Uterine fibroids are a prevalent type of non-cancerous tumour that develops in the uterus, an integral part of the female reproductive system. Around 25-30% of women are diagnosed with this condition. Uterine fibroids may occur as solitary growths or clusters—nodules from 1 mm to 8 inches in diameter. In the past, the only way to address uterine fibroids was through removing the whole uterus, but now there are many alternatives for treating this health issue. This post discusses causes, symptoms and treatment options for uterine non-cancerous growth.
Causes of Uterus Fibroids
The exact cause of uterus fibroids is not fully known, but the most common cause or risk factors of uterus fibroids include family history, age, and genetics.
No one knows exactly what causes fibroids or what causes them to grow or shrink. Also, it is unclear if the hormones – oestrogen and progesterone control them. They multiply during pregnancy when hormones are high. Conversely, they shrink when using anti hormonal drugs and grow or shrink when a woman goes through menopause.
Symptoms of Uterus Fibroids
Symptoms of uterine fibroids can vary from woman to woman, and some may not even experience any symptoms. Fibroid symptoms rely on the location and size of the tumour. Therefore, your symptoms can be influenced by the various types of tumours you have and their location and size. Sometimes these fibroids show no symptoms and shrink after the body is immobilised.
Fibroid symptoms may include:
Heavy bleeding
Lower back pain
Frequent urination
Engagement of the lower abdomen
Pain during sex
Constipation
Enlarged uterus
Miscarriage
Diagnosis of Uterine Fibroids
Symptoms of uterine fibroids depend on various conditions; some women may not notice any symptoms. These fibroids are often found after having a routine pelvic exam. If a doctor feels abnormalities in the uterus that indicate the presence of fibroids, then he will recommend the following tests:
Ultrasound: If confirmation is required, the doctor may order an ultrasound. Ultrasound is a commonly used imaging test for the diagnosis of uterine fibroids.
Ultrasound is a non-invasive and painless test that uses sound waves to create images of the inside of the body.
Ultrasound can also help differentiate between uterine fibroids and other conditions, such as ovarian cysts or uterine cancer.
Ultrasound is often the first imaging test used to diagnose uterine fibroids. Still, it may be followed by other imaging tests, such as MRI or hysteroscopy, to confirm the diagnosis or provide more detailed information.
Ultrasound is a safe and effective diagnostic tool for uterine fibroids and can monitor fibroid growth over time.
Lab tests- If your menstrual bleeding is unusual, your doctor will add additional tests to check the underlying cause. These could include a complete blood count (CBC). It will help check anaemia, blood disorders and thyroid issues.
Other Imaging Test-
Magnetic resonance imaging
Hysteroscope
Hysterosalpingography
Hysteroscopy
Endometrial biopsy
Treatment of Uterine fibroids
The type of treatment you will get depends on the following:
Age
Symptoms
Pregnancy
Types of fibroids
If you want children in future
Noninvasive treatment
Medication for Symptomatic relief:
Pain killers: They can control discomfort and pain from fibroids
Iron supplements can treat diabetes caused by excess blood
Gonadotropin-releasing hormone (GnRH) agonists can shrink fibroids
Magnetic resonance imaging-guided focused ultrasound surgery (MRgFUS) uses high-frequency ultrasound waves to heat and destroy the fibroid tissue. MRgFUS is a non-invasive procedure that does not require incisions or anaesthesia.
Invasive Treatment:
Surgery:
Some surgical options may aim to preserve the uterus, while others may damage or remove it. Therefore, the desire to preserve the uterus or the possibility of pregnancy in the future is also an essential factor in determining the type of surgery to treat uterine fibroids for surgeons to remove them.
Myomectomy- It is a surgical procedure that removes uterine fibroids from the uterus. This option is better and chosen by those women who still want to have children in the future. There are various categories of myomectomy, such as:
Abdominal myomectomy: This is an open surgery on the abdomen to remove the fibroids.
Laparoscopic myomectomy: This is a minor surgery that involves several small incisions made in the abdomen, and the surgeon uses a laparoscope (a small camera) to remove the fibroids.
Hysteroscopic myomectomy involves removing fibroids in the uterus using a hysteroscope (a thin, lighted tube) inserted into the vagina and uterus.
Surgical Options for Patients who do not desire to Protect the Uterus
This is a minor surgery that involves several small incisions made in the abdomen, and the surgeon uses a laparoscope (a small camera) to remove the fibroids.
Hysteroscopic myomectomy involves removing fibroids in the uterus using a hysteroscope (a thin, lighted tube) inserted into the vagina and uterus.
Surgical Options for Patients who do not desire to Protect the Uterus
Hysterectomy- Hysterectomy is a surgical procedure involving uterus removal.
Radiofrequency ablation (RFA) is a minimally invasive procedure using heat to destroy fibroids. During the procedure, a small needle is inserted into the fibroid under ultrasound guidance. The needle sends out radio frequency waves that heat and destroy tissue.
Complications:
Severe pain or heavy bleeding that requires emergency surgery.
Fibroid Disruption – This causes occlusion of the blood vessels that feed the tumour. If this happens, surgery is required.
Anaemia due to heavy bleeding (lack of red blood cells).
Urinary Tract Infection – If fibroids press on the bladder, it may be difficult to empty it.
Risk of developing new fibroids
In all surgeries except hysterectomy, tumours that doctors miss seeing at the time of surgery have the chance of growing and causing symptoms that require treatment. This is often referred to as recurring costs. New fibroids may also develop, which have a chance of not requiring any type of treatment.
Certain medical procedures, such as laparoscopic or robotic myomectomy, radiofrequency ablation, or MRI-guided focused ultrasound surgery (FUS), are designed to target and remove only a select number of the fibroids present at the time of treatment.
FAQs
Q: Are there chances of turning fibroids into cancer?
A. Most fibroids are not that dangerous. They are benign, meaning they are not cancerous and are unlikely to develop into cancer. However, in rare cases, fibroids can develop into cancerous tumours called leiomyosarcomas. The risk of this happening is estimated to be less than one in a thousand.
Q: How do I know that I have fibroids?
A. Some symptoms of fibroids include heavy bleeding, abdominal pain, frequent urination, constipation, and bloating. However, many women with fibroids face no symptoms. If you think you may have a fibroid, you must see your doctor for evaluation.
Q: What are the risks of uterine treatment?
A. The risks of uterine surgery depend on the specific procedure performed. Surgical procedures such as hysterectomy or myomectomy carry risks such as bleeding, infection, and damage to surrounding organs. Minimally invasive procedures such as UFE or MRgFUS have less risk of complications but can still carry risks such as infection, pain, and tissue damage
Q: Which size of the fibroid is dangerous?
A. The size of the fibroid alone does not determine its risk or danger. However, larger fibroids can cause symptoms such as heavy bleeding, abdominal pain, and pain in nearby organs. Also, large fibroids can increase the risk of complications during surgery or other procedures. The location of fibroids in the uterus may also play a role in determining risk and danger. Therefore, it is essential to discuss the details of your condition with your doctor to determine the best course of treatment.
Q: Can fibroids affect pregnancy?
A. Yes, fibroids can affect fertility in some cases. Depending on the size, location, and number of fibroids, they can cause problems during pregnancy, such as miscarriage, premature birth, or problems with the baby’s position during delivery. In addition, fibroids can cause severe pain or inflammation during pregnancy that can concern both the mother and fetus. However, many women with fibroids can become pregnant without any problems.
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