Uterine Fibroids Treatment in Chandigarh

What is Meant by Uterine Fibroids?

Uterine fibroids, otherwise referred to as leiomyomas or myomas, are non-cancerous growths in the uterus. Uterine fibroids can be found within the uterine wall, on the outer surface of the uterus, or attached to the uterine wall by a stalk. These fibroids develop in women during their childbearing age. Their size can range from undetectable seedlings to bulky masses that can enlarge the uterus. Age and hormonal factors play a major role in the development of uterine fibroids. Read further to know more.

What Causes Uterine Fibroids?

Many variables are thought to play a role in the development of uterine fibroids:

• Fibroid growth Hormones: Fibroids contain more estrogen and progesterone receptors than normal uterine muscle cells do. Fibroids seem to thrive in an estrogen and progesterone-rich environment. Taking these hormones in pill form (oral contraceptives) or in the form of injections (the depot provera shot) can cause fibroids to grow and make the symptoms worse.
• Genetics: Fibroids may run in a family. If your mother or sister has fibroids, you’re at increased risk of developing them. Researchers are studying the genes that may be involved in fibroid development.
• Growth Factors: These substances help the body maintain tissues, and insulin-like growth factors may affect fibroid growth.
• Extracellular Matrix (ECM): Fibroid cells make more ECM than ordinary uterine muscle cells do. The extra ECM makes fibroids firm and rubbery and makes it harder for the body to get rid of them.
• Other Factors:
• Age: Fibroids become more common as women age, especially during the 30s and 40s through menopause. After menopause, fibroids usually shrink.
• Pregnancy: Pregnancy increases the production of estrogen and progesterone in your body. Fibroids may develop and overgrow while you are pregnant.

It is important to remember that just because you may have one or more of the known risk factors for fibroids does not mean you will develop them. Many women with one or more risk factors never get fibroids. In addition, many women with fibroids have no known risk factors at all.

What are the Symptoms of Uterine Fibroids?

Sometimes, uterine fibroids cause no signs or symptoms. When they do, they may include one or more of the following:

• Menstrual Changes: Fibroids can lead to heavy, prolonged menstrual periods and irregular bleeding.
• Pelvic Pain and Pressure: Fibroids can cause pelvic discomfort, pain, and a feeling of fullness or pressure in the lower abdomen.
• Frequent Urination: Large fibroids can press against the bladder, leading to increased urgency and frequency of urination.
• Pain During Intercourse: Fibroids near the surface of the uterine wall can cause pain or discomfort during sexual intercourse.
• Backache or Leg Pains: If fibroids press on nerves or blood vessels, they can cause back pain or leg pains.

It's essential to consult a healthcare provider if you experience these symptoms, as they can be indicative of uterine fibroids or other gynecological conditions.

How is Uterine Fibroids Diagnosed?

During a routine pelvic examination, a healthcare provider may be able to feel the presence of larger fibroids, especially if they are close to the surface of the uterus. Common diagnostic methods for uterine fibroids include the following:

• Ultrasound: Transabdominal or transvaginal ultrasound can provide a clear image of the uterus and help identify fibroids' size, number, and location.
• Magnetic Resonance Imaging (MRI): An MRI can offer detailed images of the uterus and fibroids, providing valuable information about their location and characteristics.
• Hysterosalpingography (HSG): This procedure involves injecting a contrast material into the uterus and taking X-ray images to visualize the inside of the uterus and detect any abnormalities, including fibroids.
• Hysteroscopy: In a hysteroscopy, a thin, lighted tube with a camera is inserted through the cervix into the uterus to view the uterine cavity directly. This method is handy for identifying fibroids located within the uterine cavity.

These diagnostic methods help healthcare providers determine the presence, size, location, and characteristics of uterine fibroids, aiding in developing an appropriate treatment plan.

Treatment Methods for Uterine Fibroids

Treatment options for uterine fibroids depend on factors such as size, location, and number, the severity of symptoms, and the patient's desire to maintain fertility or avoid surgery. 

The most common treatment options include:

Medications: These cannot cure fibroids, but can help control symptoms such as heavy menstrual bleeding and pelvic pressure.

