Tag: Women’s Health

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Fibroids

Pregnant…with fibroids?

Can uterine fibroids make me look pregnant?

“Congratulations! When are you due?!” Though saying this is appropriate when there is indeed a pregnancy, sometimes this congratulatory statement is given or received when there is no pregnancy. Which, needless to say, is embarrassing and uncomfortable for all involved.

But how, you might ask, could someone mistakenly assume a woman is pregnant?

Though sometimes weight gain, especially in the form of excess belly fat can make a woman’s body appear pregnant, it’s not the only underlying cause.

In fact, sometimes, weight gain has little to do with it, and the appearance of pregnancy can be caused by something else entirely.  And, that something else, could be uterine fibroids.

That’s right.

For starters, uterine fibroids can range in size… and location.

Sometimes they are as small as 1-5 centimeters, which is about the size of a small seed or a grape. Other times they are medium-sized which is usually between 5-10 centimeters or about the size of a lemon or even an orange.

Large fibroids are 10 centimeters or more and can grow to be the size of a mango or grapefruit. And, in some cases, they can even be as large as a watermelon.

So now, imagine what a woman’s body might look like with a watermelon-sized fibroid in her uterus, and you’ll see how an erroneous “Congratulations! When are you due!?” could happen.

Fibroids can sometimes grow to the point where they distort the abdomen, making some women appear pregnant. Furthermore,  depending on their size and the number of them, fibroids can not only lead to an increase in clothing size, but they can also lead to an increase on the scale as well.

In fact, when left untreated, some larger fibroids can weigh as much as 20 to 40 pounds!

And, as if that isn’t bad enough, fibroids regardless of their size can come with a slew of terrible life-interrupting symptoms such as long and painful periods, anemia, excessive bleeding in between cycles, pelvic pressure, and pain, frequent urination, constipation, and fatigue.

All of these symptoms can not only affect a woman’s day-to-day life, but they can adversely affect the way she feels about herself and her body.

In our next article, we will take a look at the effect that fibroids can have on a woman’s body image.

In the meantime, if you or a loved one are experiencing body distortion from large fibroids, or painful symptoms from any size fibroid, you are not alone. Read this recent blog post to find out if you are a good candidate for Uterine Fibroid Embolization.

Help is available, and you can even call us today and set up a consultation where we can work together to help determine the best treatment plan for you.

Categories
Fibroids

A Good Candidate for UFE

Uterine Fibroid Embolization (UFE) is not only effective, but it has a much shorter recovery period than other treatment methods.

There is great news if you are a good candidate for Uterine Fibroid Embolization (UFE).

UFE has an excellent track record regarding its effectiveness in relieving fibroid symptoms. It also has a faster recovery time than more invasive procedures like a hysterectomy and a myomectomy.

In fact, based on the results of a meta-analysis of several studies, it is estimated that on average 92% of women treated with Uterine Fibroid Embolization, experience a decrease in fibroid symptoms.

Wow. That’s a lot of women.

So you might be asking yourself, ” Am I a good candidate for UFE?”

That’s a great question and one that can best be answered by scheduling a consultation to find out more about UFE and if it can benefit you.

However, in the meantime, we will try and answer it in a general way here.

Most women with symptomatic fibroids are good candidates for Uterine Fibroid Embolization (UFE) procedure. This includes women who experience any of the following fibroid symptoms:

  • Heavy Bleeding – This may be characterized by prolonged periods, very heavy bleeding, or irregular bleeding.
  • Pain – Pain can arise from the position of the fibroids within the uterus as well as compression on the other organs in the area. It can also be related to fibroid size.
  • Pressure Symptoms – If a fibroid pushes up against another organ, such as the bladder, it can cause problems, such as frequent urination. A large fibroid can also push against the rectum, creating problems with having a bowel movement.

So who isn’t a good candidate for UFE?

As with any medical procedure, there are contraindications or reasons that the UFE procedure may not be right for everyone.

Sometimes the reasons are absolute, meaning that under no circumstances should the procedure be performed. An example of an absolute contraindication to UFE is pregnancy.

It is not advisable to x-ray a pregnant uterus or to administer anything that will block the flow of blood to the uterus while a woman is pregnant. Therefore it’s important to share with your doctor if you are pregnant or are thinking of becoming pregnant anytime soon, as this could affect the time frame in which UFE can be performed.

Other reasons that someone might not be a candidate for UFE are:

  • Chronic Kidney Disease – The contrast dye can be harmful to someone with poorly functioning kidneys. The decision to give contrast dye to a person with chronic kidney disease is made on an individual basis.
  • Uncertain Pelvic Mass – If there is any question if the mass is something other than a fibroid, then UFE is not the appropriate procedure.
  • Any Active Infection – Any procedure not related to treating the infection should be avoided, as the infection could worsen or spread. It may be possible to reconsider UFE after the infection has resolved.
  • Asymptomatic Fibroids – UFE should not be performed unless the fibroids are causing symptoms that would indicate surgery.

