size and symptoms related to their fibroids.

The quality of life for many women with fibroid tumors is quite good. Others may grow accustomed to such symptoms as an enlarged abdomen and excessive bleeding during menstruation and continue with their regular routines. However, when symptoms become severe and affect their day-to-day routine, women often seek help from a physician.
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Uterine Fibroid Types

Diagnosing Uterine Fibroids – Uterine Fibroid Embolization (UFE)

While most women will undergo an ultrasound at their gynecologist's office to determine the presence of fibroid tumors, MRI has proven much more effective and has become the standard imaging tool used by interventional radiologists. By providing a definitive diagnosis, an MRI improves the level of care, allowing better for treatment options and better outcomes. MRI can determine if a fibroid tumor can be treated effectively using embolization or if another course of treatment (watchful waiting, medications, myomectomy or hysterectomy) would be more appropriate.

Uterine fibroid embolization (UFE) is a minimally invasive procedure that involves the release of tiny FDA-approved particles into the two uterine arteries which block the supply of blood to the fibroids, causing them to shrink and die. UFE treats all existing uterine fibroids, giving significant or total relief from symptoms to about 85-90% of women who undergo the procedure. In a study of one group of women followed for six years, no tumor treated with UFE reappeared. UFE has been proven to be as successful as surgery, while causing less serious complications.

UFE is performed with conscious sedation by board-certified anesthesiologists. Conscious sedation is administered with a combination of medicines (a sedative and an anesthetic) that help the patient relax and help to minimize pain and discomfort during the procedure. The patient is usually able to stay awake and respond to verbal cues but may not be able to speak. The patient’s heart rate, blood pressure, breathing, oxygen level and alertness are carefully monitoring during and after the procedure. Conscious sedation is safe and effective and allows patients to recover quickly.

Causes of Infertility: Endometriosis,
Pelvic Inflammatory Disease & Polycystic Ovaries

About 10% of U.S. women between 15 and 44 years of age experience infertility problems. While age, weight and smoking contribute to the prevalence of this problem, underlying medical conditions may be present that inhibit a woman’s ability to conceive. These conditions include:
  • Uterine fibroids
  • Endometriosis
  • Pelvic inflammatory disease
  • Polycystic ovaries
  • Premature ovarian failure

Hysterosalpingogram

A hysterosalpingogram (HSG) is an important procedure used to determine why a woman is having difficulty conceiving. Performed with fluoroscopic guidance, a contrast material is injected through the cervix and vagina and into the Fallopian tube. The contrast then fills the uterine cavity and the Fallopian tubes, showing if there is any abnormality or blockage in the Fallopian tubes. This can identify reason for and improve infertility.
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