November 5, 2023 • 16 mins
In this episode I am going to discuss ALL the current treatment options for fibroids - including diet, acupuncture, medications, and major surgery. 🚺📚🏥
You need to be armed with the facts to discuss with your doctor the right option for you!
Instagram: https://instagram.com/forvaginasonly
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Episode Transcript
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SPEAKER_00 (00:00):
Hey guys, Dr.
Celestine here, and welcome toanother episode of the For
Vaginas Only podcast.
In this episode, we are going totalk about fibroid treatment
options.
So I've talked about fibroidsbefore.
I have an episode called AllAbout Fibroids, where I kind of
gloss over a few things in termsof treatments and make it really
generalizable.
(00:20):
But we're just going to get downto the nitty gritty.
You have fibroids.
What the hell can you do aboutit?
Let's find out here.
But first, let's cue the music.
Hello and welcome to For VaginasOnly, the podcast about
everything female.
I'm your host, Dr.
Celestine, bringing youimportant information about
(00:40):
understanding your health andbody in the way you wish your
doctor would actually explainit.
Okay, so really quick, I'm goingto say just because you have a
fibroid doesn't mean youactually have to treat it.
If you want to find out moreabout that, listen to my All
About Fibroids podcast episode,because this episode is solely
(01:04):
about the treatment options.
Things are going on, you need itto be treated, you're talking to
your doctor about it, you wantto understand what the options
are, welcome to this podcastepisode.
So first and foremost, I'm goingto I did a TikTok actually,
believe it or not, and it wasabout Cherie from the Housewives
had fibroids and she talks aboutdoing acupuncture.
(01:27):
So acupuncture, you know, Ipractice Western medicine.
That's people that have studiedin the United States, but
acupuncture is more of a Chinesemedicine.
And it's been shown, I foundactually a really good study of
that shows that it can shrinksmall to medium fibroids over
time.
It's not instantaneous,obviously, but it has shown to
(01:50):
shrink them...
you know, and has actually beenclinically studied and have
clinical significance.
So I think that, yeah, that's atreatment option for somebody
that your symptoms aren'tsevere.
You're not like dying from yourfibroids.
Not that fibroids kill you.
Fibroids are benign.
But some of the symptoms can bejust like, I mean, torture.
(02:10):
So if you don't have really,really bad symptoms, just small
to medium fibroids, you couldtry acupuncture.
That might be a good option foryou.
Just make sure you go to areputable place to do it that
actually functions as atreatment for fibroids and
advertise it that way and havethe certifications to back it
(02:32):
up.
All right, so next I'm going tojust briefly touch on hormonal
medication.
Now, if you guys have listenedto any of my birth control
podcasts before, you know I kindof like to refer to it as
hormonal medication because justlike you take blood pressure
medication, diabetic medication,these are just hormones in a
pill, and they're used to treatmany different things.
(02:53):
Now, I will say...
Birth control, for example, oneof the hormone medications I'm
going to talk about here, is nota treatment for fibroids.
It is a treatment for thesymptoms of fibroids.
It can help decrease how muchbleeding you might have.
Sometimes it improves some ofthe pain with your periods that
might be due to fibroids.
but it doesn't actually treatthe fibroids.
(03:14):
The other medication that's kindof like that, but not hormonal,
I'm kind of going off on atangent a little bit, but the
other medications that treatsymptoms of fibroids are a
medication called tranexamicacid or Listeria.
That simply decreases the amountof bleeding you have from your
periods.
And the third is ibuprofen,which helps with the pain, which
(03:35):
can be related to fibroids.
So the hormonal one, a birthcontrol, doesn't actually treat
fibroids, treats the symptoms.
And two, Two of the medicationsthat just treat the symptoms are
listida and ibuprofen.
But if that's the only symptomyou're having, a little heavier
bleeding, you don't wantsurgery, you don't want a
procedure, you don't want any ofthe next hormonal medications
(03:56):
I'm going to talk about, thenbirth control, listida, and
ibuprofen are great options.
So the next two hormonalmedications I'm going to talk
about are actually hormone...
kind of manipulators, and theyare shown to shrink fibroids.
One category is called GNRHagonists, and the other is
(04:17):
called GNRH antagonists.
So it actually...
alters your hormone, yourhormone cycle, including this
hormone called GNRH, and itdown-regulates your estrogen in
your system.
