Certain common growths of the uterus that appear often during the years a female can get pregnant and give birth are called uterine fibroids. This is not a cancer form and these growth rarely provoke cancer. Other names of uterine fibroids are leiomyomas or myomas.
A person can experience either one or more growths which often fluctuate in amount and size. Sometimes, these growths are too small to be seen with eyes while others can reach grapefruit size or larger. In case you experience very large fibroids, they can provoke inside and outside of the uterus distortions. Severe forms of uterine fibroids grow large and can fill the pelvis and stomach area. That’s why some people with large growths look pregnant.
Almost all people have fibroids at least once during their lifetime. Commonly, growths do not provoke any symptoms and doctors identify them accidentally during a pelvic examination or pregnancy ultrasound.
Symptoms
The symptoms usually depend on the fibroid’s size, location, and amount. Check the most common symptoms below:
- Heavy or painful periods
- Periods last longer than usual
- Pelvic pain or pressure
- Frequent or troubled urination
- Growing stomach area
- Constipation
- Pain during sexual intercourse
- Stomach or lower back pain
In rare cases, fibroids can provoke serious and sudden pain. It often happens when it begins to die.
Experts classify fibroids by their location. For example:
- Intramural fibroids (within the uterus’s muscular walls)
- Submucosal fibroids (uterine cavity)
- Subserosal fibroids (outside the uterus)
When to Visit a Physician?
Immediately get medical help if any of the following cases occur. Examples include:
- Persistent pelvic pain
- Heavy and painful periods that interact with your daily routine
- Bleeding or spotting between menstrual periods
- Trouble emptying the bladder
- Weakness and tiredness
Causes
Experts do not know the exact cause of uterine fibroids but the following factors may contribute. Examples include:
- Gene changes – Some fibroids contain certain changes in genes that are different from typical uterine muscle cells.
- Hormones – Estrogen and Progesterone are hormones that help to prepare tissues inside the uterus each menstrual cycle. These hormones also can contribute to fibroids growth. In addition, these growths can shrink after menopause due to reduced Estrogen production.
- Other factors – Some substances help the body to keep tissues such as insulin-like growth factor. Therefore, they also can impact fibroid growth.
- Extracellular matrix (ECM) – This is a specific material that makes cells stick together and it can be compared to mortar between bricks. However, it can provoke some biological changes in the cells which may lead to fibroids.
Healthcare providers think that uterine fibroids occur due to a stem cell in the muscular tissue of the uterus because a single cell divides continuously. Over time, it changes into a rubbery and firm mass from nearby tissues.
Risk Factors
In most cases, these growths are not dangerous but they can provoke pain and lead to some complications. For instance, a decrease in red blood cells (anemia). This disease usually causes fatigue (extreme tiredness) from severe blood loss. Physicians usually prescribe iron supplements to people with severe bleeding during periods. Moreover, some people may require a transfusion of blood from other people due to excessive blood loss.
Pregnancy and Fibroids
Commonly, pregnant women with fibroids do not experience any problems. However, in some cases, submucosal fibroids can cause infertility or pregnancy loss. Check below other complications that may occur during pregnancy:
- Placental abruption (this is an organ that brings nutrients and oxygen to the fetus)
- Fetal growth restriction
- Premature delivery
Is It Possible to Prevent Uterine Fibroids?
Nowadays, there is no way to prevent fibroids because experts do not understand the exact cause. However, researchers still studying the possible methods that will help to prevent these growths. Anyway, uterine fibroids usually do not need treatment.
Lifestyle changes can reduce the risk of developing fibroids. Examples include regular exercise, trying to lose and keep a healthy weight, adopting a balanced diet full of vegetables and fresh fruits, and others.
Some studies suggest that birth control pills and long-acting progestin contraceptives can decrease the uterine fibroids risk but you should not use them if you are under 16 years old.
Diagnosis
Most people find they have uterine fibroids during a regular pelvic examination. Physicians commonly feel an irregular change in the uterus’s shape, which suggests fibroids presence. Additionally, physicians may order you to do some tests if you experience uterine fibroids symptoms. Examples include:
- Ultrasound – This test uses sound waves that help to create an image of the uterus. These images help the doctor to confirm whether you have fibroids or not.
- Laboratory tests – Blood tests are recommended if you experience irregular menstrual periods. For instance, a complete blood test is done to check for anemia. Other blood tests may help to search for bleeding disorders or thyroid issues.
Check below other imaging tests:
- Magnetic resonance imaging (MRI) – This test shows in detail the location and size of fibroids. It also is used to check for other tumor types.
- Hysterosonography – This test involves sterile salt water (saline) that helps to widen the space inside the uterus. Therefore, physicians can get more easy images of submucosal fibroids. Some people know this test under the saline infusion sonogram name.
- Hysterosalpingography – This test involves X-rays and it is usually recommended by doctors if you experience infertility. It can help you to determine if your fallopian tubes are open or blocked and show submucosal fibroids.
