Fibroids are abnormal growths which develop in or on a woman’s uterus. Sometimes, these growths (tumors) grow so big to cause severe abdominal pain and heavy vaginal bleeding. Is some cases fibroids do not present with any symptoms at all. They are typically benign (non-cancerous growths).
They are also known as Leiomyoma; Fibromyoma; Myoma.
It is not clear what really causes fibroids but a number of factors are known to influence the formation of fibroids. These include
- The use of hormonal contraceptive methods
- Family History of fibroids
- Age above 30 years
- Race (common in blacks)
Types of Fibroids
Intramural (these appear within the lining of the uterus ie the endometrium)
Subserosal (the appear on the outside of the uterus|)
Pedunculated (these are subserosal fibroids with a stem or a peduncle)
Myometrial (in the muscle wall of the uterus)
Submucosal (just under the surface of the uterine lining)
- lower abdominal pain radiating to the lower back
- heavy bleeding during and between menstrual periods
- menorrhagia ( prolonged menstrual flow)
- If the fibroids are very big one can experience pressure of fullness in the lower abdomen
One needs to see a medical doctor for a pelvic examination.
The basic diagnostic tool is a simple trans-abdominal ultrasound scan but other doctors prefer a trans-vaginal ultrasound scan
A visit to the doctor is recommended if one suspects that they might have fibroids. You may not need treatment at all if they are very small.
Some women with fibroids have no symptoms and may not need treatment. During a pregnancy, existing fibroids may grow due to the increased blood flow and estrogen levels. The fibroids usually return to their original size after the baby is delivered.
However treatment depends on the age of the patient and the size of the uterus.
In elderly post-menopausal women, an operation to remove the uterus can be done. However in women of child-bearing age, an operation can be done.
Surgery and procedures used to treat fibroids include:
Hysteroscopic resection of fibroids: Women who have fibroids growing inside the uterine cavity may need this outpatient procedure to remove the fibroid tumors.
Uterine artery embolization: This procedure stops the blood supply to the fibroid, causing it to die and shrink. Women who may want to become pregnant in the future should discuss this procedure with their health care provider.
Myomectomy: This surgery removes the fibroids. It is often the chosen treatment for women who want to have children, because it usually can preserve fertility. More fibroids can develop after a myomectomy.
Hysterectomy: This invasive surgery may be an option if medicines do not work and other surgeries and procedures are not an option.
Other forms of treatment include
- Birth control pills (oral contraceptives) to help control heavy periods
- Intrauterine devices (IUDs) that release the hormone progestin to help reduce heavy bleeding and pain
- Iron supplements to prevent or treat anemia due to heavy periods
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naprosyn for cramps or pain
- Short-term hormonal therapy injections to help shrink the fibroids
Complications of fibroids include:
- Severe pain or excessively heavy bleeding that may require emergency surgery
- Twisting of the fibroid, which causes a blockage in nearby blood vessels feeding the tumor (surgery may be needed)
- Anemia (low red blood cell count) if the bleeding is very heavy
- Urinary tract infections, if pressure from the fibroid prevents the bladder from fully emptying
- Cancerous changes called leiomyosarcoma (rare)
- In rare cases, fibroids may cause infertility. Fibroids may also cause complications if you become pregnant, although the risk is thought to be small
- Some pregnant women with fibroids may deliever a premature baby because there is not enough room in the womb.
- Some pregnant women with fibroids have heavy bleeding immediately after giving birth.
Fibroids in the past were called “stones of a disappointed womb” It was believed that they were caused by not falling pregnant since they were commonly found in Catholic Nuns who obviously had no children at ages above 30 years.
It was also discovered that the majority of women who had fibroids had no children hence the notion “stones of a disappointed womb” Today it is now known that fibroids can in actual fact cause primary and secondary infertility.