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Uterine Fibroids

What are Uterine Fibroids?

Uterine fibroids, also known as leiomyomas or myomas, are non-cancerous growths that develop in the muscular wall of the uterus. They can vary in size, ranging from small seedlings that are undetectable by the human eye to large masses that can distort the shape and size of the uterus. Fibroids are common among women of reproductive age and can cause a variety of symptoms depending on their size, number, and location within the uterus.

Where do fibroids grow?

Fibroids can grow anywhere in the uterus, including:

  • Subserosal fibroids: They develop on the outer surface of the uterus.
  • Intramural fibroids: They develop within the muscular wall of the uterus.
  • Submucosal fibroids: They develop into the uterine cavity.

Symptoms of Uterine Fibroids

Common symptoms of uterine fibroids include:

  • Heavy menstrual bleeding.
  • Pelvic pain or pressure.
  • Frequent urination.
  • Pain during intercourse.
  • Lower back pain.
  • Constipation or difficulty with bowel movements.

What do fibroids look like?

Fibroids can vary in appearance depending on their size and location. They may appear as smooth, round growths or have irregular edges. On imaging tests such as ultrasound or MRI, fibroids may appear as solid masses with distinct borders.

When to see a doctor?

It’s important to see a doctor if you experience symptoms such as heavy menstrual bleeding, pelvic pain, or changes in your menstrual cycle. Additionally, if you have difficulty getting pregnant or have concerns about fibroids impacting your fertility, it’s advisable to seek medical attention.

Causes of Uterine Fibroids

The exact cause of uterine fibroids is unknown, but several factors may contribute to their development, including hormonal imbalances, genetic predisposition, and estrogen and progesterone levels.

Risk factors of Uterine Fibroids

Risk factors for uterine fibroids include:

  • Age (most common in women aged 30-40).
  • Family history of fibroids.
  • African-American ethnicity.
  • Obesity.
  • Hormonal factors (e.g., estrogen and progesterone levels).

Complications of Uterine Fibroids

Complications of uterine fibroids may include:

  • Heavy menstrual bleeding leading to anaemia.
  • Pelvic pain or pressure.
  • Infertility or pregnancy complications.
  • Urinary or bowel problems.
  • Impact on quality of life.

Diagnosis of Uterine Fibroids

Uterine fibroids are typically diagnosed through a combination of medical history, physical examination, and diagnostic tests. Here’s an overview of the diagnostic process:

  • Medical history: The doctor will inquire about your symptoms, such as heavy menstrual bleeding, pelvic pain or pressure, frequent urination, or difficulty emptying your bladder. They may also ask about your menstrual cycle and any previous reproductive health issues.
  • Physical examination: During a pelvic examination, the doctor will feel the size and shape of your uterus. They may also check for any abnormalities or signs of fibroids.
  • Imaging tests:
    • Ultrasound: This is the most common imaging test used to diagnose uterine fibroids. A transvaginal ultrasound or abdominal ultrasound creates images of your uterus to identify the presence, size, and location of fibroids.
    • MRI (Magnetic Resonance Imaging): MRI provides detailed images of your uterus and surrounding structures, which can help determine the size and location of fibroids. It’s often used when more information is needed after an ultrasound.
    • Hysterosonography: This involves injecting saline into the uterus to expand it, making it easier to detect fibroids using ultrasound.
  • Other tests:
    • Hysterosalpingography (HSG): This test involves injecting a dye into the uterus and taking X-ray images to look for abnormalities in the uterine cavity, including fibroids.
    • Endometrial biopsy: If there are concerns about abnormal bleeding or other symptoms, a sample of the uterine lining may be taken for analysis to rule out other conditions.
  • Blood tests: Although there’s no specific blood test to diagnose fibroids, your doctor may order blood tests to check for anemia (low red blood cell count) if you’re experiencing heavy menstrual bleeding.

Once diagnosed, the treatment plan will depend on various factors, including the size, number, and location of the fibroids, as well as your symptoms and reproductive plans. Treatment options may range from watchful waiting and medication to surgical procedures such as myomectomy or hysterectomy.

