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Uterine Fibroids - What Every Woman Should Know?

Updated: Jul 28






Introduction 


Fibroids or uterine fibroids is one of the most common diseases among women. Various studies reflect that one out of childbearing five women may have uterine fibroids. 


Though, women under the age 20 may have less chances of having this condition. Noone may exactly predict the causes of fibroids. Although, they are generally caused by your body hormones or it may run in your genes. 


There can be an abnormal uterus growth called as fibroids which also refer to as tumors that may develop alongside fibrous tissues. Sometimes its size is too large, that it may lead to heavy bleeding and abdominal pain. 


Therefore, it is pivotal for every woman to know in-depth about uterine fibroids. So that the treatment can be initiated in the right direction. 


Uterine Fibroids - Definition 


Uterine fibroids also known by the medical terms myomas or leiomyomas are defined as the tumors that grow on the uterus. Women of childbearing age [ generally between 30-40 age group] have more chances of having this condition. 


Our uterus consists of muscles. Fibroids grow on these muscles and mainly bulges from in or out of the uterus. However, it may become difficult to assess if the uterus mass is a cancerous tumor or a common fibroid. 


One person can have one or sometimes multiple fibroids. It is vital to understand that they can be of the size of a seed. You may need a microscope in order to see them. However, they can sometimes grow really large to that of the size of a grapefruit. Also, they can be very large and can fill your entire uterus. 


Various types of fibroids 

Categorically there are five main types of uterine fibroids which are discussed below:


  • Subserosal Fibroids: These are the fibroids that commonly occur at the exterior of your uterus. If they become large, your uterus will look bigger. 

  • Intramural Fibroids: They are found in the muscle layers of your uterine wall. These fibroids have the capacity to stretch your uterus. 

  • Pedunculated Fibroids: A stem or slender base can be developed in the case of Subserosal fibroids. In this case, they are called Pedunculated fibroids 

  • Submucosal Fibroids : These fibroids are touted as rare ones that grow into your uterus. Only 5% of women account to have these uterine fibroids. 

  • Cervical Fibroids: These are the fibroids that develop on your cervix [ that connect uterus to your vagina]



Who has the more risk of getting fibroids?


Fibroids are known to be non-cancerous and have very less chances of developing into cancer. Though, they should not be ignored or taken lightly. 


Most women may have this condition sometimes in their life. Researchers believe in the fact that about 80% of the women may have at least one uterine fibroid by the age 50. 


There are multiple factors that play a pivotal role in aggravating women's risk of having uterine fibroids. Some of the most common factors includes:


  • Age: Fibroids are more common in women of age group 30-40 through the menopause. However, they usually shrink after menopause. 

  • Obesity: Women who are on the heavier side of weight have more risk of developing this disease. This risk is generally two times more than that of an average woman. 

  • Family history or genes: sometimes certain medical conditions run in your genes. And, fibroids is no exception. Hence, having a medical history aggravates your risk. These types of women have exactly three times more risk of developing this condition. 

  • Food Habits: Excess eating of ham and red meat is linked directly with the risk of developing uterine fibroids. Though, women with this condition should eat plenty of leafy or green vegetables. 

  • Ethnic Origin: Studies on fibroids shows that black women have more chances of developing this condition. 


Causes of Uterine Fibroids 


The growth of fibroids can vary based on the pregnancy. Though, they are more likely to occur during the first trimester of your pregnancy. 


However, in case of this medical condition, the exact cause may not be known. Although factors such as hormones, genetics, extracellular matrix mainly contribute to this condition. 


  • Hormones: Two hormones namely progesterone and estrogen are known to accelerate the growth of this condition. These hormones caused the tissues lines to become thick during the menstrual cycles. Fibroids usually contain cells that progesterone and estrogen bind the muscle cells of the uterus. These fibroids usually shrink after your menopause. 

