Uterine Fibroids: What You Need to Know

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Uterine fibroids are common growths that develop in or on the wall of the uterus. They are made of muscle and connective tissue, and they are usually not cancerous. Uterine fibroids can cause symptoms such as heavy menstrual bleeding, pelvic pain, frequent urination, and pain during sex. However, some people with uterine fibroids have no symptoms at all.

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Uterine fibroids can vary in size, number, and location. They can grow inside the uterine cavity (submucosal fibroids), within the muscular wall of the uterus (intramural fibroids), under the outer lining of the uterus (subserosal fibroids) or on a stalk attached to the uterus (pedunculated fibroids). The size of uterine fibroids can range from a seed to a watermelon.

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Causes Of Uterine Fibroids

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The exact cause of uterine fibroids is not clear, but some factors may increase the risk of developing them. These factors include:

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Genetics: Uterine fibroids tend to run in families, and some fibroids have gene changes that differ from normal uterine cells.

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Hormones: Oestrogen and progesterone, the hormones that regulate the menstrual cycle, may stimulate the growth of fibroids.

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Age: Uterine fibroids are more common in people who are in their reproductive years, between 30 and 50 years old. They tend to shrink after menopause when hormone levels decline.

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Race: Uterine fibroids are more common and more severe in Black people than in other racial groups.

Other factors: Obesity, high blood pressure, diet, smoking, and lack of physical activity may also influence the development of uterine fibroids.

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Diagnosis Of Uterine Fibroids

The diagnosis of uterine fibroids is usually based on a pelvic exam and an ultrasound. A pelvic exam can detect changes in the shape of the uterus, while an ultrasound can provide a detailed image of the uterus and the fibroids. Other tests, such as MRI, hysteroscopy, or biopsy, may be needed to confirm the diagnosis or rule out other conditions.

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Treatments for Uterine Fibroids

The treatment of uterine fibroids depends on several factors, such as the size, number, and location of the fibroids, the severity of the symptoms, the age and reproductive plans of the person, and their preferences and overall health. Some possible treatment options include:

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• Watchful waiting: If the fibroids are small and do not cause any symptoms, they may not need any treatment. Regular check-ups may be recommended to monitor any changes in the fibroids.

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• Medications: Hormonal medications, such as birth control pills or progestin-releasing intrauterine devices (IUDs), may help reduce heavy bleeding and pain caused by fibroids. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, may also help relieve pain. However, medications do not shrink or eliminate fibroids.
  
  
• Surgery: If medications are not effective or if the fibroids are large or causing serious complications, surgery may be needed to remove them. The type of surgery depends on the location and size of the fibroids. Some common surgical procedures include:

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•  Myomectomy: This is a surgery that removes only the fibroids while preserving the uterus. It can be done through a large incision in the abdomen (abdominal myomectomy), through several small incisions using a camera and instruments (laparoscopic myomectomy), or through the vagina and cervix using a scope (hysteroscopic myomectomy).
  
  
• Hysterectomy: This is a surgery that removes the entire uterus along with the fibroids. It is a definitive treatment for uterine fibroids, but it also means that pregnancy is no longer possible. It can be done through an incision in the abdomen or vagina, or through small incisions using a laparoscope.

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•  Endometrial ablation: This is a procedure that destroys the lining of the uterus using heat, cold, electricity, or laser. It can reduce heavy bleeding caused by submucosal fibroids, but it does not affect other types of fibroids. It may also affect fertility.

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• Uterine artery embolization: This is a minimally invasive procedure that blocks the blood supply to the fibroids using tiny particles injected through a catheter into the uterine arteries. This causes the fibroids to shrink and die. It can relieve symptoms such as heavy bleeding and pain, but it may also cause complications such as infection or damage to nearby organs.

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• Focused ultrasound surgery: This is a noninvasive procedure that uses high-frequency sound waves to destroy the fibroids without affecting surrounding tissues. It is guided by an MRI and performed while the person is inside an MRI machine. It can reduce the size and symptoms of fibroids, but it may not be suitable for everyone.

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Conclusion

Uterine fibroids are common and usually not harmful, but they can affect the quality of life of some people. If you have symptoms of uterine fibroids, talk to your healthcare provider about the best treatment option for you.

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Sources

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Uterine fibroids - Symptoms and causes - Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288. Accessed November 9, 2023.

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Uterine Fibroids: Causes, Symptoms & Treatment - Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/9130-uterine-fibroids. Accessed November 9, 2023.

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Uterine fibroids - Diagnosis and treatment - Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/diagnosis-treatment/drc-20354294. Accessed November 9, 2023.