Fibroids and endometriosis are two common issues that many women face during their reproductive years. Fibroids can lead to menstrual problems, while endometriosis often results in significant pain. When these conditions occur together, it can be particularly challenging. Since they are both prevalent, they frequently coexist in the same individual, often impacting fertility.
Women often detect fibroids when they experience heavy menstrual bleeding. Generally, their menstrual cycles remain regular, as the uterine lining remains unaffected. However, due to increased blood flow to the uterus caused by fibroids and the enlarged uterine cavity, bleeding tends to be heavier.
In some cases, as fibroids become very large, they can exert pressure on adjacent organs. This pressure may lead to urinary frequency by pressing on the bladder and constipation by affecting the bowel. In extreme cases, these fibroids can become visible and palpable.
Endometriosis presents differently, primarily causing pain. This pain typically occurs around menstruation but can manifest at any point during the menstrual cycle. You may experience pain during ovulation and sexual intercourse. Unlike fibroids, endometriosis mainly manifests as pain rather than increased bleeding.
Some women may also develop adenomyosis, which is endometriosis within the uterine muscle fibres. This condition can enlarge the uterus and increase blood supply, resulting in heavy and painful periods.
Fibroids and endometriosis are two distinct conditions, although they can re-occur. Consequently, they require different treatment approaches.
Fibroids need to be either surgically removed or treated to limit their oestrogen supply or blood flow. Surgical removal can be performed through minimally invasive keyhole surgery. However, private gynaecologists in London often attempt medical management first.
They may prescribe drugs that reduce the body’s production of oestrogen, which, in turn, shrinks fibroids by cutting off their hormonal support. Alternatively, they may employ embolisation by introducing microparticles into the blood supply, blocking the fibroids’ blood vessels. While fibroids won’t completely disappear, they will significantly shrink, leading to reduced symptoms.
Endometriosis is treated with keyhole surgery (Laparoscopy) when deemed necessary. The goal is to remove endometriotic tissue, drain cysts, and address any adhesions that may have formed.
This surgery can be complex due to distorted anatomy, and surgeons must exercise caution to prevent damage to affected or adhered organs, including the bladder, bowel, and ureters. They also need to avoid the pelvic side wall’s blood vessels. Therefore, surgery is typically considered after exhausting other options.
Distinguishing between fibroid pain and endometriosis pain can pose a challenge. However, individuals with fibroids might encounter pressure sensations in their pelvic area and notice their abdomen appearing swollen, accompanied by other symptoms.
Moreover, if a person has both fibroids and endometriosis, they may endure more intense pelvic discomfort compared to someone with sole fibroids.
Because the symptoms significantly overlap, private gynaecologists may encounter difficulty in making an accurate diagnosis.
To definitively confirm the presence of endometriosis, surgical intervention remains the sole method for healthcare professionals.
In the case of endometriosis, there are more medical treatment choices available. Progesterone-type drugs can modify the condition, making it less active and problematic. Additionally, drugs that suppress oestrogen, similar to those used for fibroids, can quiet endometriosis, reducing inflammation and associated pain. In some instances, a combination of medical and surgical treatments may be necessary to manage the condition effectively. You can Book an appointment with our London gynaecology clinic for uterine fibroid treatments.