  • Gene Factors: There are various fibroids that contain changes in your genes from that of uterus muscle cells. Hence, genetic factors plays a pivotal role in aggravating the chances of uterine fibroids 

  • Extracellular Matrix or ECM: This is a material that makes all the cells stick together. Increase of ECM in fibroids converts them into fibrous. 


Uterine fibroids Symptoms 


It is not easy to identify the exact symptoms of uterine fibroids. The symptoms usually depend on several factors including number of tumors, location of tumors and the size of tumors. 


For example; submucosal fibroid is mainly recognised by the symptoms like difficulty in conceiving and heavy menstrual bleeding. Though, if your tumor is tiny, the symptoms may not be visible. Moreover, the symptoms are also not sometimes visible if you are not going through menopause. It happens because progesterone and estrogen levels drop in such situations. They can accelerate the fibroid growth. 


Although, the most common visible symptoms of uterine fibroids include:


  • Menstrual clots 

  • Heavy bleeding during periods 

  • Increase in menstrual cramping 

  • Pain in your lower back or pelvis 

  • When your menstruation stays longer than needed 

  • Pressure in your lower abdomen 

  • Fullness feeling in your lower abdomen 

  • Enlargement of swelling in your abdomen 

  • Feeling of pain during the intercourse 

  • Increase in urination 

  • Constipation 

  • Problems like infertility or miscarriages 


Among all the above-mentioned symptoms of fibroids , menstrual cramps and abnormal period bleeding are considered as most common symptoms. Though, there are certain cases where women with this condition can conceive naturally. 


But some women may experience several reproductive issues like infertility or premature birth. Hence, it is important to recognise the symptoms of uterine fibroids at an early stage and seek medical help.  


Diagnosis of Uterine Fibroids 


In most cases, a doctor discovers the condition of uterine fibroids with the help of a pelvic exam. He determines your condition by first asking for the symptoms as a part of your diagnosis. Moreover, there are multiple tests that are required to confirm fibroids. 


You may have to undergo the following tests to check the location or severity of this medical condition. 


  • Ultrasound: In ultrasound, the sound waves are used to get an exact picture of your uterus. It helps in confirming the measurement of fibroids.a doctor can move a transducer [ ultrasound device] over the stomach or it is placed inside the vagina. This helps in getting pictures of the uterus.

  • Lab Tests: In case of irregular period bleeding, blood tests may be needed. Blood tests are used to negate the possibilities of anemia, thyroid or bleeding disorders.

  • MRI: Magnetic Resonance Imaging can help doctors find the exact location and size of fibroids. This test also helps in finding several types of tumors and to determine the right line of treatment.

  • Hysterosonography: This method uses saline [ sterile salty water] in order to expand the space of your uterus. It can easily help in getting images of uterus lining and submucosal fibroids. 

  • Hysterosalpingography: These tests mainly make use of a dye for highlighting the uterine cavity. The test is majorly recommended in case of infertility. 

  • Hysteroscopy: In this exam, a doctor will insert a lighted telescope known as a hysteroscope. This would be inserted into the uterus through the cervix. It will expand your uterus cavity and help a doctor check your uterus walls. 


Management and treatment of uterine fibroids 


Treatment of the condition of uterine fibroids may vary on the basis of size, location and the number of fibroids. Though, if you are not experiencing any type of symptom, you may not need any treatment. 


If the fibroids are small, they can be left untreated. In such cases, your medical provider can suggest monitoring your uterine fibroids. In the case of symptoms like anemia, excess bleeding, urinary tract, bowel problems, you need to undergo treatment. 


The treatment plan basically depends on several factors like:


  • Number of fibroids 

  • Size of fibroids 

  • Location of fibroids 

  • Symptoms 

  • Desire of keeping the uterus 


Though, an ideal treatment option also depends on your pregnancy plans. You can also talk to your doctor about your fertility and pregnancy agenda. The common treatment options for fibroids include:


Medications 


  • Iron Supplements: In case you suffer from anemia because of excess bleeding, you may be suggested to take iron supplements 

  • Over the Counter Medications: These types of  medications help in managing discomfort and pain caused from fibroids.

