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Fibroids
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| Fibroids |
| Symptoms |
| How do I know if I have Fibroids? |
| Treatment |
| References |
| Other Resources |
Uterine leiomyomas, commonly known as fibroids, are rounded, benign tumors arising from the smooth muscle layer of the uterus. Other names for these tumors include fibromyomas, fibromas, myofibromas, and myomas. It is estimated that between 20 and 30% of women of reproductive age have fibroids, though not all cases have been diagnosed (1). These benign tumors may cause no symptoms, and may never need treatment. Unfortunately for many women, fibroids -depending on their location- can cause a range of problems from pain, to abnormal bleeding, to infertility. Why fibroids develops a mystery, although some studies indicate a genetic component.
Fibroids are usually detected in women in their 30's and 40's and shrink after MENOPAUSE (in the absence of post-menopausal estrogen replacement therapy). However, this does not imply that college women are not at risk, but rather that they are less likely to develop these fibroids. Risk for developing fibroids is also higher in women who are heavy for their height and is lower in women who are smokers and in women who have given birth (2). However, it is important to note that the health risks posed by smoking are great. [1] [ To Top ]
The two most common symptoms of fibroids are abnormal uterine bleeding, known as menorrhagia, and pelvic pressure. Normal menstrual periods typically last four to five days, whereas women with fibroids often have periods lasting longer than their menstrual cycle. The heavy bleeding requires that women change sanitary protection frequently (as often as every hour). However, bleeding between periods is unusual and should be immediately reported to the physician for it may very well serve as a symptom for a different reproductive disorder.
Pelvic pressure can result from an increase in the size of the uterus or from a particular fibroid. Most women with fibroids have an enlarged uterus. It is not unusual for a uterus with fibroids to reach the size of a four to five month pregnancy. Since the fibroid uterus has an irregular shape and form, women can experience an unusual pressure in the uterus region in addition to pressure on specific adjacent pelvic structures including the bowel and/or bladder. Pressure on these structures can result in difficulty with bowel movements and constipation or urinary frequency and incontinence.
Fibroids are also associated with a range of reproductive problems since they are most often responsible for physically distorting the uterus. These include recurrent miscarriage, infertility, premature labor, and complications of labor. [2] [ To Top ]
In addition, imaging studies such as ultrasonography, MRI (magnetic resonance imagery), and CT (computed tomography) may be useful in confirming the diagnosis.
In women experiencing heavy bleeding (menorrhagia) or recurrent pregnancy losses, assessment of the uterine cavity is important because the presence of a submucous fibroid can be missed on traditional ultrasound. HYSTEROSALPINGOGRAPHY and sonohysterography, use X-ray pictures and ultrasound pictures, respectively, to visualize the uterine cavity after a specific dye is injected into the uterus. Hysteroscopy allows direct visualization of the uterine cavity by inserting a small camera on the end of a long tube directly into the uterus through the vagina and cervix. LAPAROSCOPY allows direct visualization of the outside of the uterus and the surrounding pelvic structures by introducing a small camera on the end of a tube directly into the abdominal cavity through an incision in the umbilicus. [3] [ To Top ]
Hormonal treatment
This treatment involves drugs such as
Nafarelin and Leuporlide, causes fibroids to shrink. This method is
sometimes used in pre-menopausal women who want to get pregnant, but have
problems conceiving because of the tumors. If fibroids become large
enough, they may block the fallopian tubes or fill the uterine cavity. The
hormones produce an environment in the body that is very similar to that
of menopause, called pseudo-menopause. The treatment spans over several
months and during this time the reduction in estrogen concentration allows
the fibroids to shrink. Since fibroids will begin to enlarge as soon as
treatment stops, the woman is encouraged to begin attempting to conceive
almost immediately.
For women who do not want to conceive, but also don't want to undergo surgery, hormone treatment is frequently an option. The side effects of this type of treatment usually include menopausal symptoms. If treatment is discontinued, fibroids will re-grow.
Myomectomy
A myomectomy, which is a surgical procedure to
remove just the fibroids, is frequently the chosen treatment, especially
for pre-menopausal women who want to bear more children. Another advantage
of a MYOMECTOMY is that it controls pain or
excessive bleeding that some women with uterine fibroids experience. This
may leave the uterine walls weakened causing most babies from future
pregnancies to be delivered by caesarean section (4).
Hysterectomy
A total hysterectomy, which involves removal of
the uterus, is another option. In past years this has been the most common
option for the removal of fibroids, physicians are turning to the less
invasive procedures discussed above to deal with fibroids.
[4]
[ To Top ]
[1]http://www.nichd.nih.gov/publications/pubs/uterine.htm
[2]http://www.nichd.nih.gov/publications/pubs/uterine.htm#Who is at Risk for Uterine Fibroids?
[3]http://medlineplus.adam.com/ency/article/000914trt.htm
[4]http://www.nichd.nih.gov/publications/pubs/uterine.htm#Who is at Risk for Uterine Fibroids?
[ To Top ]