What are uterine fibroids?
Uterine fibroids are noncancerous, fibrous growths that occur in the uterus of woman in their reproductive age group. They are quite common. They may grow on the outside of the uterus (called subserosal fibroids), inside the muscle of the uterus (called intramural fibroids), or into the uterine cavity (called submucosal fibroids). They can occur as a single or multiple growths.
What causes fibroids in the uterus?
- Genetic changes in typical uterine muscle cells.
- Hormonal changes due to Estrogen and progesterone levels. They promote the growth of fibroids. That’s why, fibroids tend to shrink after menopause due to a decrease in these hormone productions.
- Other growth factors such as insulin-like growth factor, may affect fibroid growth.
- Other factors. Periods at an early age (early menarche); obesity; vitamin D deficiency; high meat consumption, lower intake of green vegetables, fruit and dairy products; alcohol consumption.
What are the symptoms of fibroids?
Approximately 40 to 80% of women have fibroids. However, many women don’t experience any symptoms as they tend to have small fibroids Other women may have severe symptoms.
Symptoms can include
- Problems during periods
- Longer, more frequent, or heavy periods
- Menstrual pain (cramps)
- Intermenstrual bleeding
- Anemia due to heavy periods
- Pain In the abdomen or lower back
- Pain during sex
- Difficulty urinating or frequent urination
- Constipation, difficult bowel movements
- Enlarged uterus and abdomen
- Miscarriages
- Infertility
What complications can occur with fibroids?
- Fibroids ( pedunculated variety that gets attached to uterus via a stem) may twist and can cause pain, nausea, or fever.
- Fibroids that grow rapidly, or those that start breaking down , also may cause pain. Very rarely, they can be associated with cancer especially when they continue to grow after menopause.
- A very large fibroid may cause swelling, distension and discomfort in the abdomen.
What are the effects of fibroid in Pregnancy?
Fibroids usually don’t interfere with getting pregnant. However, it’s possible that fibroids — especially submucosal fibroids — could cause infertility or pregnancy loss.
Fibroids may also raise the risk of certain pregnancy complications, such as placental abruption, fetal growth restriction and preterm delivery.
How are fibroids diagnosed?
Fibroids may be found during a routine pelvic exam or during tests for other problems. Fibroids are typically diagnosed by ultrasound. MRI of the pelvis as a way to see exactly where the fibroids are.
How are fibroids treated?
Treatment plan will depend on the following factors:the number, size, location, symptoms, fertility goals, and desire to retain uterus.
Medications may reduce the heavy bleeding and painful periods that fibroids sometimes cause
- Birth control pills and other types of hormonal birth control methods—they are used to control heavy bleeding and painful periods.
- Gonadotropin-releasing hormone (GnRH) agonists drugs—They stop the menstrual cycle and can shrink fibroids.
- Iron supplements: for anemia due to excess bleeding
- Myomectomy is a procedure that allows removal of fibroids without damaging the uterus
- Hysteroscopy—This technique is used to remove fibroids that protrude into the cavity of the uterus.
- Uterine artery embolization (UAE)—In this procedure the blood flow to the fibroid is cut off and causes it to shrink
- Radiofrequency ablation (RFA)
- Hysterectomy – removal of the uterus, when other treatments have not worked or are not possible or the fibroids are very large.