Fibroids (leiomyomas), Persistent Bleeding (menometrorhagia)

Possibly as many as 20-40% of all women have uterine fibroids. While the majority usually have no symptoms, 1 in 4 end up with symptoms severe enough to require treatment.

Normal menstrual cycle shouldn’t last more than three to four days or be painful and heavy (containing clots). Normal sized uterus shouldn’t exceed one to two ounces in weight and be bigger than a peach.

Many women do experience persistent, heavy uterine bleeding, pelvic cramps and pressure. This may be caused by hormonal imbalance, fibroids, adenomyosis, endometrial hyperplasia (uterine precancer) or even uterine cancer. Patients may complain of weakness (being anemic), may not be able to leave home for days or even stay in bed because of bleeding, cramps and pelvic pressure.

Fibroids are benign tumors originating from uterine tissue. The severity and impact of symptoms depend on location, number and size of the fibroids.

Adenomyosis is a certain type of endometriosis that develops inside the uterine walls. It causes pain and bleeding.

After excluding cancer, treatment should be attempted first by using different hormonal agents, including birth control pills and oral or injection progesterone. If this is not successful, then estrogen eliminating treatment is given in the form of Lupron injection (GnRH-a, gonadotropin releasing hormone agonist). Those treatments take several months and may produce severe side effects, especially menopause-like symptoms. Usually, the therapeutic impact lasts as long as these agents are given.

Now, a new procedure is being offered – Laparoscopic Uterine Artery Ligation (LUAL). Learn more about LUAL.

Surgery is the last resort (after exhausting conservative therapy) in treating symptomatic fibroids and persistent heavy bleeding. Hysteroscopic endometrial ablation, myomectomy and D&C are the conservative surgical approaches. Definitive solution is provided by Laparoscopic Supracervical Hysterectomy (LSH).

Learn more about Laparoscopic Supracervical Hysterectomy (LSH).