Noah Rindos, MD, Talks Fibroids, Adenomyosis and Pregnancy

In an interview with HCPLive®, Noah Rindos, MD, Minimally Invasive Gynecology, Allegheny Health Network (AHN) spoke about uterine fibroids and adenomyosis, which can present with similar symptoms.

"So, adenomyosis is where the layers of the cells, or the layers of the binding of uterus, kind of mix," he explained. "And, it oftentimes presents with similar symptoms to fibroids, right? So, heavy crampy periods, painful periods, and what will happen is sometimes we won't see anything that's very definitive on ultrasound, we'll see an enlarged uterus."

Rindos also discussed how the presence of a fibroid can impact pregnancy in various ways depending on the size and location of the fibroid. If the medical team gets involved it's often because a patient is having difficulty becoming pregnant or maintaining the pregnancy.

"This can happen just because the fibroid will disrupt the inner lining of the uterus," Rindos said. "And so oftentimes, our reproductive endocrinologist colleagues will ask us to remove this fibroid, either hysteroscopically or laparoscopically to help with a future pregnancy."

If the fibroid is lower in the uterus it can impact the birth canal which can result in complications that need to be monitored or resolved.

"The next way it can impact on a pregnancy is in a woman who has gotten pregnant but has very large fibroids, sometimes this can lead to a malposition," he continued. "So, the baby being breeched, or just discomfort during the pregnancy, or sometimes it can actually lead to difficulty with delivery."

Many women don't even realize they have fibroids because they aren't always symptomatic, while others might think of their heavy bleeding and cramping as normal. But, if it's interfering with a patient's ability to enjoy life, Rindos believes it's important they get an evaluation.

"Oftentimes, women are having these symptoms–but life is so busy, right?–you have 1000 competing interests and so you don't necessarily follow up with your primary care doctor, or your gynecologist," he said. "But if your bleeding is getting heavier, progressively worse pain with your periods, you know, make sure that you take the time to get an ultrasound, or get an evaluation and figure out if there's something that we can do to help restore your quality of life there."