For Silver, an insurance adjuster, her symptoms — very heavy bleeding and anemia with dizzy spells — were a problem for at least a year before she felt forced to do something. Her gynecologist had suggested that she consider UAE and MRI-guided ultrasound; she had reluctantly made an appointment to discuss the MRI procedure. But one day, Silver started bleeding uncontrollably. Her doctor told her that she was as close to hemorrhaging as he had ever seen. She ended up having an emergency endometrial ablation — removal of the lining of the uterus — under general anesthesia. During the procedure, which is done through the vagina, her doctor shaved off small fibroids he could see, but he could not remove a large one.
Endometrial ablation is often done when the main problem is severe, heavy bleeding. Various techniques are used to permanently destroy or remove the inner lining of the uterus (the source of the bleeding) as well as certain small fibroids. In general, it’s quicker and simpler than other procedures because it requires less surgery. But since the uterine lining is disrupted, it’s not a method for women who may want to get pregnant.
After an endometrial ablation, a woman may have mild cramping as well as some vaginal discharge because the lining is still being sloughed off. Silver has no regrets. She has erratic periods, but her heavy bleeding has disappeared. Her abdomen is a bit enlarged, though "I may be the only one who notices," she says.
Fibroid Types and Symptoms
Subserosal: Fibroids that develop under the outside covering of the uterus; may also be connected to the uterus by a stalk (pedunculated).
Symptoms: Pelvic pain; back pain; a feeling of pelvic pressure; sharp pain, caused by twisting of the stalk.
Intramural: The most common type, these develop within the wall and expand inward, increasing the size of the uterus so you look pregnant. Many do not cause symptoms until they become very large.
Symptoms: Heavier bleeding with periods; pelvic pain; back pain; a feeling of pelvic pressure.
Submucosal: The least common fibroid, these occur just under the lining of the uterus.
Symptoms: Bleeding between periods; heavy period bleeding and gushing.
Want to Help Cure Fibroids?
The Finding Genes for Fibroids study, at Brigham and Women’s Hospital, in Boston, is an international research study aimed at identifying the causes of these tumors. While not a treatment study, it may one day lead to more effective therapies. You can participate if you and one of your sisters have (or have had) uterine fibroids. While 350 pairs of sisters have already completed the study requirements, a total of 500 are needed.
If you enroll, you’ll need to complete two surveys, as well as supply medical records of your fibroid diagnosis and treatment. You will also need to give a one-time blood sample. (You’ll receive a kit containing instructions on how to get blood drawn, a collection vial, and a prepaid overnight mail package. Reimbursement forms and instructions are also included; you’ll be able to do the sampling at no cost.) For more information or to enroll in the study, contact the Center for Uterine Fibroids at 800-722-5520 (ask for 525-4434) or e-mail email@example.com.
Originally published in MORE magazine, December 2006/January 2007.