Last updated on July 28th, 2018 at 05:24 am
Fibroids or uterine fibroids are smooth muscle tumors that are not life-threatening. They are found in young women of childbearing age. Fibroids are located in the uterus. The uterus is what you call “the womb”. It may rarely be found in other parts of the body. This is the metastatic or parasitic fibroid.
Fibroids affect more than 171 million women. It may show symptoms when large or not show signs at all. It is estimated that more than 50 percent of women develop fibroids in their lifetime. Fibroids are also common in young women above 30 years.
Most women with fibroids require no treatment. Many are diagnosed during test for other illnesses. However, fibroids that are huge will need treatment.
What causes fibroids in women?
The cause of fibroids is still unknown to medical experts. It is believed to be due to genetic factors. There is an increased risk of developing the disease if your mother or sister had fibroids.
Also, research has shown that estrogen is required for growth of uterine fibroid. The reduction of estrogen that occurs in menopause reduces its size.
How do fibroids look like in women?
Uterine fibroids do not have a definite shape or size. The size and shape vary among women. They can be found on the wall of the uterus or hanging into the uterus. The may be a single huge fibroid or multiple small fibroids.
However, fibroids are firm and within capsule. There is also a line of cleavage between the fibroid and the uterine muscle. This makes it easy for doctors to remove the fibroid tumor.
What are the types of uterine fibroids?
The type of uterine fibroid is where it is located. The different types of uterine fibroid are:
Intramural fibroids. This is the most common type of fibroid. They are found within the wall of the uterus or womb.
Subserosa fibroids. The fibroids are located beneath the covering of the womb. The sub-serosa fibroid can grow bigger and possess a stalk. This is the pedunculated fibroids.
Submucous fibroids. The inner lining of the uterus is covered by epithelial cell. Submucous fibroids are found beneath this covering. They can possess a stalk and form the fibroid polyp.
Cervical fibroids. These type of fibroids are uncommon. They form about 1 percent of fibroids. Cervical fibroids are found in the cervix. Because of its location, they cause problem during labor.
In addition, uterine fibroids can also be found in the broad ligament.
What are the signs and symptoms of fibroids in women?
Most women with uterine fibroid do not show symptoms. This is because most fibroids are small. However, they begin to show symptoms depending on:
- The type (site) of the fibroid
- The size of the fibroid
Symptoms of fibroids include:
- Excessive vaginal bleeding. This is often called menorrhagia. It is due to a submucous fibroid. They cause bleeding because they distort the inner lining of the womb. Furthermore, Research has shown that removal of submucous fibroids will stop bleeding.
- Swelling of the abdomen. Small fibroids in women will not cause swelling. However, as uterine fibroid grows, it will cause the abdomen to swell.
- Irregular bleeding. This is common in submucous fibroids and fibroid polyps.
- Difficulty in passing urine. This is due to the pressure of sizeable uterine fibroid on the bladder. The frequency of urination will be increased because of this.
- Difficulty in passing stool. This is due to compression effects of large fibroid tumors.
- Swelling of the legs. This is due to effects of large tumors on lymphatics. There may also be varicose veins.
- Inability to conceive. For a woman to conceive, there is union of the sperm and the ovum. Also, the zygote formed will be implanted in the uterus. Failure of both or one of this process can cause infertility. Presence of uterine fibroid at the conua end of the Fallopian tube will prevent sperm union with the ovum. Furthermore, the submucous fibroid can prevent implantation of the zygote.
- Obstructed labor from cervical fibroids
What are the risk factors for fibroids?
- African race. Fibroids are common in black women.
- Family history. There is increased chance to develop fibroids if your mother or sister had one.
- Obesity. Fibroids are common in obese women. The body mass index of women is used to check for obesity. Healthy BMI is 18.5 to 25. BMI more than 30 is obesity. Therefore, women with BMI more than 30 are at risk of fibroids.
- Nulliparous women. These are women that have not delivered before. Uterine fibroid are common with these women. Women with more than two deliveries are less likely to develop Uterine fibroid than nulliparous women.
How is uterine fibroid diagnosed in women?
The diagnosis of uterine fibroid is mainly clinical. Some of the test carried out by your doctor include:
- Full blood count. This will show low red blood cell level due to heavy vaginal bleeding in women. Anemia complicates excessive bleeding in women. Blood transfusion may be required.
- Ultrasound. Two types of ultrasound is done. Vaginal and Abdominal Ultrasound. A vaginal ultrasound can be used for cervical fibroid.
- Diagnostic curettage. This is important when cancer is suspected. This is not a procedure for young women. However, post menopause women will require this test.
- Hysteroscopy. This is an instrument used to view the inner walls of the uterus. If there are uterine fibroids, it will detect it.
What is the treatment of fibroids?
Most women with uterine fibroid require no treatment. This is because they do not show symptoms. However, it is essential to check the growth of small fibroids. Your doctor would need an ultrasound to monitor your fibroid every 6 to 12 months.
Women with symptoms would require either medical or surgical treatment.
Medical treatment of fibroids
- Tranexamic acid. This drug will prevent a blood clot from quick breakdown. However, it can cause tiredness and abdominal pain.
- Mefenamic acid and ibuprofen. Non-steroidal anti-inflammatory drugs (NSAIDS) can be used.
- Combine oral contraceptive (COC)
- GnRH agonist (Gonadotropin-releasing hormone)
GnRH agonist has shown more success than the other medical treatment. It reduces estrogen due to suppression of ovarian function, thereby shrinking the size of your fibroid. Because of this effect of decreased estrogen, patients experience post menopause symptoms. These include headache, hot flushes, dry vagina. When used for long-term can cause thinning of the bones. It is advised to use GnRH not more than six months.
Most noteworthy, medical treatment is used to shrink the size of tumors before surgery.
Surgical treatment of fibroids
- Myomectomy. This is a surgical procedure that can be done through the vagina or abdomen to remove fibroids. This procedure will require admission. If you are anemic, your doctor may transfuse you with blood before surgery.
- Hysterectomy. This can be done to remove the uterus and the fibroid mass. If you are through with childbirth, then you can choose this option. However, if your ovaries are removed, you will experience post menopause symptoms. You will also need hormone replacement with estrogen.
- Laparoscopic myomectomy. This is done to remove small uterine fibroid.
- Uterine artery embolism. This is a minimally invasive technique done by a radiologist. It involves the use of embolus to obstruct blood flow to the uterine arteries. This will reduce the size of the tumor by more than 50 percent. However, complications from this technique include high body temperature, infection, ovarian failure.
What are the complications of fibroid tumors?
- Cancer. Rarely, some women with uterine fibroid will develop cancer.
- Anemia. This is due to blood loss from vaginal bleeding.
- Failure to conceive
- Loss of pregnancy
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