DIAGNOSIS:

• Pelvic Examination
• Ultrasound Scan
• MRI Scan
• Hysteroscopy/Laparoscopy

The first level of diagnosis will be from your physician or health care provider.  He/she will take a history and possibly blood tests to investigate hormone levels - FSH (follicle stimulating hormone) to find out whether the menopause is approaching.  A pelvic examination may also be carried out .

Pelvic examination

This is similar to a cervical smear, but the abdomen (lower stomach area) will also be examined.  It is difficult to differentiate between fibroids and other problems - large cysts and cancerous growths and an imaging scan (ultrasound) is also required.

After the ultrasound, the woman will usually be referred to a gynaecologist.

Ultrasound scan:

What is ultrasound?

This is the same type of scan used in pregnancy.  It is safe and uses sound waves to generate images from the body.

What will happen?

You will be asked to drink a lot of water before your scan to ensure that your bladder is full.  A gel will be put on your abdomen to give a good contact with the ultrasound probe. The radiologist who performs the scan will move the probe over your abdomen and the image will show up on a screen. The scan is completely painless.  A special probe may be inserted into the vagina.

Ultrasound examination can show the difference between cysts and solid tumours such as fibroids.  It cannot accurately diagnose the number, size or position of the fibroids.

MRI Scan:

What is MRI?

MRI stands for Magnetic Resonance Imaging.  The scan uses radio waves and very strong magnets to produce images of soft tissues.  No x-rays are used.

What will happen?

The magnets are contained in a large tube and you will lie on a table, which moves inside the scanner.  Although people suffering from claustrophobia are often worried by this type of scan, as the abdomen and pelvis is being scanned the head will normally stay outside the scanner throughout.

Nothing should be eaten or drunk for 2 hours before the scan.  The scan will normally take 30-45 minutes and you can go home immediately afterwards.  No items containing iron such as zips, belts or jewellery should be worn. The scan is not  painful.  The scanner is very noisy and the patient will wear headphones and listen to music.  The patient will be asked to keep still and hold her breath at certain times. Some contrast agent may be injected into the arm to give clearer images.

The advantage of MRI is that the exact type, size and position of the fibroids can be seen, as well as the size of the uterus/womb.  Other diseases such as adenomyosis (the lining of the uterus/womb grows into the muscle of the uterus/womb), endometriosis (the lining of the womb grows in other parts of the pelvis), cysts and cancers etc can also been diagnosed.

Hysteroscopy/Laparoscopy:
This involves a surgeon, a gynaecologist inserting a tube into the cervix - hysteroscopy or through the belly button - laparoscopy, under anaesthetic.  This enables the surgeon to see the uterus directly and make a diagnosis.

This may require a hospital admission, for observation of the patient after receiving anesthesia.