Uterine fibroids are non-cancerous growths that can appear in or around the uterus during the childbearing years. They are also called leiomyomas or myomas. These growths are associated with an increased risk of developing uterine cancer but they themselves do not usually become cancerous. Fibroids can be tiny or very big and they might cause symptoms that range in severity from patient to patient. This is a very common condition, and many women will have fibroids at some point in their life.
If the uterine fibroids are small, they might not cause any symptoms. However, location can play a key role in experiencing symptoms related to these growths. Even small fibroids can cause significant discomfort if they are located in the right places inside the body. The most common symptoms associated with fibroids are:
Fibroids are categorised by their location. Intramural fibroids grow inside the muscular layer of the uterine wall. Submucosal fibroids can bulge into the uterine space itself. Subserosal fibroids grow on the outside of the uterus or grow from the inside of the uterus to the outside.
The cause of fibroids is not well-understood. There are some factors that seem to be related to them, however:
It is currently believed that these growths develop from a stem cell that is contained in the smooth muscular tissue of the uterus. The single cell that is not behaving correctly can divide many, many times, making a rubbery mass of tissue that should not be there.
The risk factors for fibroids are:
Uterine fibroids that are small might have to be diagnosed with imaging done by ultrasound. Larger fibroids can also be felt through external or internal palpation in most cases. Lab tests might also be done to look at anaemia and some other common side effect of fibroids that have grown larger and more complex. An MRI can also be used to look at the shape and location of the fibroids.
In cases where there are many fibroids to collect information about, hysterosonography or hysterosalpingography can be used to allow for clear images of the fibroids. The first imaging process uses saline water to make it easy to see images of the growths in the uterus, while the other uses dye injected into the uterine cavity to get a clear picture of any growths that are present in the uterine region.
It is not usually possible to prevent fibroids. If you have a family history of this condition, you might want to avoid drinking a lot of alcohol and be sure to eat a well-rounded diet.
Treatment of this condition is usually conservative as most fibroids do not cause issues with infertility and many women do not experience any symptoms related to their presence. However, some women can benefit from taking gonadotropin-releasing hormones that are agonists to the oestrogen and progesterone that are causing the fibroids to grow. These medications place women in a menopause-like state.
In some cases, the insertion of an IUD can also help manage symptoms and reduce the size of fibroids. There are medications that can be taken to help control the bleeding related to heavy periods that are caused by the presence of fibroids. Some women also benefit from being placed on oral contraceptives to help control the cycle of menstruation hormones their body is flooded with throughout the month.
In some cases, surgical intervention is necessary to remove fibroids that are causing pain or excessive bleeding every month. These surgeries might be done just to remove the fibroids, or in advanced cases, the uterus might also need to be removed. Radiofrequency ablation can sometimes also be used to destroy the fibroids without having to do a more invasive surgical procedure.