Treatment of Uterine Fibroids

The treatment of uterine fibroids depends on factors such as the size and location of the fibroids, severity of symptoms, and your overall health and reproductive goals. Here are the common treatment options:

Observation:

  • If fibroids are small and not causing symptoms, your doctor may recommend monitoring them regularly without any specific treatment.
  • Regular check-ups may include pelvic exams and ultrasound scans to monitor changes in the size or symptoms of the fibroids.

Medications:

  • Pain relievers: Over-the-counter pain medications such as ibuprofen or acetaminophen can help alleviate pelvic pain or discomfort.
  • Hormonal therapy: Hormonal medications such as birth control pills, gonadotropin-releasing hormone agonists (GnRHas), or progestin-releasing intrauterine devices (IUDs) may help control heavy menstrual bleeding and reduce the size of fibroids.
  • Tranexamic acid: This medication can help reduce heavy menstrual bleeding associated with fibroids by promoting blood clotting.
  • Non-invasive Procedures:
  • Uterine artery embolization (UAE): In this procedure, small particles are injected into the blood vessels supplying the fibroids, cutting off their blood supply and causing them to shrink.
  • MRI-guided focused ultrasound surgery (MRgFUS): High-intensity ultrasound waves are used to heat and destroy fibroid tissue without incisions. This is a non-invasive procedure that preserves the uterus and is suitable for some women with symptomatic fibroids.

Surgical Treatments:

  • Myomectomy: This surgical procedure involves the removal of fibroids while preserving the uterus. Myomectomy may be performed through traditional open surgery, laparoscopy, or hysteroscopy, depending on the size and location of the fibroids.
  • Hysterectomy: In cases where fibroids are large, multiple, or causing severe symptoms that don’t respond to other treatments, removal of the entire uterus (hysterectomy) may be recommended. This is a definitive treatment that eliminates the possibility of fibroid recurrence.

Endometrial ablation: This procedure involves destroying the lining of the uterus (endometrium) to reduce menstrual bleeding. It’s not specifically a treatment for fibroids but may be considered for women with heavy menstrual bleeding who prefer to avoid surgery or who have other medical conditions that make surgery risky.

The choice of treatment depends on individual circumstances, including the desire for future fertility, severity of symptoms, and personal preferences. 

Why choose Shukan Hospital & IVF Centre in Ahmedabad for Uterine Fibroids treatment?

Shukan Hospital & IVF Centre offers comprehensive and personalized care for women with uterine fibroids. Our team of experienced gynecologists, radiologists, and surgeons utilize advanced techniques to diagnose and treat fibroids while prioritizing each patient’s unique needs and preferences.

How to prevent Uterine Fibroids?

While there is no guaranteed way to prevent uterine fibroids, certain lifestyle changes may help reduce the risk, including maintaining a healthy weight, exercising regularly, and managing stress levels.

FAqs

Can I get pregnant with uterine fibroids?

In many cases, women with uterine fibroids can still conceive and carry a pregnancy to term. However, the presence of fibroids may increase the risk of fertility issues, miscarriage, or pregnancy complications. It’s essential to consult with a healthcare provider for personalized guidance if you’re planning to conceive with fibroids.

Can my partner feel my fibroid?

In some cases, particularly if the fibroid is large or located close to the surface of the abdomen, it may be possible for a partner to feel the fibroid during palpation. However, most fibroids are internal and not typically palpable externally.

What food to avoid with fibroids?

While there’s no definitive evidence linking specific foods to the development or exacerbation of fibroids, some women find that reducing their intake of processed foods, red meat, and caffeine can help alleviate symptoms such as heavy menstrual bleeding and pelvic pain. It’s essential to maintain a balanced diet rich in fruits, vegetables, whole grains, and lean proteins.

How large do uterine fibroids need to be before being surgically removed?

The decision to surgically remove uterine fibroids depends on various factors, including the size, location, and symptoms associated with the fibroids. Generally, fibroids that cause significant symptoms, such as heavy menstrual bleeding or pelvic pain, or those that affect fertility or quality of life, may warrant surgical intervention. However, there is no specific size threshold for surgical removal, and each case is evaluated individually by a healthcare provider.

Can fibroids cause anemia?

