Uterine Fibroids

What are Uterine Fibroids?

Uterine Fibroids (also called myomas, fibromyomas, or fibromas) are benign (non-cancerous) growths on the uterus. Fibroids can grow on the inside of the uterus, on its outer surface, or within the uterine wall itself.

Uterine fibroids are the most common type of abnormal growth found in the female pelvis. Fibroids are found most often in women in their 30s and 40s, but they can occur in a woman of any age. About one in four or five women over the age of 35 has fibroids.

Fibroids are growths that develop from cells that make up the muscle of the uterine wall. The size, shape, and location of fibroids can vary greatly. They may be attached directly to the inside or outside of the uterus, or they may appear on a stem-like structure attached to the uterus. As they grow, fibroids can distort the inside as well as the outside surface of the uterus. Fibroids can range in size from small, pea-sized growths to large, round growths that may be more than 5-6 inches in diameter. In some cases, fibroids can grow large enough to completely fill the pelvis and be mistaken for pregnancy. Fibroids may occur singly, but more frequently they appear in groups of varying sizes.

What are the Risk Factors of Uterine Fibroid?

Although fibroids are quite common, the cause of their appearance is not known. Once fibroids appear, they may grow larger when the body produces higher amounts of oestrogen, such as during pregnancy or from some types of birth control pills. During menopause, when menstrual periods end and oestrogen production slows or stops, fibroids tend to become smaller and often disappear.

What are the Symptoms of Uterine Fibroid?

Many fibroids don’t produce any symptoms. However, some symptoms include:

• Changes related to menstruation such as:
  • Increased amount of menstrual bleeding
  • Increased frequency or length of menstrual periods
  • Increased menstrual pain
• Unexpected vaginal bleeding other than menstruation
• Dull, heavy, aching pain in the abdomen or lower back
• More frequent urination, caused by pressure on the bladder

Although most fibroids do not cause problems, some complications may occur. In fibroids attached to the uterus by a stemlike structure, twisting of the stem may cause acute pain, nausea, fever, and vaginal bleeding. Sometimes, a fibroid may become infected. In very rare cases, tissues in the fibroid may change and become cancerous. In rare instances, a very large fibroid may cause unusual swelling of the abdomen and infertility. If you experience any of these symptoms, see your doctor immediately.

How is Uterine Fibroid Diagnosed?

• Pelvic exam
• Ultrasound
• Laparoscopy
• Hysteroscopy
• Hysterosalpingography - a special X-ray test where a dye in injected into the uterus and Fallopian tubes to detect abnormal changes in their size and shape

As most fibroids don’t produce any symptoms, they are often first found during a routine pelvic exam.

 What are the Treatment Options for Uterine Fibroid?

Usually, no treatment is needed if the fibroids:

• Do not cause symptoms
• Are small
• Are in a woman nearing menopause, when the natural decline in oestrogen levels usually shrink fibroids

Treatment may be needed if a woman with fibroids experience has:

• Progressively heavy or painful menstrual periods
• Abnormal vaginal bleeding
• Fibroid that is suspected to be a potentially cancerous tumour
• Large fibroid
• Fast-growing fibroid

Treatment for fibroid usually consist of:

• Medication
• Surgery
  • Myomectomy - this operation involves the removal of the fibroids only, leaving the uterus in place. Hysteroscopic myomectomy uses a hysteroscope, a telescope and thin tube inserted through the cervix, to remove fibroids that protrude into the cavity of the uterus
  • Hysterectomy - this operation involves the removal of the entire uterus. It is the only certain “cure” for fibroids. Hysterectomy is usually recommended for women whose fibroids are causing symptoms, especially if no future pregnancy is planned.