Fibroids 101: Do They Need to Be Removed?

Topic: Gynaecology

Uterine Fibroids (Leiomyomas) are non-cancerous growths of the uterus muscle. They are incredibly common—up to 70% of women will have one by age 50.

The word “tumor” scares patients. But fibroids are almost never cancer (<0.1%). The decision to treat them depends entirely on Location and Symptoms.

Types of Fibroids

1. Subserosal (Outside the wall): Bulge outward. Usually painless unless they get huge and press on the bladder.
2. Intramural (Inside the muscle): The most common. Can cause heavy bleeding if large.
3. Submucosal (Inside the cavity): The Troublemakers. Even a tiny one (1-2 cm) here can act like a natural IUD, preventing pregnancy and causing horrific bleeding.

When to Treat

You generally do NOT need surgery if:

• They are small (<4-5 cm).
• You have no symptoms (no pain, no heavy bleeding).
• You are near menopause (they shrink after menopause).

You DO need to consider treatment if:

1. Anemia: Your periods are so heavy you are losing blood faster than you can make it.
2. Pressure: You have to pee every hour (bladder pressure) or look 5 months pregnant.
3. Fertility: It is distorting the cavity (Submucosal).

Treatment Options

• Meds: Tranexamic acid (to stop bleeding).
• Procedure: Uterine Artery Embolization (UAE) cuts off the blood supply to shrink them.
• Surgery: Myomectomy (removes fibroid, keeps uterus) or Hysterectomy (removes uterus).

Don’t let a fibroid dictate your life. If it is bleeding you dry, treat it.