And estrogen, we know, is one ofthe main hormones that feeds
fibroids, feeds their growth.
(04:38):
And we know that, like,simplistically to describe why
we know that to you is becausein menopause, usually fibroids
start to shrink, and that's whenyou have your lowest estrogen.
Some other hormones change inmenopause too, but we think
Estrogen is kind of the mainculprit.
So GNRH agonist, one medicationthat is in this class is called
(04:58):
Lupron.
So Lupron can be used usuallyfor six months, sometimes up to
12 months.
If you also have pills, hormonepills that you're taking on top
of it, we call it add backtherapy.
Because when you are decreasingyour estrogen, it actually
starts to affect your bones.
It can increase your risk ofosteoporosis.
(05:19):
So this is not a medication youcould be on long-term.
Even with the add-back therapyof taking estrogen or taking
progesterone, you still reallyshould only be on it for about a
year.
So, you know, like...
I know my young girls listeningto this are like, how the hell
is this going to help me?
I can only be on it for a year.
And you're kind of right.
So this medication is given alot of the time pre-surgery.
(05:41):
So if you have a really bigfibroid where you might be
looking into almost having anopen surgery where they have to
open your abdomen like aC-section, and perhaps you want
minimally invasive surgery, likea laparoscopic procedure or
robotic procedure, we can usethis medication to shrink your
fibroids in order to make thatkind of surgery possible.
(06:01):
The other way we use it is ifyou're close to menopause and
you're having fibroid symptoms,you know, you're a year or so
from menopause about, we can usethis medication for possibly up
to a year to help shrink yourfibroids until your body
naturally will do it on its own.
So that's Lupron or a GnRHagonist medication.
(06:22):
It's injected, by the way.
The next medications are GnRHantagonists.
And there's two kind of morepopular ones that fall into this
category.
One is called Orion.
That's the brand name.
O-R-I-A-H-N-N.
And the other one is calledMyFemBree.
(06:42):
M-Y, my, fem, F-E-M, brie,B-R-E-E.
But these medications, unlikethe GnRH agonists, they don't
actually shrink your fibroids.
They, or GnRH, yes, so theseGnRH GNRH antagonists, I mean,
God, even I'm confusing myself.
So these antagonist medicationsactually treat the bleeding
(07:03):
only.
And sometimes you need to addback therapy too by taking a
little bit extra estrogen orprogesterone.
So this treats the bleeding offibroids, myofembry and oreon,
whereas Lupron can shrinkfibroids.
But again, you can't be on theseforever and ever and ever.
It alters your hormones.
It sort of makes your hormonesin the menopausal range, affects
(07:26):
your bones.
So not really long, long-termtreatments, but these,
especially the myofembry, neweroption that has helped a lot of
people.
And now we get to theprocedures.
So I am, okay, I will not rushto do surgery on anybody, but I
do love doing surgery just ingeneral.
(07:48):
Fixing something with my handsis part of the reason why I got
into medicine.
I can go in there, use my hands,and make you feel better.
It's rewarding in general forme.
I definitely do not rush mypatients into fibroid surgery,
especially if they don't needit.
But talking about the procedureoptions are just a little fun
for me.
(08:08):
So these are the procedures orsurgical options for fibroids.
So the very first one, actually,I don't even know where they do
this procedure.
I have heard of it.
I can't tell you where it'sdone.
I know that it's relatively new.
And as far as I'm aware, notreally studied that well yet,
but it's actually MRI guidedultrasound.
(08:29):
So you're in an MRI machine.
They locate the fibroid and theyput like ultrasound waves,
through each fibroid, which willshrink them over time after the
procedure is done.
And apparently some promisingresults in studies so far, but
like I said, I don't even knowanybody that does this and I've
never seen it done.
So it's not that common if it'sbeing done at all.
(08:50):
If you guys know anybody that'shad this or if you know where
they're doing it, then feel freeto let me know because I'm
interested in seeing.
how it works.
The second procedure is in theclass of minimally invasive
surgery.
So it's not a big surgery, butit's still a procedure.
It's called a uterine arteryembolization.
And actually a radiologist doesthis and they insert into your
(09:15):
blood vessels that are feedingyour uterus, these particles
that close off the bloodvessels.
that are directly feeding theuterus, preferably by where your
fibroids are located.
