Fibroids are muscular abnormal growths that develop in a woman’s uterus. Another fancy medical term for it “leiomyoma” or just “myoma”. These tumors are rarely cancerous. Rarely, less than one in 1,000 will become cancerous. This is called leiomyosarcoma. Some women with fibroids do not have symptoms but those who do usually have abdominal pain and heavy menstrual period which may be difficult to live with. It can grow as a single tumor, or as multiple tumors.
Research shows that uterine fibroids are the most common disease of reproductive-age women. It affects 25% of African American women at the age of 25 and up to 80% of African American women by the age of menopause.
Globally as well, uterine fibroids are among the most significant diseases of reproductive-age women. Despite the magnitude of the problem, nonsurgical and medical options for treatment are extremely limited.
Risk factors
- Age (it is mostly seen in women as they get older usually between the 30s and 40s to menopause. After menopause, fibroids usually shrink.
- Race: African Americans are more likely to have fibroids than Caucasian women
- Obesity: Women who are overweight are more likely to develop uterine fibroids. Research shows that uterine leiomyomata (fibroids) are also thought to be influenced by estrogens. Patients presenting with symptomatic uterine fibroids were more obese than the general population.
- Family history of uterine fibroids.
- High blood pressure.
- No history of pregnancy.
- Vitamin D deficiency.
- Eating habits.
Symptoms
Most women with fibroids do not have any symptoms. In those that do, their symptoms could be based on the size and number of fibroids.
In women who have symptoms, the most common signs and symptoms of uterine fibroids include:
- Heavy menstrual bleeding lasting more than a week (which might lead to anemia)
- Pelvic pressure or pain
- Lower back pain
- Constipation
- Painful menstrual periods
- Pain during sexual intercourse
- Feeling of fullness in the pelvic area (lower stomach area)
- Enlargement of the lower abdomen
- Frequent urination
Fibroids and Pregnancy
Fibroids in pregnancy sometimes causes problems with the development and delivery of the baby. Some of the problems include:
- There could be risk of premature labour causing abdominal pain during pregnancy
- If the fibroid is large enough to block the uterus, caesarean section might be required.
- It can cause miscarriage (the loss of pregnancy during the first 23 weeks)
- The baby could be breech ( i.e, the baby’s buttocks, feet or both are positioned to come out of the vagina first during delivery)
Diagnosis
Uterine fibroids might be found incidentally during a routine pelvic exam. It can be felt by your doctor with her or his fingers during an ordinary pelvic exam, as a painless irregular lump or mass on the uterus. If you have symptoms of uterine fibroids, Your doctor can carry out an imaging tests to confirm that you have fibroids.
- Ultrasound – It uses sound waves to get a image of your uterus. This is done to confirm the diagnosis and also measure the size of the fibroids.
- Magnetic resonance imaging (MRI) – Uses magnets and radio waves to create a more detailed image of the size and location of the fibroid to get an appropriate treatment.
- X-rays – Uses a radiation to see into the body to produce a picture.
- CT scan – it is used to take lots of X-ray images from several angles for a better view.
- Hysterosalpingogram (HSG) or sonohysterogram – While doing HSG, x-ray dye is injected into the uterus and pictures are taken. The dye is used to highlight the uterus (womb) and fallopian tubes on X-ray images. Your doctor might suggest this if infertility is a concern.
- Laparoscopy – Your doctor might inserts a long, thin scope having a bright light and a camera into a tiny incision/cut made in or near the navel. This enables him/her check the uterus and other various organ on a monitor.
- Hysteroscopy –This is done by inserting a small telescope with bright light and a camera through your vagina and cervix into your uterus. This allows your doctor to examine the walls of your uterus for fibroids or any other abnormalities.
Medications
This usually helps to secrete hormones which regulate your menstrual cycle and treat some of the symptoms such as heavy menstrual bleeding and pelvic pressure. They do not eliminate fibroids but may shrink them. Medications include:
1. Gonadotropin-releasing hormone (GnRH) agonists:
GnRH agonists include leuprolide (Lupron, Eligard, others), goserelin (Zoladex) and triptorelin (Trelstar, Triptodur Kit). They work by blocking the production of estrogen and progesterone. As a result, menstruation stops, fibroids shrink and anemia often resolves. It alters your menstrual cycle (period) but it does not affect your chances of becoming pregnant after you stop using them.Women experience menopause-like side effects like
- Vaginal dryness
- Hot flushes
- Increased sweating
Your doctor may prescribe this medication to decrease the size of the fibroids before a surgery is scheduled.
2. Progestin-releasing intrauterine device (IUD):
This can be used to decrease the bleeding and pain. It can relieve the symptoms but it does not shrink the fibroid.
Other medications
Your doctor may recommend:
- Oral contraceptives ➝ which can help control menstrual bleeding. They do not affect the size.
- Nonsteroidal anti-inflammatory drugs (NSAIDs)➝ relieving pain related to fibroids.
- Vitamins and iron➝ If you have heavy menstrual bleeding and anemia.
Traditional surgical procedures
Options for traditional surgical procedures include:
- Myomectomy: This is an open surgery done in women who have fibroid. This may be recommended above other procedures in cases of women who want to get pregnant. However, scarring can occur after surgery which might lead to infertility.
- Hysterectomy: This is a procedure done to remove the uterus. This is the permanent solution for uterine fibriod and once it is done, the patient will not be able to get pregnant again..
DISCLAIMER: The content of this blog post is not intended to be a substitute for professional medical care, diagnosis, or treatment. it is intended for informational purposes only. Ensure you seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or in the case of a medical emergency.
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