Fibroids Specialists, NYC
Maiden Lane Medical Gynecologists located in New York, NY
If you have pelvic pain, low back pain, or heavy periods, you might have symptomatic fibroids. At Maiden Lane Medical Gynecologists located in Midtown, Downtown and SoHo, New York, NY, our leading gynecologists offer the most advanced treatments for uterine fibroids so you can get relief from pain and irregular bleeding, and reduce their chances for pregnancy complications.
If these symptoms sound familiar, read on to learn more about fibroids, including what they are, and how we can treat them. You can also make an appointment with any of our experienced and compassionate gynecologists by calling the office or booking online.
What are fibroids?
Fibroids, also known as leiomyomas or myomas, are benign lumps of muscle tissue that grow within the uterine walls. The exact cause of fibroids is unknown, but hormones and genetics affect their development. It’s estimated up to 80% of women have fibroids, although only a minority of women will have symptoms.
Do uterine fibroids lead to cancer?
Fibroids don’t increase your risk for uterine cancer. It is possible for there to be cancer within a uterine fibroid, but this only happens in 1-2% of cases.
Where are fibroids located?
Although fibroids can grow in any part of the uterus, they are classified into three groups based on where they grow.
- Submucosal — Just underneath the internal lining of the uterus
- Intramural — In the muscular wall of the uterus
- Subserosal — On the outside of the uterus
Most fibroids grow within the wall of the uterus. Some fibroids grow on stalks (pedunculated fibroids) that grow out from the surface of the uterus or into the cavity of the uterus.
Who gets fibroids?
There are some specific types of patients who may be at higher risk for developing fibroids than others. Please understand, the majority of fibroids – especially smaller fibroids – tend not to cause any symptoms.
Women of childbearing age are most likely to develop fibroids, although women of all ages can get them. The recognized risk factors for fibroids include:
- Your race
- Being overweight or obese
- Not having children
The lifetime risk (cumulative incidence) of fibroids varies among ethnic groups. For example, Black women have an 80% chance of developing a fibroid.
White non-Hispanic women have a 60-70% chance of developing fibroids, and for Asian women, it is even lower. However, the actual cumulative incidence of fibroids among Asian women is not well known.
What causes uterine fibroids?
Currently, little is known about what causes uterine fibroids. Many theories exist, but none of these ideas explains fibroids completely. Most likely, fibroids are the result of many factors interacting with each other. These factors could be genetic, hormonal, environmental, or a combination of all three.
What are some of the symptoms of fibroids?
In general, symptoms of fibroids include:
- Menorrhagia — heavier periods that last longer than normal
- Bleeding between periods
- Pressure or pain in the pelvis
- Low back pain
- More frequent or urgent urination
- A bulge in the lower abdomen
- Uncomfortable intercourse
- Infertility and pregnancy
You can also have fibroids, but not experience any symptoms.
How are fibroids diagnosed?
Our doctors diagnose fibroids with a physical exam and pelvic ultrasound (similar to that used in pregnancy). We might also recommend an MRI to identify the exact locations, number, and size of fibroids.
We don’t recommend X-rays or CT scans to diagnose or manage fibroids. Additionally, while we sometimes find fibroids during surgery for other reasons, we don’t use operations as a primary tool to confirm fibroids diagnosis.
How are fibroids treated?
We offer a variety of treatment options, and our job is to educate you and let you decide. There are several factors to consider when contemplating your physician’s recommendation for treating fibroids including:
Your health and wellness
- How old are you?
- Do you have other medical conditions?
- What are your plans to get pregnant?
- What fibroid treatments have you tried?
- Have you had prior surgeries?
- What are your symptoms and how severe are they?
- How do your symptoms disrupt your life?
- How many fibroids do you have?
- How big are your fibroids?
- Where are your fibroids located?
Many women with fibroids think that the only possible option is a hysterectomy. This is not true in the vast majority of cases and is likely an overused treatment by many gynecologists.
Generally, in our practice, we do our best to avoid counseling a patient to perform a hysterectomy unless it is absolutely necessary because of some other medical issue or simply because the patient wants it.
Often a combination of treatments is necessary. Our doctors can guide you through all your treatment options and help you choose the one(s) that fit you best.
If you don’t have symptoms or if your symptoms are mild and don’t disrupt your health or quality of life, we often recommend observation.
We monitor your fibroids and symptoms and can discuss treatment options if your fibroids become more disruptive.
In addition to pain medication to ease your discomfort, our doctors might recommend:
- Gonadotropin-releasing hormone agonists
- Other anti-hormonal agents
- Levonorgestrel intrauterine device (IUD)
- Selective estrogen receptor modulators
- Selective progesterone receptor modulators
If surgery is the best option for you, please remember our doctors can almost always offer you a minimally invasive procedure. There is often a way to give you the benefits of minimally invasive surgery and provide the best treatment for your fibroids.
Uterine fibroid embolization (UFE)
UFE is a minimally invasive procedure. Your doctor uses fluoroscopic guidance to place small tubes in your blood vessels. This blocks the blood supply to your fibroids, which stops growth and causes the mass to shrivel and die.
Myomectomy removes only the fibroids and leaves the healthy tissue of the uterus in place. There are several ways to perform myomectomy, and the technique depends mainly on the location and size of the fibroids. We offer hysteroscopic myomectomy and laparoscopic/ robotically-assisted (daVinci®) myomectomy. When necessary, we also provide open myomectomy and do our best to minimize incision size and scarring.
Endometrial ablation is a minimally invasive, in-office procedure that disables the inside lining of the uterus to minimize bleeding. This procedure can stop your periods and is recommended when you don’t plan on having any more children. We use several techniques, including heat, electrical energy, cold, and Thermachoice (hot water).
During a hysterectomy, we surgically remove your uterus, leaving your ovaries intact. We can, but don’t have to remove your cervix during your procedure. Leaving your ovaries in place allows your body to continue to produce hormones and prevent immediate menopause. We use minimally invasive procedures, including robotically-assisted (DaVinci)/ laparoscopic surgery, whenever possible.
Magnetic resonance-guided fibroid ultrasound surgery (MRGFUS)
MRGFUS uses focused ultrasonic pulses to target your fibroids while minimizing harm to the surrounding healthy tissue. This procedure is still highly experimental.
If you're concerned about fibroids or have symptoms that could be caused by these benign growths, call our office or schedule a consultation online for accurate diagnosis and personalized state-of-the-art treatment.
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