Fibroids Specialists, NYC
Maiden Lane Medical Gynecologists located in New York, NY
You might have symptomatic fibroids if you have pelvic pain, low back pain, or heavy periods. At Maiden Lane Medical Gynecologists located in Midtown, 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 less than 1% 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. However, 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. However, 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
- Lower back pain
- More frequent or urgent urination
- A bulge in the lower abdomen
- Uncomfortable intercourse
- Infertility and pregnancy complications
You can also have fibroids but not experience any symptoms. Many women have fibroids but don’t know it.
Why are my fibroids so painful?
Surprisingly, the size of your fibroids isn’t the primary indicator of whether or not they’re painful or cause other symptoms. Instead, other factors such as their location and shape can contribute to fibroid pain.
For example, you may have fibroid pain if your growth has become too large to be sustained by its blood supply. Without adequate blood, the fibroid dies, creating byproducts that can cause pelvic and abdominal pain. Similarly, the stalks that attach fibroids to your uterus can twist, which also cuts off the blood supply leading to pelvic pain.
If fibroids develop outside of your uterus, they can put pressure on other pelvic organs such as your bladder, rectum, or spinal nerves. Fibroids on the inside of your uterus may distort the shape of your womb, causing pressure and pain.
How much is too much bleeding with fibroids?
On average, a woman loses 80ml of blood during her period. Fibroids can cause heavy or abnormal bleeding, such as:
- Bleeding or spotting between periods
- Having more than one period each month
- A period that lasts longer than 7-9 days
- Bleeding that keeps you from your regular activities
- Bleeding after menopause
If you have any signs of abnormal bleeding, make an appointment at Maiden Lane Medical. Many reproductive health issues can cause heavy periods, and getting the correct diagnosis is the first step in identifying the proper treatment to restore your health.
How are fibroids diagnosed?
Our doctors diagnose fibroids with a physical exam and pelvic ultrasound (similar to those used to monitor a 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 the diagnosis of a fibroid.
Can a gynecologist feel fibroids?
Depending on the size and location of the fibroids, it is possible for a gynecologist to feel fibroids during a pelvic exam. For example, your doctor may feel an abnormal lump, or your uterus may feel distended or misshapen.
However, other reproductive health issues can cause changes to the shape, size, and texture of your uterus. If your gynecologist feels anything abnormal during your pelvic exam, they typically order additional testing such as hysteroscopy, ultrasounds, or MRIs to gather more information.
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?
Fibroid Treatments in New York
Many women with fibroids think that the only possible option is a hysterectomy. Unfortunately, this is not true in most 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. Generally, this is the best 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 wither 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 we 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.
How long does it take to recover from a laparoscopic myomectomy?
You may need up to two weeks to recover from a laparoscopic myomectomy. Your physician provides aftercare instructions, but in general, you should get up and walk around for a few minutes every hour. That said, avoid strenuous activity and don’t lift anything heavy for at least a week after your operation. You can also use heating pads and over-the-counter pain relievers to manage any discomfort.
How can I soothe fibroids at home?
Your gynecologist can recommend at-home care to manage fibroid-related discomfort. For example, heating pads and over-the-counter pain relievers can help relieve your abdominal pain. In addition, some patients find that reducing stress in their lives, getting enough sleep, and taking a vitamin D supplement alleviates their symptoms. Talk to your doctor about your symptoms and how to maintain your quality of life.
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 state-of-the-art personalized treatment.
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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