Fibroids: Causes, Symptoms, and Treatments
Uterine fibroids, also known as uterine leiomyomas or fibroids, are benign smooth muscle tumors of the uterus. Most women have no symptoms while others may have painful or heavy periods. If large enough, they may push on the bladder causing a frequent need to urinate. They may also cause pain during sex or lower back pain. Occasionally, fibroids may make it difficult to get pregnant, although this is uncommon.
Uterine fibroids are very common non-cancerous (benign) growths that develop in the muscular wall of the uterus. They can range in size from very tiny (a quarter of an inch) to larger than a cantaloupe. Occasionally, they can cause the uterus to grow to the size of a five-month pregnancy. In most cases, there is more than one fibroid in the uterus.
According to the National Institutes of Health (NIH), about 70 to 80 percent of women have them by the age of 50.
Some of the symptoms of uterine fibroids include:
Excessive bleeding: One of the most common symptoms of uterine fibroids is excessive menstrual bleeding. This can be a terrible inconvenience. Severe bleeding may cause you to stay home from work, school, or other activities while you recover. The bleeding can also last a lot longer and may take place in between periods.
Bloating: Uterine fibroids can cause you to always feel “full” in your lower abdomen. This is often referred to as pelvic pressure or pelvic pain. This occurs when fibroids grow and put pressure on the organs surrounding the uterus. The severity of the pelvic pressure depends on the location of the fibroids.
Frequent urination: The uterus is not the only organ affected by fibroids. They can also put pressure on the bladder, causing you to take frequent trips to the bathroom. Fibroids may put pressure on the bowel, causing constipation or bloating.
Other symptoms of uterine fibroids include pain during sexual intercourse, pain in the back of the legs, or anemia.
Types of Fibroids
Intramural fibroids are the most common type of fibroid. These types appear within the lining of the uterus (endometrium). Intramural fibroids may grow larger and actually stretch your womb.
Subserosal fibroids form on the outside of your uterus, which is called the serosa. They may grow large enough to make your womb appear bigger on one side.
When subserosal tumors develop a stem (a slender base that supports the tumor), they become pedunculated fibroids.
These types of tumors develop in the inner lining (myometrium) of your uterus. Submucosal tumors are not as common as other types, but when they do develop, they may cause heavy menstrual bleeding and trouble conceiving.
What Causes Fibroids?
It is unclear why fibroids develop, but several factors may influence their formation.
Estrogen and progesterone are the hormones produced by the ovaries. They cause the uterine lining to regenerate during each menstrual cycle and may stimulate the growth of fibroids.
Fibroids may run in the family. If your mother, sister, or grandmother has a history of this condition, you may develop it as well.
Pregnancy increases the production of estrogen and progesterone in your body. Fibroids may develop and grow rapidly while you are pregnant.
Can fibroids turn into cancer?
Fibroids are almost always benign (not cancerous). Rarely (less than one in 1,000) a cancerous fibroid will occur. This is called leiomyosarcoma (leye-oh-meye-oh-sar-KOH-muh). Doctors think that these cancers do not arise from an already-existing fibroid. Having fibroids does not increase the risk of developing a cancerous fibroid. Having fibroids also does not increase a woman’s chances of getting other forms of cancer in the uterus.
What if I become pregnant and have fibroids?
Women who have fibroids are more likely to have problems during pregnancy and delivery. This doesn’t mean there will be problems. Most women with fibroids have normal pregnancies. The most common problems seen in women with fibroids are:
- Cesarean section. The risk of needing a c-section is six times greater for women with fibroids.
- Baby is breech. The baby is not positioned well for vaginal delivery.
- Labor fails to progress.
- Placental abruption. The placenta breaks away from the wall of the uterus before delivery. When this happens, the fetus does not get enough oxygen.
- Preterm delivery.
Talk to your obstetrician if you have fibroids and become pregnant. All obstetricians have experience dealing with fibroids and pregnancy. Most women who have fibroids and become pregnant do not need to see an OB who deals with high-risk pregnancies.
How Are Fibroids Diagnosed?
You will need to see a gynecologist to get a pelvic exam. This exam is used to check the condition, size, and shape of your uterus. You may also need other tests, which include:
1.Ultrasound – Uses sound waves to produce the picture. The ultrasound probe can be placed on the abdomen or it can be placed inside the vagina to make the picture.
2.Magnetic resonance imaging (MRI) – Uses magnets and radio waves to produce the picture
3.X-rays – Uses a form of radiation to see into the body and produce the picture
4.Cat scan (CT) – Takes many X-ray pictures of the body from different angles for a more complete image
5.Hysterosalpingogram (hiss-tur-oh-sal-PIN-juh-gram) (HSG) or sonohysterogram (soh-noh-HISS-tur-oh-gram) – An HSG involves injecting x-ray dye into the uterus and taking x-ray pictures. A sonohysterogram involves injecting water into the uterus and making ultrasound pictures.
The best treatment option varies from one woman to the next. You will need to work closely with your healthcare provider to determine what is best for your situation.
Mild fibroid symptoms can often be treated with medications. Over-the-counter drugs such as ibuprofen can help reduce pain. You may also want to take an iron supplement if you are bleeding heavily to prevent anemia.
Your symptoms may be too severe for over-the-counter medications or supplements. In that case you may need to have a procedure to relieve the pain.
Surgical procedures, such as myomectomy or hysterectomy, can be used to treat uterine fibroids. Some women may also be candidates for Uterine Fibroid Embolization (UFE). This is a less invasive procedure that cuts off blood supply to the fibroids.
UFE is performed by interventional radiologists. They use X-ray equipment to guide them as they thread a thin tube into the blood vessels that supply blood to the fibroids. Then, small bubble-like materials are injected into the blood flow to block the vessels around the fibroids. This causes the fibroids to shrink. The procedure lasts less than an hour and is performed as an outpatient procedure.
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