And over time, the fibroidsshrink.
Now, from what I've seen andheard, this can be really
uncomfortable as your fibroidsstart to shrink from cutting off
the blood supply.
And you have to also be awareof, you know, it's not
(09:38):
recommended that you havechildren or try to get pregnant
after this because you know, theblood supply to your uterus is
sort of cut off and that's wherea baby grows.
So irregular things can happenonce we start messing with that
blood supply if you actually tryto have a child.
Now overall, if we're taking thepregnancy out of the equation,
this is a pretty lower riskprocedure that works fairly well
(09:59):
to shrink your fibroids overtime after getting it done.
So that's uterine arteryembolization.
The next minimally invasiveprocedure is is something called
Excessa.
And it's actually laparoscopic.
We go in with small incisionsinto your belly button with a
camera.
We have another incision thatyou actually have a probe and
(10:20):
you look to see where thefibroid is.
You stick the probe into thefibroid and you use
radiofrequency to sort of meltthe fibroid again over time.
It starts to liquefy at firstand over the next few months or
so, you know, it really startsto degenerate the fibroid and
(10:41):
start to shrink the fibroid.
And it's minimally invasive.
It's a same day procedure.
I have done it in training.
I've never done it in my actualpractice, but I know a lot of
physicians that do this and I'veseen some success stories with
it.
So minimally invasive proceduresare those two.
Now, another one I'll kind oftalk about is an ablation.
(11:05):
And that's where we go in and weburn the lining of your uterus.
We do it through the vagina,also a same-day procedure.
But this doesn't actually treator shrink fibroids.
Again, this kind of goes intothe category with the
medications that treat thesymptoms.
because it just decreases howmuch bleeding that you have or
stops your bleeding altogether.
(11:26):
So if that's your main symptom,then this might be a procedure
for you.
At the same time, we can go in,we can look with a camera.
That's called a hysteroscopy.
And if there's any fibroidsinside the uterus, we can
actually remove it or shave themdown.
And that can severely, you know,greatly rather help the amount
(11:47):
of bleeding or discomfort youhave with periods due to your
fibroids, especially if you onlyhave fibroids that are inside
the uterus cavity.
So that's a type of myomectomyactually, which is our next
procedure.
A myomectomy in general can bedone minimally invasive or can
be done as an open procedurewhere we do an incision in your
(12:08):
lower abdomen like a C-section.
A myomectomy is actually goingin and plucking out each
individual fibroid.
So we can do it robotically, wecan do it with the small 5 to 10
millimeter incisions in yourabdomen, or it can be done with
a big cut in the lower abdomenAnd that all depends on your
other medical problems, yourprior surgeries, how big your
(12:30):
fibroids are.
So there's a lot of factors thatgo into also your surgeon's
abilities.
Some people just can't dorobotic surgery, etc.
So a lot of factors that go intowhich one you will end up
having.
So you go in, you pluck eachfibroid out or you cut each
fibroid out of the uterusmuscle.
We sew the uterus back togetherand then that's it.
(12:52):
That's the myomectomy.
Also uncomfortable, there's alot of bleeding associated with
it, a lot of cramping anddiscomfort as your uterus heals
because we've now sewn it backtogether, sometimes in multiple
different locations becausewe've had to go all over to get
your fibroids out.
But people do really well withthis.
The one thing I will say...
is, you know, if your uterus isstill there, obviously new
(13:14):
fibroids can grow back.
And I wouldn't say it's thefibroids that they took out, but
sometimes there's really, reallytiny ones that we don't see, or
there could just be new onesthat come up later on in life.
So it's not always a long, it'sa good solution, don't get me
wrong, but it might not lastforever.
And then the final one, the onlything on this entire list that
(13:36):
really lasts forever in terms ofgetting your fibroids gone is a
hysterectomy.
And that is a surgery where wetake out your entire uterus.
And that means no more fibroidscan grow back because fibroids
only grow within the uterus.
So we can still leave yourovaries in place.
So if you're not menopausal yet,you still have your hormones
(13:56):
because the ovaries are whatproduce the hormones, but the
uterus coming out removes allthe fibroids and and they'll
never, never to see them again.
So it's a more permanentprocedure.
