Don't wait to find solutions for uterine fibroids, doctor urges

Uterine fibroids are one of the most common problems women face during their childbearing years.

But finding a solution to them can be challenging, and takes persistence. In this week's Moves in Medicine, we explore the options.

Nearly every woman knows someone who's experienced fibroids.

"By the time that we are in our late 40s, about 60% of women have fibroids," says Dr. Anna Zelvianskaia, a Temple Health gynecologist who specializes in minimally invasive surgery.

No one knows what triggers them, and most don't cause symptoms.

But when they do, Dr. Zelvianskaia, says they can be life-altering.

"These severe symptoms can be really devastating. I've had patients who are barely able to work," she notes.

Although fibroids are so common, their location and size vary widely.

African American women tend to get them earlier, and they're larger earlier.

"They can be on any layer of the uterus," Dr. Zelvianskaia says.

Fibroids can be inside, in the muscle wall, or on the outside, like a mushroom.

Treatments fall into 3 categories - medical, procedural, and surgical.

Birth control is the most frequently used medication.

"Birth control methods do not shrink the fibroid size, buy they certainly can drastically improve symptoms," Dr. Zelvianskaia explains.

Other medications actually decrease hormone levels short-term.

"Those actually can shrink the size of the fibroids, but typically, they are available for certain amount of years," she says.

The doctor often removes fibroids through minimally invasive surgery, or radiologists can use Uterine Artery Embolization, or UAE.

"The blood supply to the fibroids is actually getting cut off," Dr. Zelvianskaia says, adding, "It can be very effective."

She advises women with fibroids to track their symptoms and find a gynecologist who takes their concerns seriously.

"A lot of these women still hear that their bleeding is normal and their heavy periods are normal and they just have to deal with it. And that is absolutely not the case," she says.

She also urges women not to delay treatment. That can limit their options.

"And if they get large enough, they can actually press on the bowels, the bladder, other internal organs," she cautions.

And sometimes fibroids can interfere with fertility - another reason not to put off care.