Heavy menstrual bleeding, severe pelvic pain, and painful periods (dysmenorrhea) are common gynecological symptoms that should never be ignored. Two of the most prevalent structural causes behind pelvic pain and abnormal bleeding are Uterine Fibroids and Endometriosis.

Understanding Uterine Fibroids

Uterine fibroids (leiomyomas) are non-cancerous muscular tumors that grow in or on the uterine wall. Depending on their anatomical location, fibroids are classified as:

• Submucosal Fibroids: Growing into the uterine cavity, often causing heavy, prolonged bleeding (menorrhagia) and subfertility.
• Intramural Fibroids: Embedded within the muscular wall, enlarging the uterus.
• Subserosal Fibroids: Growing on the outer surface of the uterus, causing pelvic pressure or bladder urgency.

Understanding Endometriosis

Endometriosis occurs when tissue similar to the lining of the uterus (endometrium) grows outside the uterine cavity — most commonly on the ovaries (chocolate cysts/endometriomas), fallopian tubes, and pelvic peritoneum. This ectopic tissue bleeds during every menstrual cycle, causing localized inflammation, adhesions, severe dysmenorrhea, and painful intercourse.

Diagnostic Evaluation

Accurate evaluation relies on high-resolution 3D Pelvic Ultrasound Imaging. Transvaginal scans provide precise measurements of fibroid dimensions and visualize endometriotic ovarian cysts and pelvic adhesions.

Modern Treatment Options

• Medical Management: Hormonal therapy (progestin-only pills, LNG-IUS / Mirena, or GnRH analogs) to decrease heavy bleeding and reduce pelvic pain.
• Minimally Invasive Surgeries: Laparoscopic fibroid removal (myomectomy), cystectomy for endometriomas, or laparoscopic hysterectomy when indicated.