- Hysteroscopy – This test involves a small telescope (known as a hysteroscope) through the cervix to the uterus. Thereafter saline is injected into the uterus, which helps to expand the uterus cavity and check for fibroids and openings of the fallopian tubes.
Treatment
Unfortunately, there are no effective treatments for uterine fibroids. However, there are different treatment options that can lessen the symptoms. Check below some examples:
Waiting
There are a lot of people with uterine fibroids without any symptoms or with mild ones. In such cases, watchful waiting is the best choice. Furthermore, fibroids are not cancer and can rarely interact with pregnancy. Sometimes, they shrink themselves after menopause due to decreased hormone production.
Medications
In case you experience heavy menstrual bleeding and pelvic pressure, your doctor may prescribe certain medicines. They help to shrink fibroids and reduce the symptoms. Check below some medicines:
- Gonadotropin-releasing hormone (GnRH) agonists – These medicines work by blocking the production of hormones (Estrogen and Progesterone), which help to treat fibroids. These medications put a female temporarily in a state similar to menopause. Therefore, periods stop and fibroids begin to shrink. GnRH agonists include Leuprolide, Goserelin, and Triptorelin.
- Gonadotropin-releasing hormone (GnRH) antagonists – These medications are often used to treat heavy menstrual periods in people with fibroids before menopause. However, they do not shrink fibroids. The treatment length may be up to 2 years. Physicians may also prescribe a low dose of Estrogen or Progestin along with GnRH antagonists to reduce bone loss and hot flashes.
- Progestin-releasing intrauterine device (IUD) – This treatment method helps to lessen heavy bleeding that occurs due to fibroids. IUD also helps to prevent pregnancy but cannot shrink or treat fibroids.
- Tranexamic acid – It is advised to use this medicine if you experience heavy periods.
- Other medications – Healthcare providers can also prescribe a low dose of birth control pills to control menstrual bleeding. In addition, non-steroidal anti-inflammatory drugs (NSAIDs) can also relieve the symptoms. These include Ibuprofen, Naproxen sodium, and others.
Noninvasive Procedures
This is a procedure that does not involve any cuts (known as incisions) or tools placed in the body. One of the noninvasive procedures is Focused Ultrasound Surgery (FUS), which helps your doctor to identify the exact fibroid’s location and destroy it. Researchers continue to study this treatment option but it cannot relieve symptoms as minimally invasive procedures could.
Minimally Invasive Procedures
The following treatment options involve small cuts, which are associated with fast recovery and fewer complications compared to regular surgery. Check below some of them:
- Uterine artery embolization – This procedure involves injecting some small particles (known as embolic agents) that supply the uterus with blood. Therefore, they restrict blood flow to fibroids which causes them to shrink and die.
- Radiofrequency ablation – This procedure helps to destroy fibroids using heat from radiofrequency energy. It also helps to shrink the blood vessels that supply them with blood. Radiofrequency ablation is usually performed through small cuts in the stomach region (known as laparoscopy). Sometimes, it can be done through the vagina (transvaginal procedure) or cervix (transcervical procedure). Furthermore, people who receive this minimally invasive procedure return to their daily activities within several days.
- Laparoscopic or robotic myomectomy – During this procedure the surgeon will remove the fibroids without the uterus. However, the surgeon may opt for a less invasive procedure if you have a small fibroids count. If you experience large fibroids, surgeons may remove them through small cuts with a special device. This procedure is known as morcellation.
- Hysteroscopic myomectomy – This is an effective option to remove fibroids that appear inside the uterus (submucosal fibroids).
- Endometrial ablation – This treatment option involves a device that is inserted into the uterus. It gives microwave energy, heat, hot water, cold temperature, or an electric current to destroy the tissue inside the uterus. It can help to lessen heavy menstrual periods.
All procedures that leave the uterus do not guarantee you will not experience new fibroids and symptoms.
Surgery
- Abdominal myomectomy – This is a surgery that removes fibroids through a larger cut in the stomach area (abdomen). Physicians commonly recommend this procedure if you have more fibroids, very large fibroids, or very deep fibroids.
- Hysterectomy – In such cases, the surgeon will remove the uterus completely. However, if the ovaries are removed too, this will bring on menopause and you may need to get hormone replacement therapy to lessen menopausal symptoms. Many women with uterine fibroids can keep their ovaries.
Frequently Asked Questions
What happens if people do not treat uterine fibroids?
Fibroids are certain growths that occur within or close to the uterus (womb). In case you are not treating them, you may experience extreme bleeding and fertility problems.
How to shrink fibroids quickly?
Usually, doctors prescribe a combination of treatments to shrink fibroids and reduce the symptoms. For example, lifestyle changes (healthy diet, regular exercise, and others), prescription medicines, and surgeries. Consult with your doctor for more details.
Is it possible to cure uterine fibroids?
The only effective way to cure fibroids is hysterectomy (a surgery that removes the uterus). Thereafter, the symptoms should disappear. Additionally, most people can keep their ovaries, which helps to avoid menopause symptoms after surgery. If you have any other questions, ask your healthcare professional.
