Uterine fibroids are one of the most common causes of infertility and may cause pain and excessive bleeding during menstruation. They have also been linked to infertility in women.

Genetic changes, hormonal imbalance, extracellular matrix, and other growth factors are responsible for the presence of fibroids. The growth rate and size of the fibroids may vary from one woman to the other. There are times when fibroids may even shrink on their own.

Depending on the location of the fibroid in the uterus, they may be categorized into subserosal, mucosal, pedunculated, or fundal fibroids.

However, it is possible to get rid of troubling uterine fibroids with the help of a surgery. Fibroid removal surgery is of different types and is most commonly known as myomectomy.

Depending on the size, location, and shape of fibroid, fibroid removal surgery could be performed using any of the following two techniques:

• Laparoscopic fibroid removal surgery
• Open fibroid removal surgery
• Hysteroscopic fibroid removal surgery

If there is a single, small fibroid, the specialist may choose non-surgical fibroid removal (uterine fibroid embolization or radiofrequency ablation) to remove the growth. However, if the size of the fibroid is large or if there are multiple uterine fibroids, surgery is often considered to be the best solution.

Minimally invasive myomectomy or fibroid removal surgery is nowadays most common and can be performed with much ease and success.

Who needs to undergo Fibroid Removal Surgery?

Not all of the women need to undergo a surgery to get rid of the fibroids. It is only when there are certain issues that need to be taken care of when the surgery is recommended.

The following are the appropriate candidates for fibroid removal surgery:

• Women who experience painful periods and heavy bleeding
• Women who wish to get pregnant in the future
• Women suffering from infertility due to fibroids
• Women for which alternative treatments such as drugs and non-invasive treatment has not worked before
• Women suffering from other health issues due to fibroid such as low back pain and urinary tract or bowel issues

Hysterectomy is a surgical procedure conducted to remove the uterus, also known as the womb. It is an organ that holds and protects the fetus during pregnancy. The hysterectomy surgery also involves removal of the other parts of the reproductive system such as ovaries (where eggs are produced), fallopian tubes (which carry the eggs to the uterus), and the cervix (neck of the uterus).

The hysterectomy surgery can be performed through the vagina (vaginal hysterectomy) or through the abdomen (abdominal hysterectomy), with or without the use of laparoscopy. After having a hysterectomy, the woman is not able to conceive.

Vaginal hysterectomy is the surgical procedure to remove the uterus (womb) through the vagina. Depending on the patient’s condition, the doctor will choose which part is to be removed by hysterectomy surgery.

In which conditions would the doctor suggest hysterectomy procedure?

There are many reasons why a doctor recommends this type of surgery. The general condition where hysterectomy is recommended are:

• Cancer of ovaries
• Cancer of the uterus or cervix
• Uterine prolapse – when the uterus slips from its normal position into the vagina
• Abnormal tissue growth
• In some cases, irregular or heavy menstrual flow and discomfort may make hysterectomy an important treatment option.

You should know that removal of the uterus and other reproductive organs is a serious condition and there may be several hysterectomy side effects, and it can make significant changes in your life. A vaginal hysterectomy may be contraindicated in patients with uterine cancer, big size of the uterus, and narrow vagina.

Hysterectomy is the surgical procedure to remove your uterus, also called as womb. It is the organ that holds and protects the fetus during pregnancy. The surgical hysterectomy procedure also involves removal of the other parts of the reproductive system such as ovaries (where eggs are produced), fallopian tubes (which carry the eggs to the uterus), and the cervix (neck of the uterus). The hysterectomy procedure can be performed through the vagina (vaginal hysterectomy) or through the abdomen (abdominal hysterectomy), or by laparoscopy. After having a hysterectomy, you will not be able to conceive.

In which conditions would the doctor suggest hysterectomy procedure?

