By: Devin Namaky MD
TriHealth Advanced Gynecologic Surgery
If you suffer from uterine fibroids you may wish you had a clear way to stop bleeding, eliminate pain, or rid yourself of bloating. You want to be assured you’re getting the best possible treatment, but you may prefer to avoid a hysterectomy. Hysterectomies can be life-saving and absolutely will stop your bleeding, but it isn't for everyone.
Here are six pieces of advice to help you beat uterine fibroids without resorting to a hysterectomy:
1. See a gynecologist.
This first suggestion may seem counterintuitive. Why would you go to the person who can perform a hysterectomy if you’re trying to avoid one?
Well, there are many reasons you shouldn’t wait to see a gynecologist - and three of them immediately come to mind.
- First, you won’t really know what you’re dealing with until you are evaluated. Depending on the size and location of your fibroids, some options may be better than others. In order to make a decision, you’ll need all the information you can get.
- Second, you want to avoid missing other problems. Maybe your heavy periods are actually from a polyp and not your fibroids. Maybe you have an ovarian mass you’re unaware of that is causing your bloating. Maybe your cervix is causing you to bleed. You would certainly want to know if it is cancer causing your heavy periods. By finding and treating other problems you may find your fibroids aren’t even the culprit. In some cases, treating these other problems may allow you to avoid a hysterectomy.
- Third, remember: Fibroids can grow. The larger they grow, the more likely it is that you’ll end up with a hysterectomy. Fibroids treated when they are smaller are less likely to become a big problem needing hysterectomy. You’ll only catch fibroids before they get bigger if you see a physician.
By following this first tip, you’ll end up with most of the information you need to make a decision. But it’s entirely possible that by following this first suggestion you could end up with a recommendation for hysterectomy - which is where the next few tips come into play.
2. Make sure your gynecologist is experienced and listens.
The more experienced your gynecologist is in taking care of patients with fibroids, the more likely they’ll be to offer uterine-sparing treatments. You’ll get more options, and will understand the success rates and risks of treatments that can help you avoid a hysterectomy. Look for experienced gynecologists by talking to other women with fibroids in your area. You can view a list of experienced gynecologist with TriHealth Women’s Services here. Visit blogs, interact on social networks, and look for gynecologists who engage patients and the community.
A gynecologist who really is trying to serve your needs and uphold your right to make your own decisions will definitely be one who listens. In fact, if you are suffering from fibroids and your physician is really acting to help you make decisions, they should be offering you at least three options. Your physician should never give you just one answer.
Gynecologists should treat you like the intelligent woman you are. Find a provider who listens by asking other patients, or by referring to testimonials to see if there are any that resonate with your needs. By finding a physician who listens, you can stay in control.
3. Consider seeing a radiologist.
It may be surprising to see gynecologist suggesting that you may want to see a radiologist. But as physicians we should really provide one thing: truth. And the truth is some women avoid a hysterectomy by seeing a radiologist.
There are several treatments radiologists may be able to provide, depending on your geographic location. Many of them are still experimental, but uterine artery embolization in particular has been a longstanding treatment. Depending on how long after the procedure you follow patients (typically 3 to 8 years), about one-third of women avoid another procedure.
4. Consider a myomectomy.
Myomectomy is the surgical removal of fibroids. It’s one of the simplest answers. If fibroids are the problem, then removing them will resolve the problem in many cases.
This does require surgery, but it can often be done minimally-invasively as an outpatient procedure with a quick recovery. Myomectomy is highly effective, really only falling short of hysterectomy. A caveat, though (see number 2 above): Different types of fibroids need to be approached differently when performing myomectomy, so find an experienced gynecologic surgeon.
5. Consider endometrial ablation.
Global endometrial ablation burns the inside lining of your uterus, and often makes periods lighter. This doesn’t directly treat the fibroids per say. If not used correctly you could get poor results.
But this can be particularly effective for those with fibroids located under this lining, if used in combination with myomectomy. In fact, when ablation and myomectomy are combined, more than 90 percent of women won’t need another procedure after six years of follow up. Only a hysterectomy can beat that.
6. Get a second opinion.
If the recommendation you get from a physician isn’t in line with your needs, then do yourself a favor and get a second opinion. There’s no shame in this. It’s your body. Ask your provider for a reference for someone outside of their group to give a second opinion. If they really want what’s in your best interest, they won’t hesitate to give you the information.
All of these tips really boil down to two overarching themes: Get the information you need to make decisions, and stay in control of your body by increasing the number of treatment options available to you. Remember: You are intelligent. Don’t let people treat you otherwise.
If it turns out that you need a hysterectomy after all, you can be assured and comforted in knowing that you’ve already done your due diligence and found an experienced gynecologic surgeon.
Devin Namaky, MD, FACOG is an experienced gynecologic specialist
with TriHealth Advanced Gynecologic Surgery. His fibroid-focused practice allows him
to provide comprehensive treatment options for fibroids, including fertility-sparing
and minimally-invasive surgery. He helps you experience answers, so you can
feel assured when making decisions about your body.