Yes, fibroids can lead to anemia, a condition characterized by a deficiency of red blood cells or hemoglobin in the blood. Heavy menstrual bleeding associated with fibroids can result in significant blood loss over time, leading to anemia. Symptoms of anemia may include fatigue, weakness, pale skin, shortness of breath, and dizziness.

Can fibroids change over time?

Yes, fibroids can change in size, number, and symptoms over time. Factors such as hormonal fluctuations, pregnancy, or certain medical treatments may influence the growth and behavior of fibroids. Regular monitoring by a healthcare provider is essential to assess any changes in fibroid size or symptoms and adjust treatment as necessary.

Do fibroids go away naturally?

In some cases, fibroids may shrink or disappear on their own, particularly after menopause when estrogen levels decline. However, not all fibroids resolve spontaneously, and many may persist or continue to grow over time. It’s essential to monitor fibroids regularly and consult with a healthcare provider for appropriate management and treatment options.

Can fibroids stop menstruation?

While fibroids can cause changes in menstrual bleeding patterns, including heavier or more prolonged periods, they typically do not stop menstruation altogether. However, in some cases, particularly if fibroids obstruct the uterine cavity or affect hormone levels, they may contribute to irregular menstrual cycles or amenorrhea (absence of menstruation). It’s important to consult with a healthcare provider if you experience significant changes in your menstrual cycle.

Is it best to remove fibroids?

The decision to remove fibroids depends on various factors, including the size, location, and symptoms associated with the fibroids, as well as the patient’s preferences and reproductive goals. While some fibroids may not require treatment if they are small and asymptomatic, others may warrant intervention to alleviate symptoms, preserve fertility, or prevent complications. It’s essential to discuss the risks and benefits of fibroid removal with a healthcare provider to determine the most appropriate course of action for your individual situation.

How do fibroids affect your life?

Fibroids can have a significant impact on a woman’s quality of life, affecting physical, emotional, and social well-being. Symptoms such as heavy menstrual bleeding, pelvic pain, and reproductive issues can interfere with daily activities, work, relationships, and overall health. Managing fibroids may require medical treatment, lifestyle modifications, and emotional support to help improve symptoms and quality of life.

Can a woman live with fibroids?

Yes, many women live with fibroids without experiencing significant symptoms or complications. However, for some women, fibroids may cause bothersome symptoms such as heavy menstrual bleeding, pelvic pain, or fertility issues that require medical evaluation and treatment. With proper management and support, many women can effectively cope with fibroids and maintain a good quality of life.

What size fibroids need surgery?

There is no specific size threshold for fibroids that necessitate surgery, as the decision to intervene surgically depends on various factors, including the size, location, and symptoms associated with the fibroids. Generally, fibroids that cause significant symptoms such as severe pelvic pain, heavy menstrual bleeding, or reproductive issues may warrant surgical removal. However, each case is unique, and treatment decisions should be made in consultation with a healthcare provider.

Do fibroids make you tired?

Fibroids themselves may not directly cause fatigue, but symptoms such as heavy menstrual bleeding and pelvic pain associated with fibroids can lead to fatigue and exhaustion over time, especially if left untreated. Chronic blood loss from heavy periods can result in anemia, which may contribute to feelings of fatigue, weakness, and low energy levels. It’s essential to address underlying fibroid-related symptoms and seek medical evaluation for fatigue or other concerning symptoms.

Do fibroids make your stomach big?

In some cases, large fibroids may cause the abdomen to appear distended or enlarged, leading to the misconception that fibroids make the stomach big. However, not all women with fibroids will experience significant abdominal swelling or changes in appearance. The size and location of fibroids, as well as individual factors such as body composition and overall health, can influence how fibroids affect the abdomen’s appearance.

Can fibroids be cancerous?

The vast majority of fibroids are non-cancerous (benign) growths that do not increase the risk of cancer. However, in rare cases, a type of cancer known as uterine sarcoma may be mistaken for a fibroid, particularly if it grows rapidly or exhibits atypical features. It’s essential to consult with a healthcare provider for proper diagnosis and evaluation if you have concerns about fibroids or other uterine abnormalities.