What are Fibroids and who are at risk?
The fibroids are non-cancerous tumors of wall of the womb or uterus. They are simply overgrowth of uterine smooth muscle cells that need estrogen to grow. Fibroids increases throughout a woman’s pre-menopasual years by affecting two out of every five women in their 40’s. They can grow most rapidly during the perimenopausal years when the estrogen levels are high but progesterone levels are low. Generally they shrink after menopause and their cause is unknown. They tremendously vary in size from as small as a pea to as large as a pregnancy. The vast number of women with fibroids is unaffected and need no treatment. Those who are symptomatic are likely to be over 35 and experience a wide range of problems. Women may have one fibroid or several. There are many non-surgical ways to manage the fibroids but the hysterectomy is the most common major surgery performed on non-pregnant women in India.
Fibroids occur more than three times as commonly in African American women than Caucasians. They are most likely in women who have never been pregnant. As there are not much known about the causes or risk factors for fibroids, so there are not many known preventive measures women can take. Maintaining a healthy weight may help to prevent fibroids.
While the vast majority of women with fibroids have no symptoms, it can be responsible for a variety of symptoms with a broad range in severity. While the symptoms can cause a great deal of discomfort, they are rarely life threatening. The symptoms include:
- Unusually frequent urination and pressure or pain
- Heavy menstrual bleeding
- Constipation or rectal pressure
- Painful menses
- Back pain
- Lower abdominal pressure
- Spotting between periods
- Infertility or repeated miscarriages
- Leg pain from pressure on certain nerves
Fibroids Diagnosis & Treatments
If you experience all the above symptoms then consult your physician. Your doctor will detect the fibroid during the internal pelvic exam. A pelvic ultrasound exam will confirm the diagnosis. Sometimes the fibroids are detected incidentally when an ultrasound is done for another reason or during surgery. Depending on your particular situations your doctor will recommend other tests such as hysteroscopy, an MRI or hysterosonogram.
The treatments include good general nutritional habits with low dietary fat and alcohol consumption. High fiber diets are also recommended to relieve symptoms. Drugs such as over the counter medications like non-steroidal anti-inflammatory drugs will decrease the uterine cramping. The GnRH Agonists are injectable medicines used to decrease the fibroid size before surgery. Progesterone is prescribed treatment for bleeding related to fibroids.
Endometrial ablation is a less invasive procedure to treat the problem by destroying the tissue in the lining of the uterus to stop bleeding. The uterine artery embolization (UAE) or fibroid embolization is a new minimally invasive procedure designed for women with large or numerous fibroids that are symptomatic. It eliminates the need for hysterectomy in large number of women with fibroids.
There are several surgical approaches which depend on the patient’s individual circumstances such as her plans for future fertility and the number, size and location of her fibroids. A myomectomy surgery removes only the fibroids and leaves the remainder of uterus intact. This procedure is preferred for women who want to preserve their ability to become pregnant. A hysterectomy surgery removes the entire uterus and the only treatment that eliminates fibroids completely and prevents the regrowth.