When it comes to determining if someone is a good candidate for UFE it really comes down to working with a medical expert to access your particular fibroid symptoms and all other variables at play.

An excellent way to begin this process is to schedule a consultation by calling MidAtlantic Vascular and Interventional at 301-622-5360 today.

 

Categories
Fibroids

Excessive Cramping and Pelvic Discomfort

One of the most common symptoms associated with uterine fibroids is excessive cramping and pelvic discomfort.

One of the most common symptoms associated with uterine fibroids is excessive cramping and pelvic discomfort.

Unlike menstrual cramps, which are caused by the contracting uterus as it pushes out the endometrium during a monthly period, fibroid cramps can exist outside of the average 5-7 days that menstruation lasts.

In fact, for women with uterine fibroids, not only do these cramps occur outside of the menstruation period, but they can be rather severe. And, unfortunately, if the fibroids are left untreated, these symptoms are likely to get worse and include several others as well.

Fibroids can range in size and location. They also vary in terms of how many each woman has. Some women may have a single fibroid while others could have multiple fibroids.

When it comes to the symptoms directly related to uterine fibroids- the location, size, and number of fibroids can play a role in the specific symptoms experienced and their severity.

For example, women with large fibroids have reported that they feel a heaviness or pressure in their lower abdomen or pelvis. Not only is this uncomfortable, but it can also make it hard to lie down, bend over, or exercise.

Though all fibroids can contribute to pelvic pain and cramping, more often than not, these symptoms are experienced as a result of having intramural fibroids.

Intramural fibroids grow inside the muscular wall of the uterus. As intramural fibroids grow larger, they increase the likelihood of more severe symptoms that can have a direct impact on one’s quality of life.

The other types of fibroids can also cause cramping and pelvic discomfort. These types are called: submucosal, subserosal, and pedunculated fibroids.

Submucosal fibroids grow into the uterine cavity, while subserosal fibroids grow toward the outside of the uterus. Pedunculated fibroids are those that are not directly attached to the uterus and grow from a stem-like stalk.

Cramping and discomfort caused by submucosal fibroids are usually caused by the uterus trying to rid itself of them.

Unlike the contractions that happen every month in order to shed the endometrium, painful contractions caused by submucosal fibroids can happen at any time during a menstrual cycle.

No matter what type of fibroid is causing your uncomfortable symptoms- there is treatment available.

If you think you are experiencing moderate to severe cramping outside of your monthly period, or even if it’s severe during your period- it’s important to seek out treatment right away.

Though most causes of pelvic pain and cramping are treatable, if you do not address the issue it is likely that your symptoms and the underlying condition will get worse.

If the cause of the cramping is indeed fibroids, there are many treatment options available such as medication, surgery, or uterine fibroid embolization.

UFE is a non-invasive outpatient procedure that can relieve the painful cramping and other frustrating symptoms caused by uterine fibroids.

To learn more about UFE and to find out if it could benefit you, please call our office today.

Categories
Knee Osteoarthritis

Side Effects and Risks of Corticosteroid Injections

Corticosteroid and hyaluronic acid injections can help to relieve osteoarthritis knee pain, however, it is temporary.

Corticosteroid or hyaluronic acid injections can help to relieve knee pain, however, it is temporary.

Not only is the relief temporary but there is ample evidence to support that exercise can be just as effective, and so can a simple injection with plain old saline solution (which is often used as the placebo in clinical trials).

Again and again, exercise, in order to treat knee osteoarthritis pain, is recommended over knee injections. One reason is that knee injections come with many more risks than exercise.

One of the biggest risks of knee injections is infections of the knee joint. This is especially true of corticosteroids.

If there are germs on the needle that is used for corticosteroid injections, an infection can happen.

Though joint infections are rare, they do happen. And when they do, they can cause serious problems. Therefore it is critical that these knee injections and performed by experienced doctors that follow hygiene standards such as properly disinfecting the skin before the injection.

The risk of infection is slightly higher with corticosteroid injections than with hyaluronic acid, because of the effect that steroids can have on the immune response of the joint.

In fact, repeated steroid injections over a long period of time can weaken the joint cartilage as well, furthering this risk.

Other possible side effects of steroid knee injections include pain and swelling at the injection site. This is especially true in the days after treatment when the muscles and ligaments may be slightly weakened.

There is also the risk that, for those getting treated with multiple steroid injections, the skin at the injection sight can become permanently discolored.

Some of the other potential side effects of steroid knee injections are:

–  osteoporosis of nearby bone tissue

–  osteonecrosis, which is the death of bone tissue

–  a temporary flare of pain and inflammation in the joint

–  joint infection

–  nerve damage

–  thinning or lightening of the skin and soft tissue around the injection site

–  allergic reaction

–  elevated blood sugar levels in some people with diabetes

 

There is also evidence to suggest that cortisone injections come with not only the risk of infection post-injection but that when administered in the time period before knee surgery, these injections can lead to a much greater post-surgical infection risk.

