Uterine Fibroids: What You Should Know

Uterine fibroids are common growths that form in or on the uterus. They are not cancer and usually don't cause problems. But in some women, they can lead to heavy periods, pain or pressure. In rare cases, the effects of fibroids may extend to nearby organs, including the effects of tumors on the cervix, which can cause discomfort or complications.

Understanding fibroids can help you know when to get checked and what treatments are available.

What are Uterine Fibroids?

Uterine fibroids are firm lumps made of muscle and tissue. They grow in or around the uterus. Most are small and don not cause symptoms but some can grow larger and cause issues. They are affected by hormones and are more common in women during their childbearing years.

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Causes of Fibroids

The exact cause of fibroids is unknown. However several factors are believed to contribute to their development:

Hormones: Fibroids are influenced by the hormones estrogen and progesterone. Increased hormone levels during pregnancy can cause fibroids to grow, but they often return to their normal size after pregnancy.
Genetics: There is a belief that fibroids could be hereditary, though conclusive evidence is lacking.

Due to the uncertainty surrounding the causes of fibroids, preventative measures are limited.

Uterine Fibroid Symptoms

Uterine fibroids often grow without causing symptoms. Many women with fibroids are asymptomatic. However, when symptoms do occur, they may include:

- Heavy menstrual bleeding
- Menstrual periods lasting 7 days or more
- Bloating in the lower abdominal area
- Pressure or pain in the pelvic region
- Frequent urination
- Constipation

These are typical signs, but they may also resemble symptoms of cervical cancer in women or other conditions.

Side Effects of Uterine Fibroids on Pregnancy

Usually, fibroids don not affect a woman's ability to get pregnant or have a baby. However, in some cases, fibroids can lead to complications:

Preterm Births or Miscarriages: Large fibroids that continue to grow during pregnancy may increase the risk.
Delivery Complications: Fibroids can cause abnormal fetal positioning, potentially necessitating a caesarean section.

Treatment Options for Uterine Fibroids

There are several types of treatments for uterine fibroids:

Medication for Uterine Fibroids

Several medications are available to help manage symptoms of uterine fibroids. These drugs aim to reduce heavy bleeding, control pain, or shrink fibroids without surgery.

GnRH agonists: Lower estrogen levels to shrink fibroids.
Hormonal IUDs: Reduce heavy bleeding, but don't shrink fibroids.
Birth control pills: Help control bleeding and pain.
Tranexamic acid: Non-hormonal drug to reduce heavy menstrual bleeding.
NSAIDs: Pain relievers like ibuprofen (do not reduce fibroids).
Selective Progesterone Receptor Modulators (SPRMs): Reduce fibroid size and symptoms.

Surgical Treatments

Surgery may be needed if fibroids are large, cause severe symptoms, or don't respond to medication.

Myomectomy: Removes fibroids but keeps the uterus.
Hysterectomy: Removes the uterus; permanent solution.
Uterine Artery Embolization: Cuts off blood supply to fibroids to shrink them.
MRI-guided ultrasound surgery: Non-invasive treatment that destroys fibroid tissue.

Uterine Fibroids - Prognosis

Many women have undetected fibroids without any health issues. Medical attention is usually sought when symptoms like heavy bleeding, longer periods, spotting between periods or painful cramps occur.

In rare cases, if fibroids affect pregnancy or prevent conception due to their location in the uterus, treatment is recommended.

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Prevention Tips

There is no sure way to prevent fibroids, but healthy habits may reduce the risk:

Eat a diet rich in fruits, vegetables and whole grains
Limit red meat and processed foods
Maintain a healthy weight
Manage stress and blood pressure
Avoid excessive alcohol
Get regular checkups to catch fibroids early

Frequently Asked Questions

Usually, fibroids in uterus do not cause infertility or prevent pregnancy. Submucosal fibroids may hamper conception, especially if they are larger than 6cm. In rare instances, fibroids have been known to block the fallopian tubes and prevent pregnancy.

Some fibroids appear and disappear on their own. When a woman enters menopause, fibroids tend to shrink in size or even go away by themselves. Some fibroids require treatment.

Surgery includes myomectomy (fibroid removal) or hysterectomy (uterus removal), depending on severity and future fertility plans.

Yes, fibroids can return after treatment, especially if the uterus is not removed. Regular checkups are important.

Doctors often use pelvic exams, ultrasounds, or MRIs to confirm the presence and size of fibroids.

No, fibroids are almost always benign and don't turn into cancer. Uterine cancer is a separate condition.

Postmenopausal bleeding, pelvic pressure, or a new pelvic mass should be evaluated immediately.