Fibroid in Uterus: The reasons for the formation of lump or neoplasm in the uterus are: hormonal imbalance, genetic reasons, obesity, excessive estrogen, and change in reproductive age. These lumps usually form in the muscles or tissues of the uterus and can cause various health problems.

Fibroids in Uterus: Causes, Symptoms, and Treatment

Fibroids, also known as uterine leiomyomas or myomas, are non-cancerous growths that develop in or on the uterus. While they are typically benign, fibroids can cause a range of symptoms and complications, depending on their size, number, and location within the uterus. Understanding the underlying causes, recognizing the symptoms, and exploring the available treatments are essential for managing this common gynecological condition.

Causes of Uterine Fibroids

The exact cause of uterine fibroids is not fully understood, but several factors contribute to their development. These include hormonal imbalances, genetic predispositions, obesity, excessive estrogen levels, and changes in reproductive age.

1. Hormonal Imbalance

Hormones, particularly estrogen and progesterone, play a significant role in the growth of fibroids. These hormones stimulate the development of the uterine lining during each menstrual cycle, which can also promote the growth of fibroids. High levels of estrogen and progesterone, often seen during reproductive years, are associated with an increased risk of developing fibroids. Conversely, fibroids tend to shrink after menopause when hormone levels decrease.

2. Genetic Reasons

A genetic predisposition can also contribute to the formation of fibroids. Women with a family history of fibroids are more likely to develop them. Specific genetic mutations have been identified that increase the likelihood of fibroid formation. Research continues to uncover the genetic factors involved, which may eventually lead to more targeted treatments.

3. Obesity

Obesity is another significant risk factor for fibroids. Excess body fat can lead to increased estrogen production, which, in turn, can stimulate fibroid growth. Women with a higher body mass index (BMI) are more likely to develop fibroids, and weight management is often recommended as part of a comprehensive approach to reduce fibroid risk.

4. Excessive Estrogen

Excessive estrogen levels, independent of obesity, can also contribute to fibroid development. This hormone imbalance can result from various factors, including hormone replacement therapy, the use of certain contraceptives, and conditions like polycystic ovary syndrome (PCOS). Managing estrogen levels through lifestyle changes and medical interventions can help mitigate the risk.

5. Changes in Reproductive Age

Fibroids are most common in women of reproductive age, typically between the ages of 30 and 50. During this period, hormone levels fluctuate, and the cumulative exposure to estrogen and progesterone increases the likelihood of fibroid formation. After menopause, the risk decreases significantly as hormone levels decline.

Symptoms of Uterine Fibroids

The symptoms of uterine fibroids can vary widely, depending on the size, number, and location of the growths. Some women may experience no symptoms at all, while others may have severe and debilitating symptoms. Common symptoms include:

Heavy Menstrual Bleeding: One of the most prevalent symptoms is menorrhagia, or heavy and prolonged menstrual bleeding. This can lead to anemia and severe fatigue.
Pelvic Pain and Pressure: Fibroids can cause a sensation of fullness or pressure in the pelvic area. This discomfort can range from mild to severe and may be accompanied by lower back pain.
Frequent Urination: Large fibroids can press against the bladder, leading to increased urinary frequency and urgency.
Constipation and Bloating: Fibroids that press on the rectum can cause bowel-related symptoms, such as constipation and bloating.
Painful Intercourse: Dyspareunia, or pain during sexual intercourse, can occur if fibroids are located near the cervix or lower uterus.
Reproductive Issues: In some cases, fibroids can interfere with fertility and complicate pregnancy. They may cause miscarriages, preterm labor, or difficulties during delivery.

Diagnosis of Uterine Fibroids

Diagnosing fibroids typically involves a combination of medical history, physical examination, and imaging tests. During a pelvic exam, a healthcare provider may feel irregularities in the shape of the uterus. To confirm the presence and assess the size and location of fibroids, imaging techniques such as ultrasound, magnetic resonance imaging (MRI), and hysterosonography (sonohysterography) are commonly used.

Treatment Options for Uterine Fibroids

Treatment for uterine fibroids depends on the severity of symptoms, the size and location of the fibroids, and the patient’s desire for future fertility. Options range from watchful waiting to medical and surgical interventions.