1. Hormonal birth control: Birth control pills, patches, and injections can control heavy bleeding and painful periods.
2. Gonadotropin-releasing hormone (GnRH) agonists: These drugs can be used to “turn off” the ovaries, causing estrogen and progesterone levels to drop and menstrual periods to stop, leading to tumor shrinkage.
3. Progestin-releasing intrauterine device (IUD): Progestin, a synthetic hormone, is released by this small device, which is inserted into your uterus; it treats heavy periods and does a good job shrinking fibroids and relieving pain, but this device may cause annoying spotting.
4. Nonsteroidal anti-inflammatory drugs (NSAIDs): Taken in pill form for a few days during a woman’s period, they can reduce menstrual bleeding and pain.
5. Tranexamic acid (Lysteda): Another non-hormonal medication that reduces menstrual blood loss.

Non-surgical options include MRI-guided focused ultrasound therapy (FUS): High-energy ultrasound waves generate heat to destroy fibroid tissue.

Minimally Invasive procedure:

1. Uterine artery embolization (UAE): Small particles, the size of grains of sand, are injected into the uterine arteries through a catheter, which is a small, plastic tube. The particles block the blood supply to the fibroids, causing them to shrink. 
2. Radiofrequency ablation: A small needle-like probe is inserted through the abdomen into the uterine fibroids using imaging guidance. Radiofrequency energy is transmitted to the fibroid and destroys the abnormal tissue.
3. Myolysis: An electrical current or laser destroys the small blood vessels feeding the fibroids. 
4. Laparoscopic or robotic myomectomy: If fibroids haven’t grown too large or too deeply into the wall of the uterus, they can often be removed using laparoscopic tools, including a camera and operating instruments, which are inserted through small incisions in the abdomen.
5. Hysteroscopic myomectomy: Fibroids located within the uterine cavity can often be removed using a hysteroscope inserted through the cervix and into the uterus.

Traditional Surgical Procedures:

1. Abdominal myomectomy: If you have multiple fibroids, large fibroids, or deep fibroids, your doctor may use an open abdominal surgical procedure to remove the fibroids.
2. Hysterectomy: This surgery removes the uterus. It's the only sure way to cure uterine fibroids. The decision to proceed with a hysterectomy is a permanent one.

The choice of treatment should be a decision made collaboratively, after discussing all available options and potential benefits and risks with a healthcare provider.

What are the Complications of Uterine Fibroids?

Complications:

• Heavy Menstrual Bleeding: This can lead to anemia, causing fatigue and other health concerns.
• Pain: This can be in the form of pelvic pain, pain during intercourse, or prolonged menstrual cramps.
• Pressure: Large fibroids can exert pressure on adjacent organs, leading to frequent urination, constipation, or backache.
• Pregnancy complication:

1. Infertility: Sometimes fibroids block the fallopian tubes or hinder the implantation of the embryo.
2. Miscarriage: The likelihood of miscarriage is increased by the presence of fibroid tumors.
3. Preterm delivery: The presence of fibroids increases the risk of giving birth to a premature baby.
4. Breech birth: The baby is turned so that its feet, rather than its head, are positioned to come out first. Under this circumstance, the baby may have to be delivered by cesarean section.
5. Placental abruption: The placenta breaks away from the uterine wall before delivery, making the fetus deprived of its life supply of oxygen.

• Degenerative Changes: As fibroid tumors grow, some areas may outgrow their blood supply and degenerate. This can cause pain, which sometimes requires the degenerated area to be surgically removed.
• Compression of the Ureter: A large fibroid pressing on the ureter can cause the urine flow from the kidney to be obstructed.

If you are diagnosed with fibroids, having regular checkups with your healthcare provider to monitor the condition and getting timely treatment will help prevent any complications.

How to Prevent Uterine Fibroids?

Prevention methods to reduce the risk or inhibit the growth of fibroids:

• Hormonal Birth Control: Hormonal birth control (using birth control pills, the patch, or another method) can help keep your periods light and help prevent the growth of fibroids.
• Maintain a Healthy Weight: Maintaining a healthy weight through regular exercise and a healthy diet can be helpful.
• Dietary Choices: Some studies have suggested that eating more green vegetables, fruit, and dairy may be linked to a lower risk of developing fibroids. Eating a lot of red meat, ham, and other processed meats can raise the risk.
• Limit Exposure to Environmental Toxins: It’s a good idea to be mindful of your environment and try to limit exposure to chemicals.
• Manage Blood Pressure: Getting regular check-ups and managing your blood pressure with lifestyle changes and medications (if needed) can help.
• Limit your intake of alcohol and caffeine: According to some research, cutting back on these substances may help lower your chance of developing fibroids.

It's crucial to speak with a healthcare provider if you have concerns about fibroids for individualized guidance and routine monitoring.