  • Birth Control : There are several birth control options that assist with fibroid symptoms like heavy period bleeding or menstrual cramps. Variety of these birth control option includes pills, injections and rings

  • Oral Therapy: A new oral therapy called Elagolix helps in managing heavy period bleeding among people who have not yet experienced menopause. There is another type of oral therapy known as tranexamic acid that helps in the treatment of heavy bleeding in women with uterine fibroids.

  • Ulipristal Acetate; This is a type of medicine that is helpful in treating fibroids. Though, this medicine would only be prescribed in case of moderate or heavy symptoms. This medicine also works for women who haven’t yet reached the menopause 


Surgery 


Surgeries are required for the condition of uterine fibroids especially when the symptoms are severe and the medicines are not working. 


There are several types of procedures that doctors may use to treat fibroids. Though, there are various factors that influence your decision of choosing the right kind of surgery for uterine fibroids. Among these factors, your will of future pregnancy plays a pivotal role. Certain surgical options also help in preserving the uterus so that you can conceive in the future. However, in other conditions, you may be required to remove your uterus. 


Some of the most popular surgical options for the treatment of uterine fibroids includes:


  • Myomectomy: Thi is a surgical procedure where fibroids are removed. This procedure is of various types. The procedure that will work best in your case will depend on factors like the size of your fibroids, its location and types. The most popular myomectomy procedure includes:

  

  •  Hysteroscopy: In this case, a thin, tubelight tool called scope is inserted through vagina into the uterus. This scope is used to remove the fibroids.

  • Laparoscopy: This is a procedure where the surgeon makes a large incision in the abdomen to remove fibroids. 


  • Hysterectomy: The uterus is removed in this surgical procedure. It is best suited for women who have no future pregnancy plans. When the uterus is removed, a fibroid will not come again. Moreover, your symptoms will alo vanish. Though, when your ovaries are left in its place, you won’t enter the menopause stage. This surgical procedure is generally preferable in women having high bleeding or large fibroids.

  • Uterine Fibroid Embolization: This is a procedure which is performed by your interventional radiologist with the assistance of a gynecologist. A small catheter will be placed inside the uterine artery and small particles are injected. This will help in removing the blood flow from your artery to fibroid. 

  • Radiofrequency Ablation: In this procedure, microwave energy is being used for the treatment of fibroids. This surgery is most ideal for people who haven’t yet reached their menopause stage. 


Conclusion 


Uterine fibroids is a condition that can happen to any woman. And, its symptoms can’t be ignored or taken lightly. Talking to your healthcare professional and choosing the right line of fibroid treatment would help eliminate the severity or repercussions of this condition. 



Frequently Asked Questions 


Can I conceive in case I am having uterine fibroids?


Yes, you can conceive even if you are having uterine fibroids. If you are already pregnant and have fibroids, your medical provider will make an ideal monitoring plan for the condition. As in pregnancy, the body releases hormones in elevation that can easily support your pregnancy. 


Can fibroids go away automatically?


After menopause, fibroids can automatically shrink in some women. This may also happen because of the decrease in your hormones. Moreover, small fibroids with no or less symptoms may not need any treatment. 


Which size of uterine fibroid is considered normal?


A fibroid that is usually less than 1-5 cm length would be considered normal. These kinds of fibroids are generally of the size of a cheery or pea. 


Which foods can cause uterine fibroids?


Foods like red meat or beef can cause uterine fibroid. Moreover, vitamin D deficiency can also lead to the condition of uterine fibroids. 


Can uterine fibroids stop my periods?


In rare cases, periods get stopped by uterine fibroids. They tend to increase menstrual pain and can cause heavy bleeding. This can also lead to the irregularity of your menstrual cycle. 


Do fibroids come out in the form of clots?


Yes, uterine fibroids can come out in the form of clots. As they impact your menstrual blood flow and can lead to heavy flow inside the endometrium. Hence, even small fibroids have the ability to cause large clots during periods. 


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