And that can actually be donesometimes minimally invasively.
Even if you have a largerfibroid, your doctor can
consider doing Lupron, themedication I talked about
earlier that you inject thatshrinks them, to shrink your
(14:19):
fibroids to possibly try to doit minimally invasively, whether
it's robotic or laparoscopy, ora hysterectomy can be done as
well with an incision in thelower abdomen.
like a C-section incision.
Okay, so I will say here, thereis some good evidence for diet
changes as well, specificallylike an anti-inflammation diet
(14:40):
and specifically, specificallycutting out red meat from your
diet.
I've seen some promisingresearch that shows that it
helps to shrink fibroids.
Now, if you have a large,gigantuan fibroid, do not expect
this to turn your life around.
It's really for not the hugeones, maybe like...
a five centimeter or less, whereyou can start to see some
(15:01):
difference in the fibroid sizeper se.
And what's more so been studiedare the actual fibroid symptoms
start to improve with thisanti-inflammation diet and or
cutting out red meat.
So definitely something therefor my people that want to try
the nutrition aspect oftreatment.
So those are all of thetreatment options that we have
(15:25):
right now.
for fibroids.
So it depends.
Like I said, you can have areally small fibroid that can be
seen on ultrasound and really wedon't have to do a single thing
about it.
But if you have a lot ofpressure, a lot of pain, heavy
periods, painful periods,bloating, you know, your fibroid
makes you look like you'repregnant, it's pressing on your
(15:46):
bladder, it's causing you bowelproblems, we got to intervene.
So we have to go through theseoptions, pick one that's
actually the safest route orbest route for you and also one
that you feel comfortable with.
So here you are, you're armedwith everything.
You have an idea of what optionsare out there and I hope you can
bring this to your doctor todiscuss it.
(16:09):
And that's it.
That's fibroid treatmentoptions.
So good luck to everybody outthere.
I know that a lot of times,especially black women, we have
a higher propensity to getfibroids and we also have a
higher propensity of feeling asthough doctors aren't really
listening to us or connectingwith us.
(16:29):
But I feel that one, find onethat you're comfortable with,
obviously.
And two, when you are armed withthe information, no one can turn
you away.
No one can dismiss you.
So I think knowledge is power inthat way.
And I hope that this podcastepisode has helped you with
that.
And I'll see you guys on thenext one.
Bye.
Hey guys, Dr.
Celestine here, and welcome toanother episode of the For
Vaginas Only podcast.
In this episode, we are going totalk about fibroid treatment
options.
So I've talked about fibroidsbefore.
I have an episode called AllAbout Fibroids, where I kind of
gloss over a few things in termsof treatments and make it really
generalizable.
(00:20):
But we're just going to get downto the nitty gritty.
You have fibroids.
What the hell can you do aboutit?
Let's find out here.
But first, let's cue the music.
Hello and welcome to For VaginasOnly, the podcast about
everything female.
I'm your host, Dr.
Celestine, bringing youimportant information about
(00:40):
understanding your health andbody in the way you wish your
doctor would actually explainit.
Okay, so really quick, I'm goingto say just because you have a
fibroid doesn't mean youactually have to treat it.
If you want to find out moreabout that, listen to my All
About Fibroids podcast episode,because this episode is solely
(01:04):
about the treatment options.
Things are going on, you need itto be treated, you're talking to
your doctor about it, you wantto understand what the options
are, welcome to this podcastepisode.
So first and foremost, I'm goingto I did a TikTok actually,
believe it or not, and it wasabout Cherie from the Housewives
had fibroids and she talks aboutdoing acupuncture.
(01:27):
So acupuncture, you know, Ipractice Western medicine.
That's people that have studiedin the United States, but
acupuncture is more of a Chinesemedicine.
And it's been shown, I foundactually a really good study of
that shows that it can shrinksmall to medium fibroids over
time.
It's not instantaneous,obviously, but it has shown to
(01:50):
shrink them...
you know, and has actually beenclinically studied and have
clinical significance.
So I think that, yeah, that's atreatment option for somebody
that your symptoms aren'tsevere.
You're not like dying from yourfibroids.
Not that fibroids kill you.
Fibroids are benign.
But some of the symptoms can bejust like, I mean, torture.
(02:10):
So if you don't have really,really bad symptoms, just small
to medium fibroids, you couldtry acupuncture.
