For many women, a diagnosis of uterine fibroids means entering into an unfamiliar world, replete with specific medical jargon that you’ve likely to have never previously heard.
Whether it’s within discussions focused on hormones, growths, or potential treatment paths, or listening to your doctor describe your condition, it’s easy to feel overwhelmed and confused when clinicians are using words and phrases that you don’t understand.
To take control of your fibroid journey and feel informed when it comes to partnering with your clinician for treatment decisions, it’s important that you understand the language around fibroids.
We’re breaking down 4 important terms often used in discussions about uterine fibroids, so that you can be sure of what’s being discussed and better understand your options, along with your body.
1. What is a myomectomy?
A myomectomy is a surgical procedure performed to remove fibroids from the uterus. This surgery aims to alleviate symptoms associated with fibroids, such as pelvic pain and heavy menstrual bleeding, while preserving the uterus and fertility.
During a myomectomy, the surgeon makes an incision in the abdomen (known as an abdominal myomectomy) or through the vagina (called a hysteroscopic myomectomy) to access the uterus. The specific approach taken by the doctor will vary from woman to woman, depending on the size, number, and location of the fibroids.
The surgeon then removes the fibroids from the uterine wall, taking care not to damage the surrounding tissues. After removing the fibroids, the incisions are closed, and the patient is typically monitored for a brief period of time before being discharged.
Myomectomy is an alternative to a hysterectomy, and is ideal for women who wish to preserve their fertility and uterus. However, it’s important to note that myectomy may not be a suitable option for all women, especially if the fibroids are large, numerous, or deeply embedded in the uterine wall.
Recovery time after a myomectomy varies depending on the surgical approach and the size of the fibroids removed. Generally, it takes a few weeks to fully recover, during which the patient may experience some discomfort, pain, or temporary changes in menstrual patterns.
It’s crucial that patients closely follow the post-operative instructions provided by the surgeon and attend all follow-up appointments after the procedure.
2. What is a hysterectomy?
During a hysterectomy, the uterus is surgically removed from the body. It is to treat various gynaecological conditions, including severe fibroids, endometriosis, pelvic organ prolapse, chronic pelvic pain, and certain types of gynaecologic cancers.
Are there different kinds of hysterectomies?
The term hysterectomy can describe a number of different surgical procedures. There are different types of hysterectomy:
In this procedure, both the uterus and the cervix are removed.
Also known as subtotal or supracervical hysterectomy, this procedure involves removing only the upper part of the uterus, while the cervix is left intact.
This extensive procedure is typically performed for gynaecologic cancers, such as cervical or uterine cancer. It involves the removal of the uterus, cervix, upper part of the vagina, and nearby tissues, such as lymph nodes.
Hysterectomy with bilateral salpingo-oophorectomy
In addition to removing the uterus, this procedure also involves the removal of both the fallopian tubes and ovaries. It may be recommended in cases of certain cancers, severe endometriosis, or to reduce the risk of ovarian cancer.
How are hysterectomies performed?
Hysterectomy can be performed through different surgical approaches:
In an abdominal hysterectomy, an incision is made in the abdomen to remove the uterus. When the uterus is removed through an incision made in the vagina, without any external incisions, this is called a vaginal hysterectomy.
Laparoscopic hysterectomy is a minimally invasive procedure that involves a surgeon making several small incisions in the abdomen. The surgeon then inserts a laparoscope and surgical instruments for removing the uterus.
Similar to laparoscopic hysterectomy, robotic-assisted hysterectomy sees the procedure performed using robotic surgical systems, which provide the surgeon with enhanced dexterity and precision.
The choice of surgical approach depends on various factors, including the reason for the hysterectomy, the patient’s medical history, and the surgeon’s expertise. After a hysterectomy, a woman will no longer experience menstruation or be able to conceive.
The procedure may have physical and emotional effects, and the recovery time can vary depending on the type of hysterectomy performed. It is essential to discuss the potential risks, benefits, and long-term implications with the healthcare provider before undergoing a hysterectomy.
3. What is oestrogen?
Oestrogen is a group of hormones that play a critical role in the development and functioning of the female reproductive system. Notably, the growth of fibroids appears to be influenced by the amount of oestrogen in the body. Contraceptives that contain oestrogen have been linked to an increased risk of developing fibroids, and women with higher levels of oestrogen in the body are more likely to experience fibroids.
It is primarily produced in the ovaries, although smaller amounts are also produced by the adrenal glands and fat tissues. These hormones have a wide range of effects on various tissues and organs throughout the body.
Oestrogen helps regulate the menstrual cycle, promote the growth of the uterine lining (endometrium) during the menstrual cycle, and stimulate the development of secondary sexual characteristics such as breast development and widening of the hips.
The levels of oestrogen in the body naturally fluctuate throughout a woman’s life. They increase during puberty, peak during the reproductive years, and decline during perimenopause and menopause. Oestrogen replacement therapy (ERT) or hormone replacement therapy (HRT) may be prescribed to alleviate symptoms associated with low oestrogen levels, such as hot flashes, vaginal dryness, and bone loss.
It is important to understand that oestrogen should be used under the guidance of a healthcare professional, as it may have potential risks and side effects. After menopause, when women’s levels of oestrogen plunge, the risk of fibroids is significantly lower.
4. What is progesterone?
Like oestrogen, progesterone is a hormone that plays a crucial part in the female reproductive system. It is primarily created in the ovaries, specifically in the corpus luteum after ovulation. Progesterone also has smaller amounts produced by the adrenal glands and placenta during pregnancy.
Progesterone is involved in various physiological processes, including menstrual cycle regulation and supporting pregnancy. It’s also extremely important for hormonal harmony in the body, because progesterone helps balance the effects of oestrogen. By counteracting oestrogen’s proliferative effects on the uterine lining, progesterone helps prevent excessive growth and reduces the risk of endometrial cancer.
In treating certain medical conditions, such as uterine fibroids, hormonal imbalances, infertility, or menopausal symptoms, healthcare providers may prescribe progesterone supplementation or hormonal therapies to regulate hormonal levels.
Empowering yourself with knowledge
You have the right to be fully informed of all the treatment options available to you and the impact that fibroids are having on your life and body. Understanding and familiarizing yourself with fibroid-related terms is a key step towards ensuring that you’re in control of your health and the way you manage your condition.
Even if it feels intimidating, don’t be shy to speak up and ask for clarification regarding jargon or treatment paths when you’re in a medical setting. Your clinician should take the time to make things clearer for you, and researching commonly used phrases about your condition can give you more confidence moving forward.