1. Watchful Waiting

For women with small fibroids that are not causing significant symptoms, a watchful waiting approach may be appropriate. Regular monitoring with periodic ultrasounds can help track the growth of fibroids. If symptoms worsen or the fibroids grow rapidly, more active treatment may be needed.

2. Medications

Medications can help manage fibroid symptoms, though they do not eliminate the fibroids themselves. Common medications include:

Hormonal Therapies: Birth control pills, gonadotropin-releasing hormone (GnRH) agonists, and other hormonal treatments can help regulate menstrual cycles and reduce bleeding and pain.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These can help alleviate pain associated with fibroids.
Iron Supplements: To address anemia caused by heavy menstrual bleeding, iron supplements may be prescribed.

3. Minimally Invasive Procedures

Several minimally invasive procedures can effectively treat fibroids with less recovery time than traditional surgery. These include:

Uterine Artery Embolization (UAE): This procedure involves injecting small particles into the uterine arteries to block blood flow to the fibroids, causing them to shrink.
Magnetic Resonance-Guided Focused Ultrasound Surgery (MRgFUS): This technique uses high-intensity ultrasound waves to destroy fibroid tissue while preserving surrounding tissue.
Laparoscopic or Robotic Myomectomy: These surgical options involve removing fibroids through small incisions using specialized instruments, minimizing recovery time.

4. Surgical Options

For larger fibroids or those causing severe symptoms, surgical intervention may be necessary. Surgical options include:

Hysterectomy: The complete removal of the uterus is the only definitive cure for fibroids. It is typically recommended for women who do not wish to preserve their fertility.
Abdominal Myomectomy: This procedure involves removing fibroids through an open abdominal incision. It is suitable for women who want to preserve their uterus and future fertility.
Hysteroscopic Myomectomy: This minimally invasive procedure removes fibroids through the vagina and cervix using a hysteroscope. It is effective for fibroids located inside the uterine cavity.

Lifestyle and Natural Remedies

In addition to medical and surgical treatments, lifestyle changes and natural remedies can help manage fibroid symptoms and improve overall health. These include:

Diet and Nutrition: Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help maintain a healthy weight and hormone balance. Some studies suggest that reducing red meat and increasing the intake of green vegetables may lower the risk of fibroids.
Regular Exercise: Physical activity can help manage weight, reduce stress, and improve overall health, potentially lowering the risk of fibroid development.
Stress Management: Chronic stress can affect hormone levels and overall health. Techniques such as yoga, meditation, and mindfulness can help manage stress.
Herbal Supplements: Some women find relief from fibroid symptoms using herbal supplements like green tea extract, chasteberry, and milk thistle. However, it is essential to consult a healthcare provider before starting any herbal remedies.

Impact on Fertility and Pregnancy

Fibroids can affect fertility and pregnancy in several ways. They may block the fallopian tubes, preventing sperm from reaching the egg, or interfere with the implantation of the fertilized egg in the uterine lining. During pregnancy, fibroids can increase the risk of complications such as miscarriage, preterm labor, and placental abruption.

For women with fibroids who wish to conceive, a myomectomy may be recommended to remove fibroids while preserving the uterus. This procedure can improve fertility outcomes and increase the chances of a successful pregnancy.

Uterine fibroids are a common and often challenging condition that can significantly impact a woman’s quality of life. Understanding the causes, recognizing the symptoms, and exploring the available treatment options are crucial steps in managing fibroids effectively. Whether through lifestyle changes, medical treatments, or surgical interventions, women with fibroids have a range of options to help alleviate symptoms and improve their overall health and well-being.

By staying informed and working closely with healthcare providers, women can make empowered decisions about their health and find the most appropriate strategies to manage uterine fibroids. As research continues to uncover new insights into the causes and treatments of fibroids, there is hope for even more effective and personalized approaches in the future.

Fibroids of the uterus, also known as myomas, are one of the most frequent benign tumours of the reproductive system in women. Learn what occurs to a woman who has fibroids, including the types, causes, symptoms, risk factors, and treatment options from a doctor.
Uterine fibroids, also known as leiomyomas or myomas, are a form of noncancerous muscle tumour that can grow in your uterus, on the uterine wall, on the surface, or attach to your uterus through a stalk- or stem-like structure. While some fibroids are so little that they can’t be seen with the naked eye, others develop in large masses that can alter the size and shape of your uterus.