That might be a good option foryou.
Just make sure you go to areputable place to do it that
actually functions as atreatment for fibroids and
advertise it that way and havethe certifications to back it
(02:32):
up.
All right, so next I'm going tojust briefly touch on hormonal
medication.
Now, if you guys have listenedto any of my birth control
podcasts before, you know I kindof like to refer to it as
hormonal medication because justlike you take blood pressure
medication, diabetic medication,these are just hormones in a
pill, and they're used to treatmany different things.
(02:53):
Now, I will say...
Birth control, for example, oneof the hormone medications I'm
going to talk about here, is nota treatment for fibroids.
It is a treatment for thesymptoms of fibroids.
It can help decrease how muchbleeding you might have.
Sometimes it improves some ofthe pain with your periods that
might be due to fibroids.
but it doesn't actually treatthe fibroids.
(03:14):
The other medication that's kindof like that, but not hormonal,
I'm kind of going off on atangent a little bit, but the
other medications that treatsymptoms of fibroids are a
medication called tranexamicacid or Listeria.
That simply decreases the amountof bleeding you have from your
periods.
And the third is ibuprofen,which helps with the pain, which
(03:35):
can be related to fibroids.
So the hormonal one, a birthcontrol, doesn't actually treat
fibroids, treats the symptoms.
And two, Two of the medicationsthat just treat the symptoms are
listida and ibuprofen.
But if that's the only symptomyou're having, a little heavier
bleeding, you don't wantsurgery, you don't want a
procedure, you don't want any ofthe next hormonal medications
(03:56):
I'm going to talk about, thenbirth control, listida, and
ibuprofen are great options.
So the next two hormonalmedications I'm going to talk
about are actually hormone...
kind of manipulators, and theyare shown to shrink fibroids.
One category is called GNRHagonists, and the other is
(04:17):
called GNRH antagonists.
So it actually...
alters your hormone, yourhormone cycle, including this
hormone called GNRH, and itdown-regulates your estrogen in
your system.
And estrogen, we know, is one ofthe main hormones that feeds
fibroids, feeds their growth.
(04:38):
And we know that, like,simplistically to describe why
we know that to you is becausein menopause, usually fibroids
start to shrink, and that's whenyou have your lowest estrogen.
Some other hormones change inmenopause too, but we think
Estrogen is kind of the mainculprit.
So GNRH agonist, one medicationthat is in this class is called
(04:58):
Lupron.
So Lupron can be used usuallyfor six months, sometimes up to
12 months.
If you also have pills, hormonepills that you're taking on top
of it, we call it add backtherapy.
Because when you are decreasingyour estrogen, it actually
starts to affect your bones.
It can increase your risk ofosteoporosis.
(05:19):
So this is not a medication youcould be on long-term.
Even with the add-back therapyof taking estrogen or taking
progesterone, you still reallyshould only be on it for about a
year.
So, you know, like...
I know my young girls listeningto this are like, how the hell
is this going to help me?
I can only be on it for a year.
And you're kind of right.
So this medication is given alot of the time pre-surgery.
(05:41):
So if you have a really bigfibroid where you might be
looking into almost having anopen surgery where they have to
open your abdomen like aC-section, and perhaps you want
minimally invasive surgery, likea laparoscopic procedure or
robotic procedure, we can usethis medication to shrink your
fibroids in order to make thatkind of surgery possible.
(06:01):
The other way we use it is ifyou're close to menopause and
you're having fibroid symptoms,you know, you're a year or so
from menopause about, we can usethis medication for possibly up
to a year to help shrink yourfibroids until your body
naturally will do it on its own.
So that's Lupron or a GnRHagonist medication.
(06:22):
It's injected, by the way.
The next medications are GnRHantagonists.
And there's two kind of morepopular ones that fall into this
category.
One is called Orion.
That's the brand name.
O-R-I-A-H-N-N.
And the other one is calledMyFemBree.
(06:42):
M-Y, my, fem, F-E-M, brie,B-R-E-E.
But these medications, unlikethe GnRH agonists, they don't
actually shrink your fibroids.
They, or GnRH, yes, so theseGnRH GNRH antagonists, I mean,
God, even I'm confusing myself.
So these antagonist medicationsactually treat the bleeding
(07:03):
only.
