Cure for Fibroids: The Importance of Testing for Accurate Diagnosis
To find an effective cure for fibroids, a woman must first be certain of the diagnosis. A variety of physical symptoms may suggest a uterine fibroid condition. Before treatment begins, a physical examination, preliminary laboratory tests and diagnostic procedures are necessary.
Who Should Make the Diagnosis?
A visit to her doctor’s office and appropriate testing will get the process underway. To determine the best treatment, it is important to know as much as possible about the condition. Either a primary care physician (PCP) or a gynecologist (OB/GYN) could be the appropriate doctor for a first visit.
primary care physician: doctor at the entry point for most medical and health care needs. Also known as a family medicine specialist or family physician. Primary duties: prevent/diagnose/treat diseases; coordinate/help a patient access a range of health care services
gynecologist: physician specialist who focuses on women’s reproductive health issues
How Should You Prepare for the First Appointment?
On the first office visit your healthcare team will gather pertinent information to help find a cure for fibroids. The doctor may also conduct a physical exam. Because this appointment is likely to be brief, organize well in advance to avoid wasting time. Be ready to discuss your symptoms. Bring along whatever information or documentation you have available.
The Following Steps Are Likely To Make Preparation Easier:
- Make a list of any symptoms you have noticed. Include all your symptoms. Mention each one even if you don’t think they all are necessarily related. Make note of the duration of each symptom and of any changes over time.
- Write down the name of any medications, herbs and vitamin supplements that you take. Include doses and how often you take each one. Include both prescription and over-the-counter items. If they are available, bring along the containers as well.
- Collect and organize all recent medical records, imaging scans or imaging reports.
- If possible, have a family member or close friend go with you. You are likely to receive a lot of information at your visit. It can be difficult to understand and to remember everything.
- Take a notebook or electronic recording device with you. Use it to list important information during your visit.
- Prepare a list of questions in advance to ask your doctor. Write your most important concerns first in case time runs out. Some of your questions about fibroids might include the following issues:
- How many fibroids do I have? How big are they?
- Are the fibroids located on the inside or outside of my uterus?
- What kinds of tests might I need for diagnosis?
- Which medications are available to treat uterine fibroids or my symptoms?
- What side effects can I expect from medication use?
- Under what circumstances do you recommend surgery for fibroids?
- Will I need any medication before or after surgery?
- Will uterine fibroids affect my ability to become pregnant?
- Can treatment of uterine fibroids improve my fertility?
- What other alternative treatments might I try?
Make sure that you understand everything you hear during your appointment. Do not hesitate to ask your doctor or other team member to repeat information. Ask follow-up questions whenever necessary.
What Should You Expect from the Doctor?
Medical History
Some preliminary questions from your doctor are likely to include the following issues:
- How often do you experience these symptoms?
- For how long have you been experiencing symptoms?
- How severe are your symptoms?
- Are your symptoms related to the timing of your menstrual cycle?
- Does anything improve your symptoms?
- Does anything make your symptoms worse?
- Do you have a family history of uterine fibroids?
Pelvic Exam
Most likely the doctor will next perform a manual pelvic examination to check the condition, size and shape of the uterus. During this procedure your physician might feel irregularities suggesting the presence of fibroids. Moderate and even large-sized uterine fibroids are often first detected by such an exam. At this point many women will not need much further testing for uterine fibroids. Often the pelvic exam alone — or combined with a simple ultrasound — will be enough to make the diagnosis.
Ultrasound
If your doctor needs further confirmation of the diagnosis , an ultrasound test might be the next procedure. It uses high frequency sound waves to reflect off the uterus and pelvic structures. To capture the image, a technician operates an ultrasound device (transducer) over the abdomen or inside the vagina. A screen can then display detailed images of the inner structure of the uterus. This way ultrasound allows mapping and measuring of any uterine fibroid tumors.
Which Additional Evaluation Procedures May Be Necessary To Help Find a Cure for Fibroids?
In situations where more evidence is needed, additional imaging tests may be useful. To confirm the presence and/or suggest a cure for fibroids, the following procedures may have value:
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Magnetic Resonance Imaging (pelvic MRI)
Pelvic MRI is often able to confirm fibroids when the initial diagnosis is uncertain. The MRI scanner uses a high-powered magnet and a computer to visualize images of the uterus and other pelvic structures. MRI technology offers unmatched precision to help physicians pinpoint the exact location of fibroids. This imaging test can also show the size and differentiate the type of tumors. It can even help narrow down treatment options for a cure for fibroids. It permits assessment of the volume of blood flow feeding fibroid tumors. By comparing MRI scans taken before and after treatment, physicians can measure progress.
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Uterine (endometrial) biopsy
In some cases the doctor may have concern that a mass could be cancerous rather than a simple, benign uterine fibroid. If so, a small piece of tissue (biopsy) taken from the uterus can usually distinguish between the two. The uterine biopsy is sometimes done through the vagina. A small instrument passes through the cervical opening and then “grabs” small samples of tissue inside the uterus. This procedure most often occurs at a clinic or doctor’s office. Other times, though, the biopsy may require surgery.
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Hysterosalpingogram
For this procedure the doctor injects a special dye into the uterus through the vagina and cervix. X-ray films can then show an outline highlighting the uterine cavity and Fallopian tubes. Besides revealing fibroids, this technique can also help determine if the Fallopian tubes are open. The test is most often performed for fibroid sufferers who are trying to become pregnant.
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Sonohysterogram
Sonohysterogram may reveal uterine fibroids or other growths not visible on a traditional ultrasound. This technique provides enhanced visualization into the uterus. A saltwater solution is first injected through the vagina and cervix to expand the uterine cavity. An ultrasound is then performed. This diagnostic test is useful when a woman has heavy menstrual bleeding despite normal results from traditional ultrasound.
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Hysteroscopy
With hysteroscopy the doctor advances a thin tube into the uterus. Only a few millimeters in diameter, this hysteroscope includes a miniature camera and light. Such technology allows a doctor to see inside the uterus by projecting video images onto a digital screen. The screen shows the interior of the uterus and thus can detect those fibroids projecting inward. It cannot, though, see any part of a fibroid in the uterus wall or outside the uterus. If necessary, the physician may then perform operative hysteroscopy at the same time. This followup procedure removes or destroys fibroid tissue immediately, requiring no further treatment.
Which Additional Lab Tests May Be Necessary?
Depending on physical symptoms, the doctor may order other tests to suggest a cure for fibroids. For example, with abnormal vaginal bleeding, a complete blood count (CBC) might be necessary. This diagnostic test can determine if a woman has anemia because of chronic blood loss. Other blood tests might be necessary to rule out bleeding disorders or thyroid problems.
After the diagnostic workup is complete, the healthcare team can then narrow down the available treatment options. An accurate diagnosis is the first step toward successful resolution of the fibroid problem.