Uterine fibroids, also known as leiomyomas or myomas, are non-cancerous growths that develop in the uterus, affecting a large number of women.
Types of Fibroids
Uterine fibroids can appear in various sizes, shapes, and locations within the uterus. They can grow inside the uterus, on its outer surface, within its wall, or attached to it by a stem-like structure. Fibroids range from small, pea-sized growths to large fibroids that fill the pelvis or abdomen.
Causes and Risk Factors
The exact cause of fibroid development is still unclear, but research suggests that hormonal imbalances, particularly estrogen and progesterone, play a role in their growth. Factors like genetics, hormonal fluctuations, and certain medications, such as estrogen-containing birth control pills, may contribute to the development or growth of fibroids. Fibroids commonly occur in women aged 30-40 years, but they can affect women of any age.
Common Symptoms
Fibroids can cause various symptoms, including changes in menstruation, such as longer, more frequent, or heavy periods. Other symptoms include menstrual pain (cramps) and vaginal bleeding outside of menstruation, anemia due to excessive blood loss, abdominal or lower back pain, pain during sexual intercourse, pressure, difficulty urinating, frequent urination, constipation, rectal pain, difficult bowel movements, abdominal cramps, an enlarged uterus, and abdomen. Fibroids can also lead to miscarriages or infertility. It’s important to consult with your healthcare professional for proper evaluation if you experience any of these symptoms.
Possible Complications
While most fibroids do not cause complications, there are some risks associated with their presence. Fibroids attached to the uterus by a stem may twist, leading to pain, nausea, or fever. Rapidly growing or degenerating fibroids can also cause discomfort. Although rare, fibroids can be linked to cancer. Additionally, large fibroids may result in swelling of the abdomen, making it challenging to perform thorough pelvic exams. In some cases, fibroids can contribute to infertility, but other factors should be explored before attributing infertility solely to fibroids.
Diagnosis
The first signs of fibroids may be detected during a routine pelvic exam. To gather more information, your healthcare professional may recommend additional tests such as ultrasonography, hysteroscopy, hysterosalpingography, sonohysterography, or laparoscopy. Imaging tests such as magnetic resonance imaging (MRI) and computed tomography (CT) scans are rarely needed but may be used for tracking fibroid growth over time.
Uterine Fibroids and Pregnancy
Uterine fibroids generally do not pose significant problems for pregnant women and their fetuses. However, during pregnancy, fibroids may increase in size due to increased blood flow to the uterus. This can lead to discomfort, pressure, or pain. There is a slightly increased risk of complications such as miscarriage (before 20 weeks) and preterm birth, as well as breech birth (when the baby is positioned feet-first instead of head-first).
Treatment Options
The choice of treatment depends on factors such as the woman’s preferences and the medical advice of healthcare professionals regarding the size and location of the fibroids.
Medications
Medications can be used to manage fibroids and reduce heavy bleeding and painful periods. Medications used for fibroids include birth control pills and other hormonal contraceptives, gonadotropin-releasing hormone (GnRH) agonists, and progestin-releasing intrauterine devices (IUDs).
Myomectomy is a surgical procedure that involves removing fibroids while preserving the uterus. It allows women to potentially conceive and bear children. Myomectomy can be performed through different methods, including laparotomy, laparoscopy, and hysteroscopy.
Uterine Artery Embolization (UAE) is an alternative treatment that involves blocking the blood vessels supplying the uterus, effectively reducing blood flow to the fibroids. This procedure is performed by a specially trained radiologist and can be done as an outpatient or with a short hospital stay.
Hysterectomy, the complete removal of the uterus, may be necessary in cases where other treatments are not feasible or when there is persistent pain or abnormal bleeding.
Magnetic Resonance Imaging-Guided Ultrasound Surgery is a newer approach being studied to determine its long-term effectiveness in destroying fibroids using ultrasound waves guided by magnetic resonance imaging (MRI).
Regular checkups with healthcare professionals and staying aware of warning signs and changes are essential for women with uterine fibroids. While fibroids are generally benign and often require no treatment, some cases may warrant medical intervention.
At Burjeel Hospital in Abu Dhabi, our experienced healthcare professionals provide comprehensive care for women with uterine fibroids. We offer a range of diagnostic tests, treatment options, and personalized care plans to meet the individual needs of our patients. If you have uterine fibroids or suspect you may have them, don’t hesitate to schedule a consultation with our expert team.
