Uterine Fibroids

Uterine fibroids, medically termed as leiomyomas, are the benign (non-cancerous) growths that may develop in the muscle of the uterus. The size of a fibroid may range from very tiny (less than one inch) mass to a melon sized mass. You may have one fibroid or many fibroids of different sizes. According to National Institute of Health (NIH), nearly 70% to 80% of women experience fibroids by the age of 50.

Uterine fibroids may drastically affect a women’s quality of life. A very large-sized fibroid expands the uterus to a size of 18 weeks pregnancy. In addition to this, the fibroids compress the bowel or the bladder leading to constipation or frequent urination.

The cause of uterine fibroids is still unclear. But the experts believe that the following factors may cause uterine fibroids.

  • Genetic mutations: In most of the cases, fibroids may occur as a result of genetic alterations in the healthy uterine muscle cells.
  • Hormonal changes: The hormones, estrogen and progesterone, causes the regeneration of uterine lining during each menstrual cycle. These hormones stimulate the growth of the fibroids in the uterus.
  • Pregnancy: Due to an increase in the levels of estrogen and progesterone during pregnancy, most of the pregnant women develop fibroids in the uterus which may shrink off after the pregnancy.
  • Other causes: The factors that help to maintain normal body mechanisms, such as insulin-like growth factor may also cause uterine fibroids.

In most of the cases, uterine fibroids do not cause any symptoms. The symptoms may occur depending on the location, size, and number of fibroids. The most common symptoms of uterine fibroids are listed below:

  • Heavy menstrual bleeding
  • Increased urination
  • Menstruation lasting more than a week
  • Pelvic pressure or pain
  • Difficulty emptying the bladder
  • Constipation
  • Swelling of the abdomen
  • Increased menstrual cramping
  • Backache or leg pains

The factors that increase the risk of uterine fibroids include the following:

  • Being a woman of reproductive age
  • Family history of uterine fibroids
  • Onset of menstruation at an early age
  • Diet high in red meat and lower in green leafy vegetables
  • Vitamin D deficiency
  • Consumption of alcohol
  • Being obese
  • Use of birth control pills

Uterine fibroids may not lead to life-threatening complications; however, it may cause discomfort. The presence of fibroids in the uterus may cause heavy blood loss during menstruation, and this may lead to iron deficiency anemia. In pregnant women, uterine fibroids may increase the risk of placental abruption, preterm delivery, and inadequate development of the fetus.

In most of the cases, uterine fibroid remains unnoticed and discovered incidentally during a routine check-up. If your doctor suspects uterine fibroids, any of the following tests might be ordered to confirm the diagnosis.

  • Ultrasound of the pelvis: The test provides detailed images of the internal organs and helps to identify the abnormal structures in the pelvis.
  • Imaging tests: If an ultrasound doesn’t identify the condition, your doctor might order other imaging tests such as pelvic MRI (magnetic resonance imaging), hysterosonography, hysteroslpingography, and hysteroscopy.
  • Blood tests: Your doctor might order complete blood count if you have menstruation for longer periods. The test identifies the presence of anemia and helps to prevent the complications.

The treatment for uterine fibroids depends on your age, the size of the fibroid, and extent or severity of the condition. Your doctor might order a combination of following treatments.

Medications: The medications are used to relieve the symptoms such as discomfort, pelvic pain, and massive blood loss (menstrual cycle). Your doctor might prescribe the drugs that shrink the fibroids. The drugs include:

  • Gonadotropin-releasing hormone (Gn-RH) agonists- to block the production of estrogen and progesterone
  • Progestin-releasing intrauterine device (IUD)- to relieve from heavy blood loss due to menstruation
  • Other drugs such as tranexamic acid, Nonsteroidal anti-inflammatory drugs (NSAIDs), and vitamin supplements.

Minimally invasive procedures: Your doctor might suggest certain procedures to destroy the uterine fibroids and include:

  • Uterine artery embolization: During the procedure, your doctor injects certain medications that stop the blood flow to the fibroids allowing them to shrink.
  • Myolysis: It is performed using laparoscope. During the procedure, high-energy electric current is passed that destroys the fibroids.
  • Laparoscopic myomectomy: The procedure involves removal of fibroids using a laparoscope. During the procedure, the fibroids are broken into small pieces and then removed.
  • Other procedures include hysteroscopic myomectomy and endometrial ablation.