Uterine Fibroids: Causes, Symptoms and Treatment

Uterine Fibroids

Are you suffering from heavy menstrual periods? Does your menses last longer than normal? Are you going through frequent abdominal pain? If your answer to the above-mentioned questions is “Yes”, then you may have uterine fibroids.

What are Fibroids?

Fibroids are a form of non-cancerous growth that happens in the muscle cells of the uterus, thus forming a bulky uterus. From one to many, women can have a different number of fibroids varying in size. It can be as smaller as a tiny seed to as larger as a bulky mass. These are found incidentally during pelvic examinations without a proper test. And after that, Imaging and lab tests are usually carried out to confirm the presence of these fibroids.
Approximately, 20-40% of women who have attained menopause suffer from fibroids. According to some doctors, this number is estimated to be even higher. In fact, only 25% of women with them actually face any symptoms. The nature of fibroids is usually non-dangerous, and they do not spread to other parts of the body but when they started showing symptoms, they can be severe.
Since most women having fibroids don’t experience any symptoms, it makes the condition even more serious. However, women who don’t experience any symptoms often have to make drastic lifestyle changes to deal with them. Suffering from fibroids can lead to uncertain menses which further make women to feel discomfort and uneasiness. And the most challenging aspect of this condition is the way it affects a woman’s peace of mind.

What are the Symptoms of Uterine Fibroids?

The symptoms of uterine fibroids completely depend on the number of tumors a woman has. Their location and size are also major factors. For example, submucosal fibroids may lead to heavy menstrual bleeding and troubles in having pregnancy.

Women having smaller tumors or the ones who have already attained menopause, may not face any symptoms because fibroids may shrink during or post-menopause as they experience a drop in their estrogen and progesterone levels which use to stimulate their growth. Uterine fibroids symptoms include-

1. Prolonged, heavy or abnormal menstrual bleeding which often leads to the possibility of anaemia.
2. Severe pain in the pelvis. Pain in back and legs are also a symptom in many cases.
3. Pain during physical intercourse
4. Pressure in the bladder leads to frequent urge to urinate
5. Constipation due to pressure in the bowel
6. Abnormal abdominal swelling

Are fibroids common?

Fibroids are actually a very common type of growth in your pelvis. Approximately 40% of women have fibroids. However, many women don’t experience any symptoms from their fibroids, so they don’t realize they have fibroids. This can happen when you have small fibroids — called asymptomatic because they don’t cause you to feel anything unusual.

Who is at risk for uterine fibroids?

There are several risk factors that can play a role in your chances of developing fibroids. These include:

• Obesity and a higher body weight (a person is considered obese if they’re more than 20% over the healthy body weight).
• Family history of fibroids.
• Not having children/Infertility.
• Early onset of menstruation (getting your period at a young age).
• Late age for menopause.

What causes uterine fibroids?

There is no clear cause behind the development of fibroids but there are several factors which may influence the formation of fibroids. Causes of uterine fibroids include-

Hormones including estrogen and progesterone are produced by women’s ovaries. These hormones lead the uterine lining to regenerate during every menstrual cycle and may stimulate the growth of fibroids.

The condition of uterine fibroids may run in the family. If your family members including your grandmother, sister or mother has had a history of fibroids, then you may develop it as well.

Pregnancy increases the production of estrogen and progesterone hormones in a woman’s body as a result of which, fibroids may grow and develop rapidly during pregnancy.
These are some of the major causes of uterine fibroids.

1. Hormones-
2. Family History-
3. Pregnancy-

How are uterine fibroids diagnosed?

For fibroids to be diagnosed properly, you will need to consult a gynaecologist. After going through the pelvic exam, the doctor will be able to analyze the condition, size and shape of the uterus. You may have to go through other tests for a precise and detailed diagnosis which include-

An ultrasound scan uses high-frequency waves which produces images of woman’s uterus on a screen. This will help your specialist to analyze its internal structures and presence of fibroids. In this case, a transvaginal ultrasound scan may provide clearer pictures for a better diagnosis as here; an ultrasound probe is inserted in the vagina as it is closer to the uterus during the procedure.

Pelvic MRI is an in-depth imaging test procedure that produces clear pictures of a woman’s uterus, ovaries and other pelvic organs.
In such conditions, changes in diet and lifestyle may help as well. Avoiding meat and high-calorie foods and opting for food high in flavonoids, green leafy vegetables, green tea and fish like tuna or salmon can be very helpful.
Managing stress levels and losing weight in case of obesity can also benefit women suffering from fibroids.

1. Ultrasound Scan

2. Pelvic MRI

What are the treatment schedules for uterine fibroids?

Once you visit your doctor regarding your problems related to fibroids, he/she will develop a treatment plan according to your age, the size of your uterine fibroids and your overall health. You may need to go through a combination of treatments. The uterine fibroids treatments include-

Medications

To treat uterine fibroids, medications are prescribed to regulate your hormone levels so as to make the fibroids shrink.

Gonadotrophin-releasing hormone (GnRH) agonists including leuprolide (Lepron) helps in dropping the levels of estrogen and progesterone hormones. Prominent drops in the levels of these hormones will eventually stop menses and fibroids will shrink.

GnRH antagonists, including cetrorelix acetate and ganilrelix acetate, also help in shrinking fibroids. They help in inhibiting your body from producing FSH (Follicle-stimulating hormone) and LH (Luteinizing hormone).

There are other options too that helps in controlling menstrual bleeding and pain, but they won’t eliminate or shrink fibroids. These include,

1. Birth Control Pills
2. An intrauterine device (IUD) which releases the progestin hormone e.g. Mirena.
3. Over the counter (OTC) anti-inflammatory pain relievers including ibuprofen etc.

Surgery

Multiple or larger fibroid may be removed through surgery. This process of removal is called myomectomy which involves carrying out a larger incision in the abdominal part to access the uterus and remove the fibroid growth. The surgery can also be performed through laparoscopy with the help of a few small incisions through which surgical tools and a camera is inserted. But there is a probability that fibroids might grow after the surgery.
Even after this procedure, if your condition doesn’t stop degrading and no other treatments are working then your specialist may perform a hysterectomy. However, this procedure involves the removal of the uterus forbidding you from bearing children naturally in the future.

Different least invasive procedures

• Focussed ultrasound procedure (FUS) is an advanced and completely non-invasive surgical procedure. In this process, the patient has to lie down inside a special MRI machine that helps the doctors to visualize the inside of the woman’s uterus. In this case, fibroids are ablated or destroyed by directing high energy and high-frequency sound waves towards them.
• Myolysis is also a procedure that shrinks fibroids with the help of electric current or laser whereas cryomyolysis freezes the fibroids.
• With the help of endometrial ablation, a special instrument is inserted into your uterus to destroy the uterine lining through electric current, heat or hot water.
• Uterine Artery Embolization is a procedure through which small particles are injected into the uterus so as to cut off the blood supply to fibroids. The above mentioned are the treatments of uterine fibroids usually recommended by doctors.

How does fibroid affect women’s fertility?

The prognosis of fibroids completely depends on their size and location. Some fibroids may not need treatment if they are small and don’t show any symptoms.
If a woman is pregnant and has fibroids or she is yet to become pregnant and have fibroids then her doctor will carefully monitor her condition. In many cases, fibroids don’t cause any problems during pregnancy.
It’s better to consult your doctor when you are trying to get pregnant with fibroids and share even the minute health details with them for better and more precise treatment.