They are one of the most prevalent benign tumours of the female reproductive system. Uterine fibroids are said to affect 40-77 percent of women at some time in their lives, however not all of them produce symptoms or consequences.

Types:

According to Dr. Anjali Kumar, Senior Consultant Gynaecologist, Obstetrician, and Founder of Maitri Woman’s Health, fibroids can be of many sorts depending on their location:

1. Intramural – Fibroid is present within the muscular wall of the uterus

2. Submucosal – Fibroid is bulging into the cavity of the uterus

3. Subserosal – Fibroid is located on the outer surface of the uterus

4. Pedunculated – Fibroid is attached only with a thin stalk to the surface of the uterus

Causes:

“Despite enormous advances in medical science and technology, we have still not been able to pin-point the specific reason why fibroids grow in some women but not in others,” Dr. Anjali Kumar said. Although the risk factors have been established, the actual reason has yet to be determined. Fibroids, on the other hand, are hormone-dependent tumours that form in response to the feminine hormones oestrogen and progesterone.”

“The action of these hormones induces enlargement of the uterine muscle tissue in certain women, resulting in the production of fibroids,” she continued. The fact that fibroids are rarely discovered before puberty and are known to reduce in size after menopause supports this theory.

Symptoms:

It is important to note that not all of the uterine fibroids will cause any symptoms or complications and the development of its symptoms depends to a large extent on the size, location and the number of fibroids present in the uterus. Dr Anjali Kumar asserted that many women who have fibroids may not experience any symptoms at all but about 25-50% of women may experience problems like:

1. Heavy and/or prolonged periods

2. Bleeding in between two periods (Inter-menstrual bleeding)

3. Painful periods

4. Pelvic pressure or pain

5. Difficulty in passing urine

6. Frequent urination

7. Constipation

8. Lump in abdomen

9. Difficulty in conceiving

10. Pain during intercourse

Risk factors:

For the uninitiated, fibroids can develop in any woman and at any age and given these are hormone dependant tumours, they are found more commonly in women who have certain risk factors like:

1. A family history of uterine fibroids

2. Obesity

3. Pregnancy

4. African-American origin

5. Age 30 years or older

Diagnosis:

Highlighting that the doctor may do a physical abdominal and pelvic examination of the presence of fibroids, Dr Anjali Kumar shared that one may be advised to undergo certain tests based on the symptoms and clinical examination. These include:

1. Ultrasound of the pelvis and abdomen to detect the number and size of the fibroids.

2. Magnetic Resonance Imaging ( MRI) – This is required in certain cases to differentiate the fibroids from other benign or cancerous conditions like adenomyosis or sarcomas.

3. CT scan may be required to study the organs of the pelvis and abdomen in detail.

4. Hysteroscopy is a minimally invasive procedure where a thin and long camera is introduced into the uterus through the vagina to study the cervix, uterine cavity and endometrial lining. This may help diagnose submucosal fibroids or fibroid polyps.

5. Laparoscopy is also a minimally invasive technique where a thin telescopic camera is introduced into the abdomen under anaesthesia to study the internal organs, uterus, tubes and ovaries.

Treatment:

“Small, asymptomatic fibroids which are diagnosed only by chance and are not causing any symptoms do not require any specific treatment and are usually just kept under observation by an annual ultrasound and clinical examination,” explained Dr Anjali Kumar. However, she revealed that larger fibroids or the fibroids that are causing symptoms require treatment and there are various options available like:

1. Over the counter medications- Painkillers and medications for controlling the bleeding may be prescribed by your doctor.

2. NSAID’s- These are medications that help control the pain and bleeding.

3. Hormonal medications- These can be either oral or injectables.

4. Intrauterine device containing the hormone levonorgestrol has been found very effective in controlling the bleeding and works well for 5 years.

5. Surgical procedures- Sometimes, when conservative medical methods fail or are unsuitable for some women, the doctor may recommend a surgical procedure to remove only the fibroids (Myomectomy) or occasionally, the entire uterus may need to be removed (Hysterectomy).

6. Other methods- Some newer methods are being used to control the symptoms and growth of the fibroids. These include High Intensity Focussed Ultrasound (HIFU) or Uterine Artery Embolisation (UAE).

fibroids

Watch Video: Discover the Causes, Symptoms, and Treatments of Uterine Fibroids