And sometimes you need to addback therapy too by taking a
little bit extra estrogen orprogesterone.
So this treats the bleeding offibroids, myofembry and oreon,
whereas Lupron can shrinkfibroids.
But again, you can't be on theseforever and ever and ever.
It alters your hormones.
It sort of makes your hormonesin the menopausal range, affects
(07:26):
your bones.
So not really long, long-termtreatments, but these,
especially the myofembry, neweroption that has helped a lot of
people.
And now we get to theprocedures.
So I am, okay, I will not rushto do surgery on anybody, but I
do love doing surgery just ingeneral.
(07:48):
Fixing something with my handsis part of the reason why I got
into medicine.
I can go in there, use my hands,and make you feel better.
It's rewarding in general forme.
I definitely do not rush mypatients into fibroid surgery,
especially if they don't needit.
But talking about the procedureoptions are just a little fun
for me.
(08:08):
So these are the procedures orsurgical options for fibroids.
So the very first one, actually,I don't even know where they do
this procedure.
I have heard of it.
I can't tell you where it'sdone.
I know that it's relatively new.
And as far as I'm aware, notreally studied that well yet,
but it's actually MRI guidedultrasound.
(08:29):
So you're in an MRI machine.
They locate the fibroid and theyput like ultrasound waves,
through each fibroid, which willshrink them over time after the
procedure is done.
And apparently some promisingresults in studies so far, but
like I said, I don't even knowanybody that does this and I've
never seen it done.
So it's not that common if it'sbeing done at all.
(08:50):
If you guys know anybody that'shad this or if you know where
they're doing it, then feel freeto let me know because I'm
interested in seeing.
how it works.
The second procedure is in theclass of minimally invasive
surgery.
So it's not a big surgery, butit's still a procedure.
It's called a uterine arteryembolization.
And actually a radiologist doesthis and they insert into your
(09:15):
blood vessels that are feedingyour uterus, these particles
that close off the bloodvessels.
that are directly feeding theuterus, preferably by where your
fibroids are located.
And over time, the fibroidsshrink.
Now, from what I've seen andheard, this can be really
uncomfortable as your fibroidsstart to shrink from cutting off
the blood supply.
And you have to also be awareof, you know, it's not
(09:38):
recommended that you havechildren or try to get pregnant
after this because you know, theblood supply to your uterus is
sort of cut off and that's wherea baby grows.
So irregular things can happenonce we start messing with that
blood supply if you actually tryto have a child.
Now overall, if we're taking thepregnancy out of the equation,
this is a pretty lower riskprocedure that works fairly well
(09:59):
to shrink your fibroids overtime after getting it done.
So that's uterine arteryembolization.
The next minimally invasiveprocedure is is something called
Excessa.
And it's actually laparoscopic.
We go in with small incisionsinto your belly button with a
camera.
We have another incision thatyou actually have a probe and
(10:20):
you look to see where thefibroid is.
You stick the probe into thefibroid and you use
radiofrequency to sort of meltthe fibroid again over time.
It starts to liquefy at firstand over the next few months or
so, you know, it really startsto degenerate the fibroid and
(10:41):
start to shrink the fibroid.
And it's minimally invasive.
It's a same day procedure.
I have done it in training.
I've never done it in my actualpractice, but I know a lot of
physicians that do this and I'veseen some success stories with
it.
So minimally invasive proceduresare those two.
Now, another one I'll kind oftalk about is an ablation.
(11:05):
And that's where we go in and weburn the lining of your uterus.
We do it through the vagina,also a same-day procedure.
But this doesn't actually treator shrink fibroids.
Again, this kind of goes intothe category with the
medications that treat thesymptoms.
because it just decreases howmuch bleeding that you have or
stops your bleeding altogether.
(11:26):
So if that's your main symptom,then this might be a procedure
for you.
At the same time, we can go in,we can look with a camera.
That's called a hysteroscopy.
And if there's any fibroidsinside the uterus, we can
actually remove it or shave themdown.
And that can severely, you know,greatly rather help the amount
(11:47):
of bleeding or discomfort youhave with periods due to your
fibroids, especially if you onlyhave fibroids that are inside
the uterus cavity.
So that's a type of myomectomyactually, which is our next
procedure.
