Fibroids can cause infertility by increasing in size in the uterus, affecting embryo implanting and the change of blood flow within the uterus resulting in fibroids drawing blood from the developing embryo.

Symptoms of severe, life-threatening fibroids include:

• Excessive bleeding (alarming blood clots)
• Anaemia
• Bowel and bladder pressure (kidney damage)
• Infertility

Subserosal fibroids are common types of fibroids that have the potential to increase in size, pushing outside of the uterus into the pelvis and can attach through a stalk to the uterus. Submucosal fibroids commonly grow in an open space inside the womb and also have the potential to attach to the uterus utilising a shoot.

Hormones, genetics and pregnancy contribute to the formation of fibroids. The hormones, estrogen and progesterone released every menstrual cycle regenerate the uterine lining stimulating the growth of fibroids. If fibroids run in your family; if your mother, sister or grandmother had fibroids, it is highly likely that you may develop them. During pregnancy, the production of oestrogen and progesterone increases and becomes rampant, stimulating the growth of fibroids while you are pregnant.

Dr Benecke will conduct a pelvic or abdominal examination to feel for firm, painless, irregular lumps that could indicate signs of uterine fibroids. For further diagnosis, an ultrasound uses sound waves to scan and diagnose fibroids and involves placing a probe inside the vagina or on the abdomen to examine the uterus and ovaries. An imaging test or MRI helps distinguish between adenomyosis and fibroids utilising magnets and radio waves to produce images providing the location, number and size of the fibroids.

The gynaecologist will conduct a Hysterosonogram to examine the interior of the uterus. The procedure involves placing a small catheter inside the womb through which water is injected. A series of ultrasound images diagnose uterine polyps or intracavitary fibroids as potential causes for heavy bleeding.

There are various treatments for fibroids ranging from endometrial ablation, cryoablation, the insertion of a heated balloon, heat fluid, radiofrequency, microwaving to electro-surgery aimed to remove or destroy uterine tissue.

Cryoablation involves applying a thin probe to freeze uterine tissue. Uterine tissue is obliterated by inserting a balloon filled with hot fluid that destroys the uterine lining and only takes a few minutes to complete. Microwaving involves inserting a probe emitting microwave energy damaging the uterine lining within five minutes.

Uterine fibroid embolisation (UFE) offers permanent relief without having to resort to an invasive hysterectomy. Regrowth of fibroids can occur after undergoing an open surgery myomectomy which is the excision of fibroids, and patients may display symptoms of heavy bleeding or heavy periods. A minimally invasive uterine fibroid embolisation involves clotting blood flow to fibroids, starving them of their nutrient supply, causing them to shrink and die. Thin wires and catheters are inserted through a small incision in the uterine artery, and tiny particles are injected into the fibroids supply. The fibroids shrink as they die once the blood supply is cut off.

Dr Benecke and his team of specialists at the Endometriosis Clinic strive to treat fibroids using tailored treatments best suited to each individual for a better quality of life, taking into account the psychological damage fibroids can cause.