Fibroids are benign ( Non cancerous ) growths that develop from the muscle tissue of the uterus. Although their cause is unknown, still they are known to be hormone dependant tumors & estrogen stimulates their growth. They may be present inside the cavity of uterus/ within its wall / on its outer surface or attached to it by a stem like structure.
Who is most likely to have fibroids ?
They are more common in women aged 30-40 yrs but may actually occur at any age. Commonly associated with familial predisposition & early onset of periods, these tumors are found more frequently in African- American women & Caucasians.
How does a woman suspect she may have fibroids ?
Symptoms of Fibroids :
Most of the fibroids may not cause any symptoms at all & be diagnosed on routine check up. When symptomatic , the Fibroids may cause the following symptoms :
- Changes in menstruation- Longer, more frequent or heavy menstrual periods. Painful periods or vaginal bleeding at times other than menstruation.
- Pain- Often dull, heavy & aching pain in the lower back or abdomen
- Pressure symptoms- Difficulty in urination or frequent urination; constipation/ rectal pain or difficult bowel movements
- Large lump in abdomen
- Infertility or miscarriages
How are fibroids diagnosed ?
The fibroids may present with above symptoms of fibroids or be detected on routine pelvic examination. Once clinically suspected, the diagnosis may be confirmed by:
- Ultrasonography- Uses sound waves to create a picture of uterus & other pelvic organs
- Hysteroscopy- Uses a camera mounted on slender long device to see the inside of the uterus
- Hysterosalpingography- Special X- ray test used to detect changes in shape & size of Uterine cavity and fallopian tubes.
- Laparoscopy– Uses a camera on a slender long device to see the inside of abdominal cavity
- MRI- Uses magnetic waves to produce exact images of body tissues
Do all fibroids need to be treated ?
No, fibroids that do not cause symptoms, are small or occur in a woman nearing menopause often may not require treatment. However, certain signs & symptoms of fibroids may signal the need for fibroid treatment:
- Heavy or painful periods
- Bleeding in-between periods
- Rapid increase in size
- Pressure symptoms, Difficulty in urination or defaecation
- Pelvic pain or lump abdomen
Can medications be used for Fibroid Treatment ?
Medications can be used to decrease the heavy bleeding or pelvic pain caused due to fibroids , but they do not prevent the growth of the fibroids nor do they make the fibroids disappear. Some medications that can be used are the painkillers eg. Paracetamol & Brufen, Oral contraceptive pills, Progesterone pills or IUCD & Gn RH agonists.
What surgeries may be used for Fibroid Treatment ?
Myomectomy is the surgical removal of fibroids while leaving the uterus intact. It may be done by laparoscopy/ hysteroscopy or by giving a cut on the abdomen in conventional manner.
Hysterectomy is the surgical removal of the uterus with the fibroids. The ovaries may or may not be removed. This also may be done by Laparoscopy or abdominally or vaginally. Hysterectomy is done when other treatments have failed or the fibroids are too large & childbearing function of uterus has been completed.
Other treatments modalities include Uterine artery embolisation or HIFU (High intensity focused Ultrasound ).