What you need to know about uterine fibroids in women
What are uterine fibroids?
Uterine fibroids are cells that grow from the uterine muscle. There are several types of uterine fibroids. They can grow on the wall of the uterus and put pressure on the bladder or bowel. They can also grow inside the wall of the uterus, or even emerge from the wall of the uterus as a mass hanging by a thin leg in the uterine cavity or ectopic.
Fibroids can be as small as a pea bean or as large as a football, and they are always benign in approximation, regardless of their size. Fibroids do not increase your risk of cancer. If the size of the fibroid is clearly large or if it grows on the outer surface of the uterine wall, we can sometimes push the uterus back. The growth of the uterus may compress the bladder or bowels.
In rare cases, if the fibroid is large or grows in the lower part of the uterus, the uterus may close. In this situation, pregnant women may need to have a cesarean delivery.
What causes uterine fibroids? Why do women get fibroids?
No one knows exactly what causes uterine fibroids, but changing estrogen levels seems to play a role in their growth. When estrogen levels are high because of pregnancy or taking birth control pills, for example, the rate of fibroid growth increases. About 20 percent of women of childbearing age have fibroids, but few women under age 30 have them. They rarely appear in young girls before they menstruate.
As women approach menopause and estrogen levels drop, their uterine fibroids are likely to decrease or almost disappear. We have found no factors to increase the risk of fibroids but women of childbearing age.
What are the symptoms of fibroids in women?
Many women do not even know they have fibroids. If symptoms are obvious, they may include:
A painful menstrual cycle
A menstrual cycle that is very bleeding and persistent for a long time (which can lead to iron deficiency or anemia)
Frequent urination or discomfort when urinating due to pressure on the bladder
Feeling of fullness or pressure in the lower abdomen
Pelvic pain
Back pain
Constipation
Infertility (inability to conceive)
Miscarriage
How is it diagnosed?
We detect most uterine fibroids during a routine internal examination, when your doctor notices lumps in the uterus or if the shape of the uterus is abnormal. If you have symptoms of frequent pain, your doctor may order an ultrasound to distinguish fibroids from tumors and other lumps that appear in the pelvic area. If fibroids have developed on the inner lining of the uterus or inside the uterine cavity, we can also see them with a hysteroscopy, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside the uterus.
How are fibroids treated?
Most fibroids do not require treatment unless the symptoms are bothering you and causing problems. Your doctor will make a recommendation based on:
How much pain or blood you lose during your period.
The rate of growth of the fibroids
Your age, because fibroids shrink as you enter menopause
Your desire to have children
In rare cases, fibroids can contribute to infertility and, in some surgical options, can cause women to become infertile and unable to reproduce. If you need treatment, there are several options you can consider (some of which are more widely available). These include:
Endometriosis removal: we can do this for fibroids that have developed in the inner layer of the uterus using a laser, hot-wire loop, electromagnetic waves, or hot-balloon treatment.
Electrolysis of the fibrous tumor (electrotherapy) can be performed during a simple operation called laparoscopy or endoscopy. The surgeon inserts a needle-like tool or probe or sends a direct electric current into the fibroblast and infects both the fibroblast and the surrounding blood vessels.
Surgical removal procedure: This is an operation to remove the fibroids and leave the uterus intact. We use this procedure for women who still plan to have children. It is actually a major challenge and can cause more blood loss than a hysterectomy.
Laparoscopic removal of fibroids can be used sometimes, especially when the fibroids grow outside the uterine cavity. If the fibroids develop inside the uterine cavity, the hysterectomy which is inserted through the vagina will perform the fibro-hysterectomy.
Hysterectomy: an operation to remove the entire uterus. As a result, women cannot have children. Although hysterectomy has been the standard option to treat uterine fibroids, we strongly recommended primarily it for women who are near menopause, or women who are not concerned about infertility and the inability to have children, or who suffer from severe symptoms.
Uterine fibroid embolization (UFE) is a procedure performed by a radiologist. (For women who do not plan to become pregnant in the future, UFE is an alternative to fibroid surgery.
Medications: Women can use medications that reduce estrogen levels to temporarily reduce or stop fibroid growth, especially before surgery. However, because these medications often cause menopausal symptoms, such as hot flashes, vaginal dryness and low bone density, the treatment cycle usually lasts only 3 to 6 months. Fibroids often continue to develop once this hormone therapy is stopped.
Herbal remedies for fibroids: Herbs and green tea have been shown to treat uterine fibroids and help reduce the fibroid tumor.
Some treatments are more effective than others. For example, after fibroids are removed, there is a 25% chance that new fibroids will develop within 10 years of surgery. The artery blocking the tumors prevents them from growing again, but we need more research on this relatively new technique before any conclusions can be drawn. The only procedure that guarantees no recurrence of fibroids is a hysterectomy.
Questions and answers about Uterine Fibroids:
Can fibroids in women cause fertility problems?
There is evidence linking fibroids to low fertility. We have associated them with an increased risk of miscarriage in the first and second stages of pregnancy, increasing the likelihood of premature birth. We have also linked fibroids to low success rates of fertility treatments.
However, there is no agreement on how and why this happens, as some women become pregnant and have a successful pregnancy even though they have relatively large fibroids in the uterus. One theory is that fibroids mutilate the uterus in a way that affects pregnancy or fertilization, while the other theory states that they impair the ability to tolerate and sustain a pregnancy because the tumor affects blood flow. If you know you have uterine fibroids and are having problems with pregnancy, see your doctor for a referral to a fertility specialist. The fertility specialist will first identify and treat other potential causes of the fertility problem.
Fibroids in women alone can cause fertility problems in less than 3% of women. If this is the case, your doctor may advise you to continue trying to conceive normally for up to two years, unless you are over the age of 34. Here, it is best to try treatment as soon as possible, as fertility declines rapidly with age.
You are unlikely to be asked to undergo artificial insemination immediately, as there is little evidence that this improves your chances of a successful pregnancy. There is also no evidence that surgery helps women with fibroids get pregnant and have a successful pregnancy. Your doctor will help you decide the best treatment option for your condition.
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If pain or bleeding persists or gets worse during your period because of fibroids, see your doctor right away for options. In the meantime, you can try the following to relieve discomfort:
Take painkillers to relieve cramping and soreness.
Rest in bed when symptoms worsen
Eat iron-rich foods (such as lean red meat and spinach) and iron supplements (if advised by your doctor) to avoid anemia from heavy menstrual bleeding
Put a warm water bottle on your stomach or take a hot bath to relieve pain