Even when corticosteroids are effective, according to a research study published by an independent group of scientists from the Cochrane Collaboration, these injections might reduce osteoarthritis symptoms for several weeks in roughly 10 out of 100 people.

 

The Bottom Line: Though there was a time when corticosteroid injections were considered to be some sort of miracle cure for knee pain, in more recent years, research has shown that this isn’t entirely true.

In fact, several studies have found that corticosteroid knee injections provided no significant pain relief after two years. And, some studies have even shown that cortisone can make the situation worse by thinning out the meniscus, causing more bone on bone in the knee.

In our next article, we will take a look at the effectiveness of hyaluronic acid injections, as well as the potential side effects and risks.

Categories
Fibroids

Hysterectomy: Is This Treatment Option Right For You?

Depending on the severity of the fibroids and fibroid-related symptoms, some women may still opt to have a hysterectomy.

Though hysterectomy surgery was once common practice for women with fibroids, today there are many different options. However, depending on the severity of the fibroids and fibroid-related symptoms, some women may still opt to have a hysterectomy.

Therefore, today let’s dive deeper into this surgical procedure, and cover the different types of hysterectomies, as well as reasons why some women might elect to have this operation.

There are three different types of hysterectomies, and they are:

  • Supracervical hysterectomy: During this procedure, surgeons remove the uterus but not the cervix. A doctor may also refer to this procedure as subtotal or partial hysterectomy, it is most often used to treat conditions such as endometriosis.
  • Radical hysterectomy: This surgery removes the uterus, cervix, and surrounding support tissue. Doctors often recommend this type of hysterectomy for people with cancer.
  • Total hysterectomy: This surgery involves the complete removal of the uterus and cervix. This can be used to treat many conditions, such as heavy menstrual bleeding, and uterine fibroids.

It’s also important to note that depending on the circumstances surrounding the need for a hysterectomy, the surgeon may also remove the ovaries (oophorectomy) and the fallopian tubes (salpingectomy).

Though there are some promising medications available, such as the Gonadotropin-releasing hormone (GnRH) agonists Lupron, Synarel, and Zoladex which can shrink fibroids and reduce fibroid-related heavy bleeding- some women would prefer a permanent surgical procedure such as a hysterectomy, so as to avoid having to take these medications due to their side effects and risks.

In fact, it is estimated that 40% of women taking GnRH agonists experience side effects such as:

  • hot flashes
  • mood changes
  • increased sweating
  • muscle stiffness
  • vaginal dryness

And the most concerning side effect of GnRH agonist therapy,  osteoporosis.

Other medications that are used to treat fibroids are:

  • Birth control: Birth control can also be used to help with symptoms of fibroids — specifically heavy bleeding during and between periods and menstrual cramps.
    – Given that some of the most commonly prescribed birth control pills can increase estrogen and therefore increase the size of fibroids, birth control is not always the best solution.
  • Progesterone-containing agents: Pills, implants, injections, or an intrauterine device (IUD) — may also control bleeding.
    – If the fibroids are small, and the symptoms are mild, a progesterone-containing birth control pill may be beneficial in reducing symptoms. However, they come with their own set of side effects, and they can sometimes mask the severity of fibroids and other underlying conditions.
  • Elagolix: A combination of a GnRH agonist, estradiol, and norethindrone that has proven to be effective at reducing fibroid symptoms with a lower risk of adverse problems that can come from GnRH agonists alone.
    – Elagolix interacts with several other medications, and if taken long-term can cause permanent bone loss.
  • Tranexamic acid: An antifibrinolytic oral drug that’s indicated for the treatment of cyclic heavy menstrual bleeding in women with uterine fibroids.
    – Though it is a nonhormonal option to reduce menstrual blood loss, it does not affect or address the underlying cause of the bleeding- which is the fibroids themselves. It is also expensive.

Medications can be effective at managing fibroid symptoms, however, they do so, as a temporary solution. Medications do not fix the problem and sometimes they can even make things worse.

Therefore the main benefit of having a hysterectomy is that it doesn’t just manage fibroid symptoms, but by surgically removing the uterus, it removes the fibroids completely.

Not only does a hysterectomy remove fibroids and eliminate any possibility of them returning, but it also eliminates any possibility of having children.

For women that would like to have children, medication may be a good option to help manage fibroid symptoms allowing them to postpone a hysterectomy.  Or they may opt to have a uterine-sparing procedure done such as a myomectomy or Uterine Fibroid Embolization, which we specialize in here at MidAtlantic Vascular and Interventional.

The Bottom Line: For women with severe fibroids, fibroids that keep coming back, and fibroids that haven’t responded well to medication or other procedures, a hysterectomy may be an option worth considering. That being said, just like with medications, having a hysterectomy isn’t without its own set of side effects and risks. In our next article, we will take a look at what those are.