Causes Symptoms And Treatment Of Fibroids
One of the most common female health problems affecting women during their reproductive years is fibroids. These are benign growths that can actually arise in muscle tissue anywhere in the body but are found most commonly in the uterus.
The medical terms for fibroids are myoma, leiomyoma and fibromyoma. Uterine fibroids are benign (meaning non-cancerous or precancerous) growths in the uterine wall that often cause unpleasant and sometimes painful symptoms. Also, fibroids are the most common cause for hysterectomy.
Risk Factors
Several risk factors have been identified, such as ethnicity, nulliparity, genetics and hormonal factors. Yet, little is known regarding the reasons for the heterogeneity in behaviour of fibroids and the symptoms attributable to them. One in three women will develop fibroids at some point in their life and the most commonly affected age group is 30-50 years.
Types Of Fibroids
Fibroids are typically classified according to location, and include submucosal, intramural, and subserous subtypes.
Intramural: These fibroids usually develop in the muscle wall of the womb and is the most common type. They are also usually present with heavy bleeding during periods.
Subserous: It grows from the outer wall of the womb and grows outside. Usually these fibroids don’t cause any symptom but if they are very big in size, they may present themselves with mass per abdomen and in rare cases ¡fit has a long pedicle, it may present acutely as torsion of the subserous fibroid.
Submucosal: This fibroid grows form the inner lining of the womb and grows in to the uterine cavity. This type may present with bleeding. infertility or recurrent miscarriage.
Fibroids are symptomatic based upon their position within the uterus and therapy choice may be dictated by myoma location. Fibroids are classed in to subgroups according to their position and relationship to the uterine layers.
Causes
The exact cause of fibroids is unknown but research and studies have shown that ¡t is caused by some genetic factors, as fibroids tend to run in the family. Also, the growth of fibroids is stimulated by hormones such as oestrogen. Hormonal association is also proved by the fact that the fibroids’ size decreases in menopause when the body is deficient in hormones such as oestrogen and progesterone and also some factors such as insulin like growth factor may be responsible for fibroid occurrence.
Risk Factors
Heredity: If your mother or sister had fibroids, you are likely to get fibroids too.
Race: Black woman get more fibroids as compared to women of other races and also they tend to get complicated and big fibroids.
Other factors: Dietary habits such as eating red meat and less of green vegetables and fruits, alcohol intake including beer ups the risk of getting fibroids.
Pregnancy And Fibroids
Fibroids usually do not interfere with pregnancy but sometimes they may increase in size during pregnancy, decrease or remain the same size. They rarely may cause infertility and pregnancy loss.
Submucous fibroids may interfere with pregnancy implantation and may result in the loss of pregnancy. Sometimes they may be located near the cornual end of the tubes which may result in infertility. In these circumstances fibroid removal may help.
Treatment
Treatment of fibroids is not needed if they are not causing any symptoms or if the symptoms are minor so as not to affect your everyday life.
Medical
There are some medications which can be used for symptomatic relief. There are also medications that shrink the size of fibroids, but their effect is reversible so it can be used before surgery to shrink the size of the fibroid to make surgery technically easier and also ¡t reduces bleeding so it helps in increasing haemoglobin levels before surgery.
Surgical
This treatment may be recommended if symptoms are moderate to severe and medications are not helping. There are different types of surgical treatments such as Myomectomy (laparoscopic, hysteroscopic, robotic or open) that is removal of fibroids. Hysterectomy (laparoscopic, robotic or open) is removal of the uterus.
In some cases non-surgical procedures such as UAE (uterine artery embolisation) or MRI guided focused ultrasound can be used. However, the choice of treatment depends on the age of the woman, reproductive requirements, size and location of the fibroids and the symptoms caused by the fibroids. The best treatment can be decided by a gynaecologist based on clinical experience and expertise with different procedures.
Common Symptoms
- Low back pain
- Heavy menstrual bleeding
- Frequency of urination
- Constipation
- Increasing size of abdomen like a pregnant woman
- Infertility
- Recurrent miscarriage in case of submucosal fibroid
- Sometimes there may be acute pain in the abdomen in case of degeneration of the fibroid or torsion of the pedunculated subserous fibroid.