Treatments

Fibroids (myomas)

Fibroids are benign lumps of muscle tissue in or on the womb. They are common and often cause no symptoms at all. When they do, the impact on daily life can be considerable.

At Femmecare we examine where your fibroids are and how large they are. We then choose the treatment that suits you, together.

Make an appointment Information for your GP

What is it?

What are fibroids?

A fibroid, or myoma, is a benign lump of muscle tissue in the womb. You may have one, or several at the same time. Fibroids are common in women of childbearing age.

Whether they cause problems depends on their size, their location and how many there are.

In the cavity, in the wall or on the outsideA fibroid can sit inside the cavity of the womb, in the wall of the womb or on its outer surface. The location helps determine which treatment is possible.

In figures

More common than you think

Fibroids are common, and often you notice nothing at all.

  • Almost 7 in 10women in their late forties turned out to have one or more fibroids, in a large ultrasound study.
  • Halfof the women who had never been diagnosed with a fibroid turned out to have one on an ultrasound scan.

Source: Baird et al., American Journal of Obstetrics & Gynecology (2003); a study of 1,364 women aged 35 to 49 in the United States. The figure of almost 7 in 10 applies to the white women in this study.

Symptoms

Which symptoms can you have?

Fibroids can cause a range of symptoms, such as:

  • Heavy or prolonged bleeding during your period
  • A feeling of pressure in the lower abdomen
  • Needing to pass urine often, or constipation, from pressure on the bladder or bowel
  • Fatigue caused by anaemia
  • Pain in the lower back
  • A swelling in the lower abdomen that you can see or feel

Not all women with fibroids have symptoms. If you have few or none, treatment is often unnecessary.

Your visit

How do we make the diagnosis?

  1. A conversation

    Among other things, we discuss:

    • your symptoms and how long you have had them
    • whether you want (more) children
    • which contraception you use

  2. Examination and ultrasound

    The doctor performs an internal examination and an internal ultrasound scan. This shows how many fibroids there are, how large they are and where they sit.

  3. Sometimes further tests

    If a fibroid may be inside the cavity of the womb, we perform an ultrasound scan with water or gel, or look inside the womb with a thin camera. We can do this at our clinic. An MRI scan is rarely needed and takes place in hospital.

Treatment

Treatment at Femmecare

Which treatment is right depends on your symptoms, whether you want children and the size and location of the fibroids.

Watchful waiting

Watchful waiting and monitoring

For mild symptoms or none at all. After 6 to 12 months we check again with an ultrasound scan.

With hormones

hormonal coil

Can reduce bleeding. We fit the hormonal coil ourselves.

With fibroids, a coil is more likely to be expelled on its own.

Medication

Medication to reduce bleeding

For example tranexamic acid, or the pill. With fibroids the pill works less well than without them.

At our clinic

Hysteroscopy

The doctor can remove a small fibroid inside the womb with a thin camera, without an incision in the abdomen and without general anaesthetic.

Up to about 3.5 cm. Larger fibroids: referral to hospital.

If heavy bleeding is your main problem, we also discuss the options using the Dutch national decision aid. More about heavy bleeding

Good to know

What we do and do not do

Not at Femmecare

We do discuss these treatments with you. If one of them is needed, we refer you to a hospital.

  • Surgery to remove fibroids, by keyhole surgery or through the abdomen
  • Embolisation: blocking the blood vessels supplying the fibroid
  • Removal of the womb
  • Treatments under sedation or general anaesthetic

Available at Femmecare

  • Internal ultrasound and, if needed, an ultrasound with water or gel
  • Hysteroscopy, and removal of small fibroids inside the womb
  • Fitting a hormonal coil
  • Medication to reduce bleeding, and follow-up ultrasound scans

Our approach

What can you expect?

  • A clear diagnosis quickly
  • Personal advice with room for your wishes, including if you want children
  • Tests and treatment under local anaesthetic or without anaesthetic

See also

Heavy bleeding and cycle problemsFibroids are one of the possible causes of heavy bleeding. ContraceptionWe fit the hormonal coil ourselves.

For GPs

Referring patients with fibroids

Diagnosis and outpatient treatment of fibroids in line with the Dutch NVOG guideline Hevig menstrueel bloedverlies (fibroid modules). Procedures under general anaesthetic, embolisation and MRgFUS are referred on to hospital.

ZorgDomein: ‘Femmecare Clinics’

Reasons to refer

  • HMB or pressure symptoms with (suspected) fibroids
  • Suspected submucosal fibroid
  • Counselling about treatment options, including where there is a wish to conceive

What we offer

  • Transvaginal ultrasound with FIGO classification
  • SIS/GIS and diagnostic hysteroscopy
  • Outpatient hysteroscopic resection of FIGO type 0–1 up to approx. 3.5 cm
  • LNG-IUD, tranexamic acid, watchful waiting with ultrasound monitoring
  • Referral for myomectomy, embolisation or hysterectomy

All about referring to Femmecare

Choosing together what suits you

If you have symptoms that could fit with fibroids, or a fibroid has been seen, you can discuss a referral to Femmecare with your GP.

Make an appointment
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