Are Uterine Fibroids Dangerous? Causes, Risks, and Treatment

What Are Uterine Fibroids?

Uterine fibroids are described as growths that develop in the uterus from the muscle tissue. These growths can form in or on the wall of the organ. While the term “growths” may cause panic in a person, it is important to note that fibroids are benign, i.e., non-cancerous. In fact, they are the most common non-cancerous tumours found in the female body.

Fibroids can grow as a single unit or they can form clusters, with their size ranging from 1 millimetre to over 20 centimetres in diameter. There are multiple types of uterine fibroids, including:

• Intramural fibroids: The most common type of uterine fibroid, intramural fibroids are found attached to the muscular wall of the uterus.
• Submucosal fibroids: These grow just beneath the inner lining of the uterus.
• Subserosal fibroids: Such fibroids are found under the lining of the uterus’s outer surface and can grow exponentially in size, often expanding into the pelvis.
• Pedunculated fibroids: They have a mushroom-like appearance as they attach to the uterus with a stalk or a stem. Pedunculated fibroids are the least common type.

Can Uterine Fibroids Be Dangerous?

Since uterine fibroids are benign, they are fairly harmless. However, they can cause certain complications in the female body, including pain. In addition to pain, patients may experience a sudden drop in red blood cell count. This condition is commonly known as anaemia, which can cause immense fatigue from the blood loss.

While there is not much to worry about, some fibroids can be problematic depending on their size. Some fibroids stay small in size, causing no noticeable issues. On the other hand, some may grow large enough to affect the surrounding organs, causing pain, heavy bleeding, and pressure on the pelvic region.

Can Uterine Fibroids Turn Into Cancer?

Uterine fibroids or leiomyoma are non-cancerous in nature, meaning that a cancer scare should be the last thing on your mind if you develop these fibroids in your uterus. That being said, some rare cases have been reported where a benign leiomyoma transitions into a cancerous leiomyosarcoma. However, the supposed transformation remains unproven so far.

Uterine leiomyosarcoma is a rare and aggressive form of cancer that can mimic the symptoms and appearance of a fibroid, but it is not believed to develop from existing fibroids.

Causes: How Do Uterine Fibroids Develop?

An exact cause of a uterine fibroid remains unknown, but researchers and medical professionals believe that hormones play an important role here. The said hormones include oestrogen and progesterone.

When the hormone levels are higher, such as during pregnancy, fibroids tend to grow. On the other hand, they shrink when the hormone levels decrease. This may happen during menopause. There is also a genetic component to the development of uterine fibroids.

Symptoms, Risks, and Complications of Uterine Fibroids

More often than not, fibroids do not cause any noticeable symptoms in the body, especially when they are much smaller in size. However, when the growths become larger, a person may experience the following symptoms in their everyday life:

• Prolonged or heavy bleeding during their period.
• Bloating or feeling full in the lower belly.
• Unexplained bleeding between two periods.
• Frequent urination.
• Painful intercourse.
• Pain in the lower back.
• Chronic vaginal discharge.
• Increased enlargement of the abdomen, causing you to look pregnant.
• Constipation or a feeling of pressure in the rectum.

Some people may be more prone to developing uterine fibroids than others due to exposure to risk factors like:

• Obesity.
• Family history.
• Getting your period at an early age.
• Late menopause.
• Deficiency of Vitamin D.
• Age.

As discussed, fibroids are usually harmless, but while they do not cause serious complications that affect a person’s day-to-day life, they may cause some problems, including but not limited to:

• Unmanageable or unbearable pain.
• Swollen abdomen or pelvic area.
• Heavy bleeding.
• Anaemia.
• In rare cases, infertility.

Do Fibroids Affect a Woman's Fertility or Pregnancy?

There is no particular answer to the question as the relationship between fertility and uterine fibroids is unpredictable. Since they can go undetected for years, they usually only have a negative impact on a woman’s fertility, depending on the size and location of the growth.

For example, submucosal fibroids found underneath the inner lining of the uterus can grow into the uterine cavity, decreasing fertility and increasing the risk of pregnancy loss. Here are some ways in which fibroids can affect fertility:

• They can change the shape of the cervix, thus limiting the number of sperm entering the uterus.
• They can block the fallopian tubes.
• Fibroids can disrupt the size and shape of the uterine cavity lining.
• They can also negatively affect the blood flow to the uterine cavity. By doing so, they make it difficult for an embryo to stick to the uterine wall.

