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Uterine fibroids (leiomyomas) are non-cancerous growths within or on a woman's uterus. Fibroids typically form during a woman's reproductive years, from approximately age 16 to 50, when oestrogen (female reproductive hormone) levels peak.
Fibroids can appear anywhere within the uterus and can vary significantly in size, ranging from being minuscule (the size of a pea) or occasionally as large as a grapefruit.
Firbroids can be categorised into three main types. Intramural fibroids are the most common type of uterine fibroid that forms within the muscular wall of the uterus. Subserosal fibroids develop on the outer wall of the uterus, extending into the pelvic area. They can sometimes grow quite large. Submucosal fibroids originate in the muscle layer beneath the inner lining of the uterus and can protrude into the uterine cavity.
Additionally, some subserosal and submucosal fibroids are connected to the uterus by a slender stalk of tissue, and these are referred to as pedunculated fibroids.
The exact cause of uterine fibroids is not fully understood. However, several risk factors may increase the risk of developing uterine fibroids: early menarche below the age of 10 years old, previous exposure to diethylstilbestrol during pregnancy, and being overweight or obese.
Excessive consumption of beef and other red meat and the consumption of beer seems to be linked to a higher likelihood of developing fibroids.
There is evidence suggesting the existence of specific susceptibility genes that may play a role in the development of fibroids.
Many women with uterine fibroids are asymptomatic (have no symptoms), although certain symptoms may be experienced, for example heavy or prolonged menstrual bleeding, painful periods, painful sexual intercourse, frequent urination, and constipation.
Fibroids are more likely to cause symptoms when they are large, when multiple fibroids are present, or when located in specific areas within the uterus.
Fibroids tend to diminish in size when estrogen levels decrease and the symptoms associated with fibroids often improve when a person reaches menopause, when a woman's menstrual cycles cease.
While most uterine fibroids do not cause significant health problems, it is crucial to seek medical attention if you suspect you have uterine fibroids or are experiencing symptoms.
The probability of complications depends on various factors, including the location and size of the fibroids. Large fibroids may be a cause for infertility. Fibroids may cause complications during pregnancy, such as premature labour, preterm birth, and foetal malpresentation. They may also increase the risk of miscarriage.
Your doctor would first question your general health and symptoms before conducting a thorough physical examination. Diagnosis is made based on your reported symptoms, physical examination, and investigations.
Ultrasound is the most common test used to diagnose uterine fibroids. This is a non-invasive imaging procedure that utilises a probe emitting high-frequency sound waves to generate a visual representation of the inside of your body.
Hysteroscopy is a procedure involves inserting a small camera into the uterus through the cervix to look for fibroids.
Magnetic resonance imaging (MRI) is the most effective imaging technique for accurately visualising the size and location of all uterine myomas. It also can differentiate between various uterine conditions, such as leiomyomas, adenomyosis, and adenomyomas, providing valuable diagnostic information.
Treatment for fibroids may not be required if you are asymptomatic (do not experience any symptoms) or if you only have mild symptoms that do not significantly disrupt your daily activities.
Antifibrinolytic medication such as Tranexamic acid tablet
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Hormonal birth control (birth control pill, skin patch, vaginal ring, contraceptive shot, hormonal intrauterine device (IUD), implant)
Levonorgestrel intrauterine system (LNG-IUS)
Gonadotropin-releasing hormone analogues
If your symptoms are severe and medication has been ineffective, surgery may be suggested. Hysterectomy is a surgical procedure to remove the uterus that may be recommended if one has large fibroids or severe bleeding and does not wish to have any more children.
Another option is myomectomy, a surgical procedure to remove fibroids from the uterine wall. It is often considered an alternative to a hysterectomy, especially if you desire to preserve your fertility and have children in the future.
Non-surgical procedures that are available to treat fibroids include uterine artery embolisation (UAE), a procedure done to block blood supply to the fibroids. Endometrial ablation is a procedure done to destroy the lining of the uterus, but it does not shrink the fibroids. It may help to reduce heavy menstrual bleeding due to fibroids.
Read more: Fibroids vs Cysts
If you suspect that you are experiencing symptoms of uterine fibroids, get in touch with us to find out more about our Obstetrics & Gynaecology Services at your nearest Gleneagles Hospital.
You may also contact the Health Screening Centre at your nearest Gleneagles Hospital for health screening appointments
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