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Fibroids are non-cancerous growths of the uterus, made up of muscle and fibrous tissue. They are also known as uterine myomas or leiomyomas. Not all fibroids cause symptoms. Women who have symptoms (1 in 3 women) may experience heavy menstrual bleeding, pain during periods, lower back pain, abdominal mass, frequent need to urinate, constipation, pain during intercourse, or, rarely, infertility.
The exact cause of fibroids growing in the uterus is unknown. They are linked to estrogen and progesterone hormones produced by the ovaries. They usually develop during the reproductive years of a woman and sometimes shrink in the post-menopausal period. Uterine fibroids and Endometriosis are identified in every 2 in 3 women at some point in their lives, sometimes appearing together, makes it a standard condition for most women. They are most common in women ages 30 to 50. Mostly thought to occur in overweight and obese women as the levels of estrogen are higher.
Types Of Fibroids
Fibroids can grow anywhere in the uterus and vary in size. The main types are:
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Intramural
Which grows inside the muscle layer of the uterus, the ones which usually cause heavy menstrual bleeding and pain.
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Subserosal
The ones that grow on the outer part of the uterus have a tendency to grow into larger ones without causing many symptoms.
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Submucosal
Fibroids develop in the inner lining of the uterus, which almost always causes symptoms.
Diagnosis Of Uterine Fibroids
The diagnosis is made mainly by the symptoms, examination, and ultrasonography combined together. Sometimes MRI may be required for mapping and confirmation of the location of fibroids.
Complications Of Fibroids In The Uterus
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Fibroids if present during pregnancy, can sometimes lead to problems like miscarriages, bleeding episodes during pregnancy, problems with growth and development of the baby, severe intolerable abdominal pain during pregnancy, premature delivery, difficulties during delivery, increased chances of caesarean section, excessive blood loss after delivery (PPH).
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Fibroids are rarely a cause of infertility. It might block the fallopian tube causing problems with conception.
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If the symptomatic fibroids are not treated, complications like severe anaemia due to heavy menstrual bleeding can happen.
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It can press on the ureters (urine flow) and cause kidney problems.
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<0.01% chance of changing into a cancerous condition (leiomyosarcoma).
Advanced Fibroids Treatment And Personalised Care
All fibroids do not need surgery to remove them. If you have no or minor symptoms, they can be managed with medications alone. There are medications to alleviate the symptoms, which can be directed only at the symptoms alone, or medications to shrink the size of the fibroids. These have to be discussed and treated individually, as your gynaecologist will be the best person to assess the best treatment options for your condition depending on your age, family completion status, and main symptoms.
The fibroids, which cause symptoms, have failed medical management, and are affecting your quality of life significantly, are to be treated surgically. The surgical fibroids treatment options are:
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Myomectomy (fibroid removal)- laparoscopic or abdominal
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Hysterectomy– laparoscopic or abdominal
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Hysteroscopic resection of fibroids
Newer, nonsurgical procedures using ultrasound guided or MRI guided focused ultrasound, such as uterine artery embolization have their own benefits and risks, which will be discussed as part of management plan. At Manipal hospitals, Mysore, experienced gynecologists take extra care in discussing the condition with our patients before proceeding with the treatments accordingly.
Manipal Hospitals, Mysore
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