What Are Uterine Fibroids?
Uterine fibroids, also known as leiomyomas, are noncancerous growths composed of muscle and connective tissue that form in or on the walls of the uterus. They are one of the most common benign tumors in individuals assigned female at birth (AFAB), especially those aged 30 to 50. Fibroids can vary in size, from as small as a seed to as large as a watermelon, and may appear as single growths or clusters.
Types of Uterine Fibroids:
- Intramural Fibroids: The most common type, found within the uterine wall.
- Submucosal Fibroids: Grow beneath the inner lining of the uterus, potentially affecting menstrual bleeding.
- Subserosal Fibroids: Develop on the outer uterine wall and may extend into the pelvis.
- Pedunculated Fibroids: Attach to the uterus by a stalk or stem, resembling a mushroom.
Prevalence:
Fibroids are highly common, affecting 40% to 80% of people with a uterus. They typically occur during reproductive years and are rare before menstruation begins or after menopause.
Symptoms:
- Heavy or painful menstrual bleeding.
- Bleeding between periods.
- Bloating or fullness in the lower abdomen.
- Frequent urination due to bladder pressure.
- Pain during sex.
- Constipation or rectal pressure.
- Lower back pain.
- Abdominal enlargement, mimicking pregnancy.
Some people experience no symptoms and may not realize they have fibroids until a routine pelvic exam.
What Causes Uterine Fibroids and What Are the Risk Factors?
Causes:
While the exact cause of uterine fibroids is unknown, they are closely linked to the hormones estrogen and progesterone. These hormones promote fibroid growth, particularly during reproductive years. Fibroids often grow larger during pregnancy due to increased hormone levels and shrink after menopause when hormone levels decline.
Risk Factors:
Several factors can increase the likelihood of developing fibroids, including:
- Genetics: A family history of fibroids increases risk.
- Obesity: A higher body mass index (BMI) is associated with a greater likelihood of fibroids.
- Early Onset of Menstruation: Getting your period at a young age.
- Not Having Children: Pregnancy and childbirth may reduce the risk.
- Late Menopause: Extended exposure to estrogen.
Complications of Fibroids:
Although most fibroids are benign and do not lead to serious issues, they can cause:
- Severe pain or pelvic swelling.
- Heavy bleeding leading to anemia.
- Rare fertility challenges or pregnancy complications.
Pregnancy and Fibroids:
Fibroids can sometimes interfere with pregnancy by increasing the risk of preterm labor, C-section delivery, or placental abruption. If you are pregnant or planning to conceive, consult with your healthcare provider to monitor fibroid-related risks.
How Are Uterine Fibroids Diagnosed and Treated?
Diagnosis:
Fibroids are often identified during a routine pelvic exam. Your provider may recommend imaging tests to confirm their presence, size, and location, including:
- Ultrasound: A noninvasive imaging test using sound waves to create internal images.
- MRI (Magnetic Resonance Imaging): Provides detailed visuals of fibroids and surrounding tissues.
- Hysteroscopy: Involves inserting a camera through the cervix to view the uterine cavity.
- Sonohysterography: Uses saline and ultrasound to provide clearer uterine images.
- CT Scans and Laparoscopy: Help in assessing more complex cases.
Treatment Options:
Treatment varies depending on fibroid size, location, and associated symptoms. Your desire for future pregnancies also plays a significant role in deciding the best course of action.
Non-Surgical Treatments:
- Medications:
- Over-the-counter pain relievers like ibuprofen.
- Iron supplements for anemia caused by heavy bleeding.
- Birth control methods to manage heavy periods.
- Gonadotropin-releasing hormone (GnRH) agonists to shrink fibroids temporarily.
- Elagolix, a newer oral therapy, and tranexamic acid to manage heavy bleeding.
- These medications can relieve symptoms but may not eliminate fibroids.
Surgical Treatments:
- Myomectomy: Removes fibroids while preserving the uterus. Types include:
- Hysteroscopy: Fibroids are removed via a scope inserted through the vagina and cervix.
- Laparoscopy: Minimally invasive surgery through small abdominal incisions.
- Laparotomy: Open surgery with a larger abdominal incision.
- Hysterectomy: Complete removal of the uterus, recommended for severe cases. This is the only definitive cure for fibroids.
- Uterine Fibroid Embolization: A procedure to block blood flow to fibroids, causing them to shrink.
- Radiofrequency Ablation (RFA): Uses microwave energy to shrink smaller fibroids, typically for premenopausal individuals.
Choosing the Right Treatment:
Your provider will recommend treatment based on the severity of symptoms, fibroid size, and your reproductive goals.
Can Fibroids Be Prevented or Left Untreated?
Prevention:
There is no guaranteed way to prevent fibroids. However, you can lower your risk by:
- Maintaining a healthy weight.
- Having regular pelvic exams to monitor changes in your uterus.
When to Leave Fibroids Untreated:
Small fibroids that don’t cause symptoms often don’t require treatment. Instead, they may be monitored with periodic pelvic exams or ultrasounds.
Risks of Untreated Fibroids:
- Persistent heavy bleeding can lead to anemia.
- Untreated large fibroids may cause pelvic pain or pressure on other organs.
- Fibroids may rarely contribute to infertility.
Do Fibroids Shrink on Their Own?
Fibroids may shrink after menopause due to lower hormone levels. When this happens, symptoms often improve or disappear.
FAQs About Living with Fibroids
Can You Get Pregnant with Fibroids?
Yes, many individuals conceive successfully despite having fibroids. Monitoring during pregnancy is essential, as fibroids can grow due to elevated hormone levels.
Do Fibroids Cause Fatigue?
Fibroids themselves don’t cause fatigue, but anemia from heavy bleeding can lead to tiredness. If you feel fatigued, consult your provider to address potential anemia.
Do Fibroids Make Your Stomach Bigger?
Yes, large fibroids can cause abdominal bloating or distension, giving the appearance of pregnancy.
What Happens If Fibroids Return?
Fibroids can grow back after treatment, especially if the uterus is preserved. Regular follow-ups with your provider are important for long-term management.
How Large Do Fibroids Need to Be for Removal?
Size alone isn’t the deciding factor. Even small fibroids can cause significant symptoms depending on their location. Surgery is typically recommended if fibroids cause excessive bleeding, severe pain, or pressure on other organs.
Your Next Step: Care You Can Count On
If you’re experiencing symptoms of uterine fibroids or have concerns about your reproductive health, reach out to Aarogya Hospital. Our team of experienced professionals will work with you to create a personalized treatment plan that aligns with your health needs and future goals.
Schedule your consultation today and take control of your health.
