What Are Uterine Fibroids?
Uterine fibroids, also known as leiomyomas or myomas, are non-cancerous growths that form in or around the uterus. Composed of muscle and fibrous tissue, they are incredibly common affecting up to 70–80% of women by the age of 50. While many remain small and symptom-free, others enlarge enough to impact quality of life and fertility.
Fibroids can vary in size from a few millimeters to more than 10 centimeters in diameter. In some cases, women may develop multiple fibroids of varying sizes.
Types of Fibroids
Fibroids are classified based on their location in or around the uterus:
- Intramural fibroids grow within the muscular wall of the uterus (most common).
- Submucosal fibroids grow into the uterine cavity and often cause heavy bleeding and fertility issues.
- Subserosal fibroids grow on the outer surface of the uterus and can cause pelvic pressure or pain.
- Pedunculated fibroids are attached to the uterus by a thin stalk and may twist causing acute pain.
Understanding the type and location of your fibroids is essential for choosing the right treatment approach.
Common Symptoms of Fibroids
Fibroids can present with a wide range of symptoms, depending on their size, number, and location. Some women experience no symptoms at all, while others face persistent pain and bleeding.
Typical symptoms include
Heavy or prolonged menstrual bleeding
Pelvic pain or pressure
Pain during intercourse
Frequent urination or difficulty emptying the bladder
Constipation
Backache or leg pain
Bloating or abdominal distention
Infertility or difficulty maintaining pregnancy
If left untreated, fibroids can grow larger over time, worsening symptoms and increasing the risk of complications.
What Causes Fibroids?
The exact cause of fibroid development is unknown, but research suggests a combination of hormonal and genetic factors:
- Estrogen and progesterone, hormones that regulate the menstrual cycle, are known to promote fibroid growth.
- Genetics: Family history elevates risk.
- Ethnicity: Certain ethnic groups, particularly Black women, are more likely to develop larger, more symptomatic fibroids earlier
- Lifestyle: Diet, stress, and obesity may influence growth (research ongoing).
Fibroids are hormone-sensitive, which means they often shrink after menopause due to reduced hormone levels.
How are Uterine Fibroids Diagnosed?
Fibroids are often discovered during routine pelvic exams or when investigating heavy bleeding or infertility. Dr. Meyer uses advanced imaging to pinpoint size, number, and location.
Diagnostic tools include
Transvaginal ultrasound
First-line tool to visualize the uterus and identify fibroids.
MRI
Provides detailed images of the uterus, especially useful for complex or large fibroids.
Sonohysterography
Saline-infusion ultrasound to evaluate the uterine cavity.
Hysteroscopy
A small camera is inserted into the uterus to view fibroids that protrude into the uterine cavity.
How are Uterine Fibroids Treated?
Some fibroids can be managed medically or monitored. For moderate–severe symptoms or fertility goals, surgery is often most effective. Dr. Meyer specialises in minimally invasive techniques that minimise pain, lower complications, and shorten recovery.
Laparoscopic Myomectomy
Laparoscopic myomectomy is a minimally invasive surgery where fibroids are removed through small incisions in the abdomen. Dr. Meyer uses advanced tools and a high-definition camera to carefully excise fibroids and reconstruct the uterus.
Benefits include:
- Smaller incisions and minimal scarring
- Faster recovery (1–2 weeks vs. 6 weeks for open surgery)
- Lower risk of infection or blood loss
- Preservation of the uterus for future fertility
Even large fibroids previously thought to require open surgery can now be removed laparoscopically in many cases, thanks to Dr. Meyer’s experience and advanced technique.
Robotic-Assisted Myomectomy
For certain complex cases, Dr. Meyer may perform robotic-assisted myomectomy using the da Vinci robotic system. This technique offers even greater precision and control, especially in patients with multiple fibroids or fibroids in difficult-to-access locations.
Hysteroscopic Myomectomy
For fibroids located within the uterine cavity (submucosal), Dr. Meyer uses hysteroscopy a scarless technique performed through the cervix. This is a particularly effective option for women with heavy menstrual bleeding and fertility concerns.
Medical Management
In some cases, medical therapies can temporarily shrink fibroids or reduce symptoms:
- GnRH agonists to suppress hormone production and shrink fibroids
- Hormonal IUDs to reduce bleeding
- Oral contraceptives or progestins to regulate cycles
- Tranexamic acid for managing heavy bleeding
However, medical treatments are typically temporary and may not prevent fibroid regrowth.
Should I Consider a Hysterectomy?
While hysterectomy (removal of the uterus) offers a permanent solution to fibroids, it is not always necessary. Dr. Meyer prioritizes conservative, uterus-sparing options whenever possible especially for women who wish to preserve fertility or avoid major surgery.
For women with severe symptoms, recurrent fibroids, or other uterine conditions, a minimally invasive hysterectomy may be considered. Dr. Meyer performs laparoscopic and robotic hysterectomies with the same focus on precision and recovery.
How Fibroids Affect Fertility
Depending on their location and size, fibroids can interfere with conception and pregnancy in several ways:
- Blocking the fallopian tubes
- Distorting the shape of the uterus
- Interfering with implantation
- Causing miscarriage or preterm labor
Submucosal and large intramural fibroids are particularly associated with reduced fertility. Dr. Meyer tailors fertility-preserving plans for patients trying to conceive.
Why Choose Dr. Raanan Meyer
Dr. Raanan Meyer is a fellowship-trained gynecologic surgeon known for his meticulous surgical skill, compassionate care, and patient-first philosophy. He specializes in treating complex fibroid cases with a minimally invasive, fertility-preserving approach.
What sets Dr. Meyer apart:
- Laparoscopic and robotic surgery even for large fibroids
- Emphasis on organ preservation and fast recovery
- Individualized care plans for symptom relief and fertility
- Advanced imaging and diagnostic protocols
- Extensive experience with complex cases and multidisciplinary care