A myomectomy in general can bedone minimally invasive or can
be done as an open procedurewhere we do an incision in your
(12:08):
lower abdomen like a C-section.
A myomectomy is actually goingin and plucking out each
individual fibroid.
So we can do it robotically, wecan do it with the small 5 to 10
millimeter incisions in yourabdomen, or it can be done with
a big cut in the lower abdomenAnd that all depends on your
other medical problems, yourprior surgeries, how big your
(12:30):
fibroids are.
So there's a lot of factors thatgo into also your surgeon's
abilities.
Some people just can't dorobotic surgery, etc.
So a lot of factors that go intowhich one you will end up
having.
So you go in, you pluck eachfibroid out or you cut each
fibroid out of the uterusmuscle.
We sew the uterus back togetherand then that's it.
(12:52):
That's the myomectomy.
Also uncomfortable, there's alot of bleeding associated with
it, a lot of cramping anddiscomfort as your uterus heals
because we've now sewn it backtogether, sometimes in multiple
different locations becausewe've had to go all over to get
your fibroids out.
But people do really well withthis.
The one thing I will say...
is, you know, if your uterus isstill there, obviously new
(13:14):
fibroids can grow back.
And I wouldn't say it's thefibroids that they took out, but
sometimes there's really, reallytiny ones that we don't see, or
there could just be new onesthat come up later on in life.
So it's not always a long, it'sa good solution, don't get me
wrong, but it might not lastforever.
And then the final one, the onlything on this entire list that
(13:36):
really lasts forever in terms ofgetting your fibroids gone is a
hysterectomy.
And that is a surgery where wetake out your entire uterus.
And that means no more fibroidscan grow back because fibroids
only grow within the uterus.
So we can still leave yourovaries in place.
So if you're not menopausal yet,you still have your hormones
(13:56):
because the ovaries are whatproduce the hormones, but the
uterus coming out removes allthe fibroids and and they'll
never, never to see them again.
So it's a more permanentprocedure.
And that can actually be donesometimes minimally invasively.
Even if you have a largerfibroid, your doctor can
consider doing Lupron, themedication I talked about
earlier that you inject thatshrinks them, to shrink your
(14:19):
fibroids to possibly try to doit minimally invasively, whether
it's robotic or laparoscopy, ora hysterectomy can be done as
well with an incision in thelower abdomen.
like a C-section incision.
Okay, so I will say here, thereis some good evidence for diet
changes as well, specificallylike an anti-inflammation diet
(14:40):
and specifically, specificallycutting out red meat from your
diet.
I've seen some promisingresearch that shows that it
helps to shrink fibroids.
Now, if you have a large,gigantuan fibroid, do not expect
this to turn your life around.
It's really for not the hugeones, maybe like...
a five centimeter or less, whereyou can start to see some
(15:01):
difference in the fibroid sizeper se.
And what's more so been studiedare the actual fibroid symptoms
start to improve with thisanti-inflammation diet and or
cutting out red meat.
So definitely something therefor my people that want to try
the nutrition aspect oftreatment.
So those are all of thetreatment options that we have
(15:25):
right now.
for fibroids.
So it depends.
Like I said, you can have areally small fibroid that can be
seen on ultrasound and really wedon't have to do a single thing
about it.
But if you have a lot ofpressure, a lot of pain, heavy
periods, painful periods,bloating, you know, your fibroid
makes you look like you'repregnant, it's pressing on your
(15:46):
bladder, it's causing you bowelproblems, we got to intervene.
So we have to go through theseoptions, pick one that's
actually the safest route orbest route for you and also one
that you feel comfortable with.
So here you are, you're armedwith everything.
You have an idea of what optionsare out there and I hope you can
bring this to your doctor todiscuss it.
(16:09):
And that's it.
That's fibroid treatmentoptions.
So good luck to everybody outthere.
I know that a lot of times,especially black women, we have
a higher propensity to getfibroids and we also have a
higher propensity of feeling asthough doctors aren't really
listening to us or connectingwith us.
(16:29):
But I feel that one, find onethat you're comfortable with,
obviously.
And two, when you are armed withthe information, no one can turn
you away.
No one can dismiss you.
So I think knowledge is power inthat way.
And I hope that this podcastepisode has helped you with
that.
And I'll see you guys on thenext one.
Bye.
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