What Are Uterine Fibroids?

Clinical research suggests there are a lot of reasons for fibroid development. It prominently appears during the reproductive years of a woman and therefore could be associated with the following.   

• Genetic Change: Fibroids can be influenced by the genetic change in the body and their gene content differs from the normal uterine cells.
• Hormones: Hormones largely influence uterine fibroids. With estrogen and progesterone stimulating the development of the uterine wall during the menstrual cycle, it could promote the growth of fibroids. Fibroids are made up of estrogen and progesterone receptors. In some cases, fibroids tend to shrink post-menopause due to less hormone production. Insulin also might be a reason to trigger fibrous development.

Common symptoms of uterine fibroids include:

• Heavy bleeding during menstruation
• Prolonged menstrual periods (more than 7 days)
• Pain or pressure on the pelvic pressure
• Frequent urge to urinate
• Difficulty or incomplete emptying of the bladder
• Constipation
• Backache or leg pain

There are three main types of uterine fibroids: 

1. Intramural Fibroids: Fibroids that grow within the uterine wall are called intramural fibroids.

2. Submucosal Fibroids: Fibroids that bulge in the uterine cavity. 

3. Subserosal Fibroids: Fibroids that project from the outer wall of the uterus. 

Uterine fibroids are diagnosed by the following procedures:

• Ultrasound: This procedure makes use of sound waves to take a picture of the uterus from the inside through an ultrasound device to scan, map as well as measure the size of uterine fibroids.
• Lab Tests: A doctor might recommend a blood test including CBC to check if the patient is anemic. In case of abnormal menstrual bleeding, these investigations help check bleeding disorders or thyroid problems.
• Magnetic Resonance Imaging (MRI): The MRI technique gives better visibility and findings in terms of the size and location of uterine fibroids. This can further help the doctor decide the type of treatment. MRI technique is mostly suggested in women approaching menopause or with a larger uterus.
• Hysterosalpingography: This procedure makes use of a dye to highlight the uterine cavity and fallopian tubes to map on the x-ray. This procedure is used to check in case of women attempting pregnancy to check if the fallopian tubes are open or blocked due to submucosal fibroids.

Fibroids can be treated in various ways depending on the size, location, and symptoms they carry. The doctor suggests a treatment depending on your overall condition.

• Fibroid Embolization: This treatment procedure is done to shrink a fibroid. Your healthcare provider will inject polyvinyl alcohol (PVA) into the arteries that feed the fibroid. This blocks the supply of blood to the fibroid thus shrinking its size. It is not a surgery and you would need to spend several nights in the hospital due to symptoms such as vomiting, nausea, and pain that are temporary. 
• Endometrial Ablation: In this procedure, a doctor destroys the lining of the uterus to cut down on the bleeding that is linked to tiny fibroids.
• Myomectomy: It is a surgical procedure done to remove uterine fibroids. If you plan to get pregnant, your healthcare provider may recommend this over other procedures. This procedure can cause minimal scarring leading to infertility in rare cases. It is recommended that you wait four to six months after surgery before you try to conceive. A surgeon may use a hysteroscope or laparoscope to remove the fibroids by making a tiny cut on your abdomen. 
• Hysterectomy: This is a surgical procedure to remove the uterus. You won’t be able to get pregnant after this operation.

Women with the following conditions are at higher risk of developing uterine fibroids: 

• Heredity: Fibroids run in the family and if the woman in your family that is your mother or sister had fibroids, you are at risk of developing them.
• Obesity
• Vitamin D deficiency
• Excessive alcohol consumption

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