There are many reasons why a doctor recommends this type of surgery. The general condition where hysterectomy is recommended are:

• Cancer of ovaries
• Cancer of the uterus or cervix
• Uterine prolapse –when uterus slips from its normal position into the vagina
• Abnormal tissue growth
• In some cases, irregular or heavy menstrual flow, and discomfort may make hysterectomy an important treatment option.

You should know that removal of the uterus and other reproductive organs is a serious condition and there may be several hysterectomy side effects, and it can make significant changes in your life.  

Endometrial ablation is an outpatient procedure that is used to remove the endometrial lining in the uterus of a woman suffering from unusually high menstrual bleeding. During the procedure, the endometrium is ablated or destroyed with the help of laser or microwave.

Endometrial ablation surgery is not recommended for women who wish to conceive in the future. This is because this procedure may permanently damage the layers of the uterus and the endometrium may no longer be suitable for the attachment of the developing fetus.

Uterine ablation is most commonly recommended for women who suffer from heavy menstrual bleeding and do not wish to undergo hysterectomy or the surgical removal of the uterus. This procedure is either conducted at the doctor’s office or at a hospital. It can be conducted under local or light anesthesia or general or spinal anesthesia.

Uterine ablation is not recommended for patients who have:

• Uterine, cervical, or vaginal infection
• Pelvic inflammatory disease (PID)
• Endometrial, uterine, or cervical cancer
• An intrauterine device (IUD)
• Pregnancy

Women suffering from polycystic ovarian syndrome may show different symptoms. Therefore, polycystic ovarian syndrome treatment for them may differ depending on their concerns.

For example, some women suffering from PCOS could be overweight, therefore, weight loss and diet monitoring may be advised to them initially. Some women with PCOS may have a normal body mass index (BMI), however, they could be suffering from other symptoms such as cystic acne or excessive facial hair. Therefore, she may be put on birth control pills for a while to negate the symptoms.

The following are some of the most common forms of polycystic ovarian syndrome treatment available worldwide:

For women not planning a pregnancy

• Self-care: Weight loss, lifestyle modifications, and physical exercising
• Medications: Anti-diabetic medications (metformin), statins, and hormone and hair inhibitors
• Hormonal: Birth control pills

For women planning a pregnancy

• Self-care: Weight loss, lifestyle modifications, and physical exercising
• Medications: Anti-diabetic medications (metformin), statins, and hormone and hair inhibitors
• Ovarian stimulation: Gonadotropins, letrozole, and Clomid
• Surgery: Laparoscopic ovarian drilling (ovarian diathermy)

In laparoscopic ovarian drilling, two to three minor incisions are made in the lower abdomen to pass the laparoscope and instruments through which the laser is passed. The ovarian cysts producing high amounts of androgens are ruptures with the help of heat generated by the laser. This lowers the LH and testosterone levels and therefore, the hormone imbalance is temporarily restored.

Symptoms of Polycystic Ovarian Syndrome

The following are some of the symptoms of polycystic ovarian syndrome:

• Irregular periods
• Absence of periods
• Difficulty getting pregnant
• Excessive hair growth (hirsutism) mainly on the neck, face, back, and chest
• Weight gain
• Male-type baldness
• Hair thinning
• Cystic acne
• Oily skin
• Depression and mood swings
• Severe premenstrual syndrome (PMS)

Diagnosis for PCOS

Irregular periods or absence of periods is one common sign that may indicate that the woman may have a polycystic ovarian syndrome. However, it can only be confirmed with the help of ultrasound during a regular visit to the gynecologist.

The following tests are performed to confirm PCOS:

• Ultrasound (abdominal or transvaginal)
• Blood work-up: LH, FSH, blood sugar, TSH, free testosterone, and Prolactin

Who all can get PCOS Treatment?

Not all women suffering from the polycystic ovarian syndrome are a candidate for treatment. The following women are advised to seek treatment for the polycystic ovarian syndrome:

• Those with irregular or missing periods
• Women with severe symptoms such as cystic acne, hair loss or thinning, and considerable weight gain
• Women trying to conceive but are unable to due to irregular ovulation