Fibroids

Data gathering

• Red flags – IMB, PCB, weight loss
• Others – periods, abdo pain, back pain, urinary symptoms
• Examine – abdo, pelvis, speculum

Clinical management

• Investigations
  • Bloods – FBC
  • Pelvic USS

• Explanation
  • fibroids are noncancerous growths in the womb causing symptoms such as heavy periods, abdominal swelling, urinary problems.
  • Can get larger with age and pregnancy and get smaller after menopause.

• Treatment
  • Watch and wait
  • Medications – tranexamic acid, NSAIDs, COCP
  • Mirena coil – sometimes difficult to insert
  • Refer – medications to shrink, uterine artery embolisation, myomectomy, hysterectomy

• Follow-up / Safety-net – PIL, review if not improved for referral