Fibroids

Overview

Uterine fibroids are common, noncancerous tumors that can develop in and on the uterus. While many people with fibroids experience no symptoms, those who do may suffer from heavy menstrual bleeding, abdominal pressure, back pain, frequent urination, and pain during sex. Though the exact cause is unknown, genetics and prolonged estrogen exposure are believed to be risk factors. Fibroids are often detected during routine pelvic exams or imaging and can be managed with medications or surgery if necessary.

What is Fibroids?
Uterine fibroids are growths composed of smooth muscle and fibrous connective tissue that develop in or on the uterus. They can vary in size, from as small as a grain of rice to as large as a melon, and may appear singly or in clusters. In some cases, fibroids may grow into the uterine cavity or extend outward on stalks.

Approximately 20% to 50% of women of reproductive age have fibroids, and up to 77% may develop them during their childbearing years. Despite their prevalence, only about one-third of fibroids are large enough to be detected during a physical exam, making many cases undiagnosed.

Fibroids can cause symptoms such as pain and heavy, irregular vaginal bleeding, but some individuals may have no symptoms and remain unaware of their condition. Treatment options typically depend on the severity of symptoms. Uterine fibroids, also known as leiomyomas or myomas, are noncancerous tumors that rarely develop into cancer and do not increase the risk of uterine cancer.

How Fibroids affect fertility?
Fibroids often remain undetected during healthy pregnancies. However, their size and location can impact pregnancy outcomes. Fibroids are typically categorized by their position in the uterus. For example, submucosal fibroids, located just under the lining of the uterus, are more likely to affect a person’s ability to conceive or maintain a pregnancy. In contrast, intramural fibroids, particularly smaller ones, generally have little to no effect on fertility or pregnancy.

Types of Fibroids
It’s necessary for an individual to know what type of fibroids she falls under. There are various types of Fibroids, but the most common type is intramural fibroid, and studies suggest many people have intramural fibroids. While it can become a part of your health at any stage but knowing what type of fibroids has caught you up is essential. Types of fibroids includes,

Intramural fibroids: This type of fibroids is the most common type of fibroids. They develop in the muscular wall of the uterus. These types of fibroids tend to grow larger and, in some cases, can stretch your uterus.

Pedunculated fibroids: When the subserosal fibroids develop a stem, an actual base that supports the tumour, the tumours formed during that time are known as pedunculated fibroids.

Subserosal fibroids: These types of fibroids grow on the outside of the uterus which is also referred as serosa. These kinds of fibroids grow bigger and make your uterus look larger on one side.

Cervical fibroids: These types of fibroids are rare and develop on the cervix which connects the uterus to the vagina.

Submucosal fibroids: These types of fibroids grow underneath the inner lining of the uterus. The middle layer of uterus is affected and this type is not really common. Women suffer through heavy bleeding, prolonged periods and difficulties with fertility.

The determination of the types is necessary for doctors to prescribe suitable medications to the individuals. The customization of the treatments is the right approach and the identification of symptoms will be the best information for the individuals. Severity of fibroids must be kept under immediate consideration to provide effective treatment for the betterment of an individual.

Symptoms of Fibroids

Most small fibroids are asymptomatic and usually only require regular monitoring by a healthcare provider. Many women with fibroids may not experience noticeable symptoms, while others may face significant issues that disrupt their daily lives. Common symptoms of fibroids include:

• Heavy or prolonged menstrual bleeding
• Intermittent bleeding between periods
• Abdominal discomfort or a feeling of fullness
• Pelvic pain
• Lower back pain
• Bladder issues such as frequent urination or difficulty fully emptying the bladder
• Bowel problems like constipation or straining during bowel movements
• In addition, fibroids can sometimes lead to infertility, complications during pregnancy, and pain during intercourse.

Causes of Fibroids

The exact cause of fibroids remains unclear. However, hormones and genetic factors may increase your likelihood of developing them. The causes of development of fibroids are still not clear. The following factors play a role in the development of fibroids:

Hormones: During the reproductive years when the hormone levels are higher, fibroids tend to develop. The oestrogen and progesterone levels play a major role in the formation and growth of fibroids as they thicken the lining inside the uterus during every menstrual cycle leading to development of fibroids.

Genetics: Research suggest that fibroids might get passed on through genes. If a woman has a family medical history of fibroids, her body is most likely to develop fibroids.

Extracellular matrix: Fibroids contain more ECM than the normal cells, the main role of the ECM is to stick all the cells together. ECM stores growth factors and helps in causing changes to the cells, hence increasing the risk of growth of fibroids.

Other growth factors: Substances like insulin-like growth factor which keeps the tissues in the body intact may influence the growth of fibroids.

These factors come with immense risk and many individuals tend to develop fibroids due to the imbalance making it necessary to take an immediate action on the treatment of fibroids.

Tests and Treatment for Fibroids

To understand what your body is trying to tell you, certain tests to diagnose the issue. A gynecologist can simply find out more about the fibroids after a pelvic exam, here are a list of tests that can detect fibroids in your body:

Ultrasound: In this test, the doctor will move the ultrasound device over your abdomen area and the soundwaves will get a picture of your uterus, while conforming that you have fibroids.

MRI: This test will give a more in-depth knowledge about the location and size of the fibroids. It can also help in identifying other types of tumours and help regulating treatment options. MRI can also provide information about the blood supply to the fibroids.

Hyster sonography: This type of test involves injecting sterile salt water also called as saline to delve deeper into the uterus through cervix. It helps in identifying fibroids present in lining of the uterus. This test is also called saline infusion sonogram.

Hysteroscopy: This type of test involves small lighted telescope inserted through the cervix into the uterus, followed by injecting saline which helps in expanding the uterine cavity, making it easier for the doctor to check the openings of fallopian tubes and walls of the uterus.

Hysterosalpingography: This type of test involves the usage of a dye which highlights fallopian tubes and uterine cavity on the X-Ray. This type can help in figuring the blockage in the fallopian tubes, if there’s any.

Doctors prescribe various medications for women with fibroids as well since they are supposed to undergo tests associated with fibroids, for accurate reading and treatment tests are performed accordingly if an individual is tested positive for fibroids.

There’s no specific treatment for fibroids, but many treatment options exist. The treatment plan is recommended on the basis of severity of symptoms, the location and size of the fibroids. Treatment includes:

When the fibroids are small, they won’t affect your life and your doctor will provide instructions related to regular monitoring or spotting of symptoms if they appear. This is most likely to happen during the menopause as the fibroids naturally shrink during that time.

Non- invasive procedure include incisions also called as surgical cuts. The procedure includes:

A non- invasive treatment option
MRI guided focused ultrasound surgery
Minimally invasive procedures: This treatment incorporates no cuts or small cuts. Focuses on faster recovery. Treatment options include:

Uterine artery embolization
Laparoscopic or robotic myomectomy
Endometrial ablation
Hysteroscopic myomectomy
Traditional surgical procedures include surgeries with bigger incision, such as:

Hysterectomy
Abdominal myomectomy
Prevention of Fibroids
Prevention of fibroids has not been discovered yet, but there are certain preventive measures that can reduce the risk of developing fibroids. Most common preventive measures are incorporating healthy and a balanced diet and adopting healthy lifestyle. Other preventions include:

• Limit alcohol consumption
• Considering pregnancy at younger age
• Avoid smoking
• Managing stress
• Lose extra inches
• Birth control pills
• Regular check-ups
• Incorporate fruits and vegetables in your diet
• Regular exercise

These preventions can help control the development of uterine fibroids and might lower the risk of chances of having them.