As for pregnancy, uterine fibroids may not usually cause any complications, but some women may experience problems, especially when the fibroids are larger than 5 centimetres in size. While the most common complication is pain, others may include:

• Frequent urination: Fibroids larger in size can put pressure on the woman’s bladder, causing her to take more frequent trips to the bathroom.
• Caesarean section: The presence of fibroids may increase the chances of a woman having to go through a C-section to give birth.
• Fetal growth: The fetus may not grow in size properly.
• Preterm labour: If a woman develops fibroids, there is a chance that the baby could be born before the 37th week of pregnancy.
• Miscarriage: The risk of losing a baby is higher in people with fibroids.
• Other complications: In some cases, the placenta can get detached from the uterine wall, restricting the flow of oxygen and nutrients to the fetus. Again, this can lead to premature delivery or even a miscarriage.

When to See a Doctor

Fibroids smaller in size do not cause problems, but larger ones can lead to multiple complications. It is important to know when it is the right time to seek help from a medical professional. Uterine fibroids may become dangerous when:

• They cause pressure on neighbouring organs and affect a person’s urination habits and bowel movements.
• They increase the risk of anaemia due to excessive blood loss.
• They expand in size at a rapid pace. Remember, fibroids can range from 1cm (a small pea) to more than 10 cms (a grapefruit). Some can also grow up to the size of a football in rare cases.
• They affect a woman’s fertility or cause complications in her pregnancy.
• They disrupt your everyday life through severe cramps, bloating, and discomfort.

Make sure to visit a doctor if you experience any of the above symptoms for quick diagnosis and treatment.

Diagnosing Uterine Fibroids and Treatment Options

Uterine fibroids are usually discovered during a pelvic exam. When a patient experiences symptoms like heavy bleeding, doctors may begin to consider fibroids as a possible diagnosis. Some tests that can be carried out to confirm the suspicions include:

• Magnetic Resonance Imaging (MRI): Through MRI, professionals are able to obtain detailed photos of the patient’s internal organs by using magnets and radio waves.
• Ultrasonography: A non-invasive imaging test that produces images of internal organs using sound waves.
• Computed Tomography Scan (CT Scan): This allows doctors to create detailed images of internal organs from various angles by using X-ray images.
• Laparoscopy: In this test, a small cut is made in your lower abdomen through which a thin tube with a camera is inserted into your internal organs.
• Hysteroscopy: A scope is again used to look at the fibroids inside the uterus. In this case, the scope is passed through the vagina and cervix first.
• Hysterosalpingography (HSG): Here, contrast material is injected into the patient’s body before the professional takes X-ray images of the uterus for a detailed result.
• Sonohysterography: A small catheter is placed in the vagina before saline is injected into the uterus. This provides the healthcare professional with a clear image of the uterus.

The next step is treating uterine fibroids. One size does not fit all, and a personalised treatment plan will vary depending on elements like the size and location of the fibroids, symptoms, quantity of fibroids, and whether or not you want to get rid of the uterus entirely. Some effective treatment methods include:

• Certain medications: Before going for surgery, fibroids can be treated by using OTC pain medications, iron supplements, birth control pills, etc. Oral therapies like Elagolix, which help in managing heavy bleeding, can also be helpful in treating uterine fibroids.
• Surgery: While the size, location, and number of fibroids influence the surgery, so does the person’s desire to get pregnant in the future. Through myomectomy, doctors can remove the fibroids from the uterus. There are several types of myomectomy, including hysteroscopic, laparoscopic, and laparotomic. However, if you are not planning a pregnancy, you can also have your uterus removed through hysterectomy.
• Uterine fibroid embolisation: A small catheter is placed in the uterine or radial artery, after which small particles are inserted, causing the blockage of blood from the artery to the fibroid, thus shrinking it in size.
• Radiofrequency ablation: A safer and effective treatment carried out by using microwave energy. Usually treats smaller fibroids.

How to Manage Fibroids Naturally

Women can make certain lifestyle adjustments to manage fibroids better, even if it won't completely eliminate the problem. Some strategies to keep in mind are:

• Maintaining a healthy body weight.
• Eating a balanced diet rich in fibre.
• Avoiding sugar, alcohol, and red meat.
• Keeping your stress in check.
• Engaging in regular physical activity.

Conclusion

Uterine fibroids are common and benign growths that develop in and around the uterus. While they may not be dangerous or cause noticeable symptoms, they can sometimes lead to more serious complications depending on their size, location, and number. Yes, the growths aren't cancerous, but they can easily disrupt a person’s day-to-day life and overall reproductive health.

Those who experience stubborn symptoms should consult a doctor for proper evaluation and guidance. With the right medical assistance and lifestyle adjustments, individuals with fibroids can easily lead a normal life.