The importance of finding the right treatment for fibroids

“I first noticed something wasn’t right when I started having very heavy periods,” Violeta recalls. “I assumed that because of my age, it might just have been perimenopause.” Violeta’s periods were so heavy that she ended up in A&E twice because of the amount of blood she’d lost.

Looking for answers, Violeta saw a gynaecologist at her local hospital, who prescribed her HRT to help with her symptoms. This helped for a couple of months, but Violeta was soon experiencing very heavy periods again. “I was losing so much blood that I was anaemic and was having to take iron supplements,” she says.

A shock diagnosis

Things came to a head for Violeta when she was going on holiday. “On the day of my flight I had my period, and it was my worst nightmare,” she says. “I thought that they might need to land the plane because of the amount of blood I was losing, and I was scared about needing a blood transfusion in another country.

“When I got back, I knew I’d do anything because I was so scared,” she says. Using her health insurance, Violeta saw a private gynaecologist. During her appointment, she had an MRI scan that revealed that the cause of her bleeding wasn’t perimenopause — she had a large fibroid almost eight centimetres in diameter.

Choosing the right treatment

Fibroids can be treated using medications to control their symptoms, but Violeta’s bleeding was so severe that she needed treatment to shrink her fibroid. Violeta’s gynaecologist explained what her treatment options could be - Violeta could choose to have a hysterectomy, which is the surgical removal of the uterus, or uterine artery embolisation (UAE). 

UAE is a minimally invasive procedure performed by an interventional radiologist that blocks the arteries that provide blood to the fibroid. It’s performed by injecting small particles into the artery leading to the fibroid through a catheter, using an X-ray camera for guidance. It usually shrinks fibroids to about half their size, and they’re unlikely to grow back after treatment. It’s also very safe and carried out under local anaesthetic, and its minimally invasive nature means patients recover much faster, letting them return home after just an overnight stay in hospital.

Of the two, Violeta chose to have a UAE. “When doing my research, lots of women talked about hysterectomies, but not embolisation,” she says. “I’m happy that something like this exists for women as a hysterectomy is a big surgery that needs lots of time to recover from.”

Reassured, relaxed and ready

For her treatment, Violeta was referred to Dr Paul Crowe, Consultant Interventional Radiologist at The Harborne Hospital. She had her initial appointment over the phone to discuss her treatment. “We had quite a short discussion because I knew it would be the best treatment for me, and I knew he’d be the person to do it.”  Violeta had questions about how long her recovery would be, how long she’d need off work and what the post-treatment pain might be like. With all her questions answered by Dr Crowe, Violeta felt informed and empowered to book her procedure. 

“On the day of my treatment at The Harborne Hospital, I was feeling a little nervous as I’d only been into a hospital for a blood test and when I went into my local A&E,” Violeta recalls. “But all the staff were so friendly, taking my bag for me like I was in a hotel, and the room was so comfortable — these things made me much more relaxed.”

To perform the procedure, Dr Crowe was joined by his team from HCA UK’s hospitals in London, giving him the support of a breadth of expertise from across the hospital network. Violeta was still a little nervous at the beginning of her procedure, but the team were there to support her and help ease any nerves.

“The anaesthetic nurse was amazing, she was so calm and talked with me the whole time,” Violeta says. UAE is performed under local anaesthetic and light sedation, so Violeta was awake during the procedure. “I was looking into a monitor the whole time and I could see what Dr Crowe was doing. He was perfectly calm the entire time.” 

The whole procedure took around an hour, and after it was complete Violeta was taken to the recovery room. She was feeling some initial post-procedure pain, but could take painkillers when needed to help her feel more comfortable. After a couple of hours, she was taken to her room, where she was greeted by her family. “I was really lucky to have them there, and it really helped me feel better having them around.”

On the road to a swift recovery

After an overnight stay, Violeta was discharged the next day and was picked up by her husband to return home. “After a day or two all I had was a small bruise. For the first week after the surgery, I was off work, but by the second week I slowly started getting back to working from home.” 

After about a month, Violeta was starting to feel back to her usual self. She was still slightly anaemic after her heavy bleeding, but the procedure meant her periods were now much lighter.

“After two or three months, I was feeling myself again,” Violeta says. “My periods got lighter and lighter, and now my iron levels are perfectly fine.” Six months on from her UAE, Violeta went for a check-up, and her fibroid had halved in diameter to four centimetres, equivalent to a reduction in volume of over 80%, and her symptoms had stopped.

After the success of her treatment, Violeta is now encouraging others with fibroids to look into UAE. “I’d recommend it to anyone, and not enough people know about it” she says. “I was speaking to someone who just moved to the UK whose treatment for fibroids back in her home country hadn’t worked, and I sent her Dr Crowe’s email.”