What Are Uterine Fibroids
Fibroids are non-cancerous growths that develop in or around the uterus. These often emerge during the childbearing years. These benign growths can modify the shape or size of the uterus. Fibroids are also termed Leiomyomas or Myomas.
These growths differ in size and their pattern of growth (slow or fast). A single or multiple fibroids can be present. Fibroids don′t multiply to other body parts except in some rare conditions.
Common Symptoms of Fibroids in Women
Generally, fibroids are asymptomatic.
Certain females do experience symptoms including:
- Prolonged menstrual periods (more than a week)
- Heavy bleeding
- Constipation: occurs if a fibroid is pressing on the bowel
- Frequent urination
- Trouble while emptying the bladder
- Pelvic cramps
- Pain in the legs and back
- Pain during intercourse
- Bloating or a sensation of fullness in the pelvis
A fibroid might often result in acute pain when it outgrows its blood supply and starts dying.
Types and Classification of Uterine Fibroids
Fibroids are classified according to their location in the uterine wall:
- Intramural fibroids: commonly found, develop within the muscular uterine wall.
- Submucosal fibroids: project into the uterine cavity.
- Subserosal fibroids: grow on the external wall of the uterus.
Who Is at Risk of Developing Fibroids
- These commonly occur in overweight women and in women who fail to conceive in the past.
- Fibroids occur in 20% of females in their reproductive years.
Causes and Risk Factors of Uterine Fibroids
The exact reason is unknown; however, research indicates these causes responsible for fibroids:
- Hereditary: There is a consistent link between fibroids and heredity. So if other women in your family had fibroids, you are predisposed.
- Hormones: Progesterone and Estrogen have been found to stimulate fibroid development. These hormones are responsible for the stimulation of the growth of the uterine lining during each menstrual cycle.
- Other growth factors: Insulin-like growth factor has been found to affect the growth of fibroids.
How Uterine Fibroids Are Diagnosed
Mostly no symptoms are seen. Thus frequently, fibroids go unnoticed. Sometimes, fibroids are seen during a regular pelvic assessment by a gynecologist. A pelvic exam determines the size and shape of the uterus.
Numerous tests help to diagnose fibroid. They are:
- Vaginal Ultrasound
- CT scan or Magnetic Resonance Imaging (MRI)
- Hysteroscopy
Treatment Options for Uterine Fibroids
No single approach for treating fibroids exists, as there are many treatment options. The treatment type totally depends on the age, symptoms, and type of fibroid. Treatment options depend upon the outcomes (fibroid size and location) and whether the symptoms mild, moderate, or severe.
- Vigilant Waiting: Fibroids are non-cancerous. They seldom hamper pregnancy. Their growth is usually slow or not at all and appears to contract after menopause when there is a fall in the hormonal levels.
- Medications: target hormones regulating the menstrual cycle to treat fibroid complications like pelvic pain or heavy menstrual bleeding. They do not eradicate fibroids but may reduce them in size.
When Surgery Is Recommended for Fibroids
Generally, surgery is done when the fibroids result in significant symptoms.
If a female plans to conceive in the future, then Myomectomy is the only surgical option (in which the fibroids are surgically removed). In this procedure, the fibroids are removed by the surgeon, leaving the uterus in place.
Myomectomy can be of several types, based upon the size and location of the fibroids. All Myomectomies affect future fertility and carry a risk of scarring and adhesions. Also, the procedure involves the risk of undue bleeding, which may necessitate a Hysterectomy.
Myomectomy can be:
- Abdominal Myomectomy (Laparotomy): Removes fibroids present on the uterus’s external surface and the adjacent organs. An incision is done in the abdomen area.
- Laparoscopic Myomectomy: It is quite a simple and minimally invasive technique. A laparoscope removes fibroids through tiny 5-10 mm incisions done in the abdomen via the navel.
- Hysteroscopic Myomectomy: Best intervention for fibroids contained inside the uterus (submucosal). A telescope-like device is placed through the cervix. Then, fluid fills up the uterus to inflate the uterine walls. This increases the access and image of the uterus. A hysteroscope is used to eliminate the submucous fibroids.
With any technique that doesn’t eliminate the uterus, new fibroids may develop and result in symptoms.
Chances of Fibroid Recurrence After Myomectomy
After a myomectomy, the risk of developing fibroid is about 30% over a period of 10 years. Patients with multiple fibroids have chance to get fibroid again compared to patients with single fibroid.
Frequently Asked Questions About Fibroids
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1. What are uterine fibroids in women?
Most uterine fibroids are non-cancerous growths that develop in or around the uterus, usually during the reproductive years. Also called leiomyomas or myomas, they vary in size and number and may alter the shape of the uterus. Most fibroids are benign and slow-growing.
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2. Are uterine cyst and fibroid the same?
A uterine cyst is not the same as a fibroid. Fibroids are solid muscular growths, whereas cysts are fluid-filled structures.
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3. Can fibroid removal cause infertility?
Fibroid removal through myomectomy aims to preserve fertility, especially in women planning pregnancy. However, all myomectomy procedures carry risks such as scarring and adhesions, which may affect fertility. In rare cases, excessive bleeding during surgery may require a hysterectomy.
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4. Can fibroids cause infertility?
Yes, fibroids can contribute to infertility, particularly if they distort the uterine cavity or interfere with embryo implantation. Submucosal fibroids are most commonly associated with fertility issues. Fibroids are more frequently seen in women who have had difficulty conceiving.
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5. How are fibroids diagnosed?
Fibroids are often detected during routine pelvic examinations. Diagnostic tools include vaginal ultrasound, MRI or CT scans, and hysteroscopy. These investigations help determine the size, number, and location of fibroids, especially when symptoms such as heavy bleeding or pelvic pain are present.
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6. What causes fibroids to grow?
The exact cause of fibroid growth is unknown. However, hormones such as oestrogen and progesterone stimulate their development. Genetic factors and growth factors such as insulin-like growth factor also influence fibroid growth, explaining why fibroids often run in families.
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7. What treatment options are available for fibroids?
Treatment depends on age, symptoms, and fibroid type. Options include watchful waiting, medications to manage symptoms, and surgery for severe cases. Myomectomy removes fibroids while preserving the uterus. Surgical approaches include abdominal, laparoscopic, and hysteroscopic methods based on fibroid location.
