Fibroids, also known as uterine fibroids or leiomyomas, are noncancerous growths that develop in the uterus. They are made up of smooth muscle cells and fibrous connective tissue, and can vary in size from tiny seedlings to large masses that can distort the shape of the uterus.
Fibroids are quite common, and are estimated to affect up to 70% of women by age 50. They can occur at any age, but are most common in women aged 30-40. While many women with fibroids do not experience any symptoms, they can cause a range of problems in others, including heavy menstrual bleeding, pelvic pain, and infertility.
The exact cause of fibroids is not well understood, but they are thought to be linked to hormonal imbalances, particularly involving estrogen and progesterone. Other risk factors for developing fibroids include a family history of the condition, obesity, and certain racial or ethnic backgrounds (such as African-American women, who are more likely to develop fibroids and experience more severe symptoms than women of other races).
Types of Fibroids
1. Subserosal Fibroids
Subserosal fibroids are the most common type of fibroid, accounting for approximately 60% of cases. They grow on the outer surface of the uterus, just beneath the serosa, which is the lining that covers the uterus. Subserosal fibroids typically grow outward, away from the uterus, and can become quite large without causing any symptoms. However, in some cases, they can cause pain or pressure on nearby organs, such as the bladder or rectum.
2. Intramural Fibroids
Intramural fibroids are the second most common type of fibroid, accounting for approximately 30% of cases. They grow within the muscular wall of the uterus, and can cause the uterus to become enlarged or distorted. Intramural fibroids can also cause heavy menstrual bleeding, pain, and infertility.
3. Submucosal Fibroids
Submucosal fibroids are the least common type of fibroid, accounting for approximately 10% of cases. They grow just beneath the lining of the uterus, known as the endometrium, and can protrude into the uterine cavity. Submucosal fibroids can cause heavy menstrual bleeding, pain, and fertility problems, as well as other complications such as miscarriage.
It’s worth noting that some fibroids may be a combination of these types, and the specific symptoms and treatment options can vary depending on the location and size of the fibroid(s). A healthcare provider can help determine the best course of action based on individual circumstances.
Symptoms of Fibroids
There are many symptoms of fibroids. But remember, that not all women with fibroids experience symptoms, and the severity of symptoms can vary widely depending on the size and location of the fibroid. A healthcare provider can help diagnose and manage fibroids based on individual circumstances. Some of the symptoms include:
Heavy or Prolonged Menstrual Bleeding
One of the most common symptoms of fibroids is heavy or prolonged menstrual bleeding. This can include periods that last longer than seven days, or require changing pads or tampons every one to two hours. Some women with fibroid may also experience clots during their period.
Pelvic Pain or Pressure
Fibroids can cause pain or pressure in the pelvic area, especially if they are large or located in certain areas of the uterus. This can include cramping, discomfort, or a feeling of fullness or heaviness in the lower abdomen.
Bladder or Bowel Problems
Fibroids that grow in certain areas of the uterus can put pressure on nearby organs, such as the bladder or rectum. This can cause urinary urgency or frequency, difficulty emptying the bladder, or constipation
Infertility or Miscarriage
Fibroid can sometimes interfere with fertility or lead to complications during pregnancy. Depending on the size and location of the fibroid(s), they can block the fallopian tubes, interfere with implantation of a fertilized egg, or cause problems with the placenta.
Other Symptoms
In addition to the above, fibroid can also cause a range of other symptoms, including fatigue, back pain, and pain during sex. Some women with fibroid may also notice a visible swelling or bulge in the lower abdomen.
Causes of Fibroids
Hormonal Imbalances
Hormonal imbalances, particularly involving estrogen and progesterone, are thought to play a major role in the development of fibroid. This is because these hormones can stimulate the growth of the smooth muscle cells in the uterus that give rise to fibroid. Women who have higher levels of estrogen, either naturally or through hormone replacement therapy, may be more likely to develop fibroid.
Genetic Factors
There is evidence to suggest that genetic factors may play a role in the development of fibroid. Women with a family history of fibroid are more likely to develop the condition themselves. Certain genetic mutations have also been linked to an increased risk of fibroids.
Lifestyle Factors
While the exact relationship is not well understood, there is some evidence to suggest that certain lifestyle factors may be associated with an increased risk of fibroids. These factors can include obesity, a diet high in red meat and low in fruits and vegetables, and a lack of physical activity.
Other potential risk factors for fibroid include age (fibroid are more common in women aged 30-40), race (African-American women are more likely to develop fibroid than women of other races), and certain medical conditions such as endometriosis.
Treating Fibroids
Medications
There are several medications that can be used to help manage the symptoms of fibroids. These can include nonsteroidal anti-inflammatory drugs (NSAIDs) to help relieve pain, and hormonal medications such as birth control pills or progesterone to help regulate menstrual bleeding. Gonadotropin-releasing hormone agonists (GnRHas) can also be used to temporarily shrink fibroid, but these medications are typically only used for short periods of time due to their potential side effects.
Surgery
In cases where medications are not effective or fibroids are causing significant symptoms, surgery may be necessary. A procedure to remove fibroids while leaving the uterus intact. This can be done through open surgery or minimally invasive techniques such as laparoscopy or hysteroscopy.
Hysterectomy is a procedure to remove the uterus, and sometimes the cervix, ovaries, and fallopian tubes. This is typically only recommended for women who do not wish to have children in the future, or for whom other treatments have not been effective. Uterine Fibroid Embolization (UFE) is a minimally invasive procedure that blocks the blood supply to the fibroid, causing them to shrink over time.
Non-Invasive Options
There are also several non-invasive options for treating fibroids. Magnetic Resonance-guided Focused Ultrasound (MRgFUS) is a non-invasive procedure that uses focused ultrasound waves to heat and destroy the fibroid tissue. Endometrial Ablation is a procedure to remove or destroy the lining of the uterus, which can help manage heavy menstrual bleeding caused by fibroid. While the evidence is mixed, some women report relief from fibroid symptoms with acupuncture.
Final Words
In conclusion, fibroid are a common condition that can cause a variety of symptoms including heavy menstrual bleeding, pelvic pain, and pressure. While the exact cause of fibroid is not well understood, hormonal imbalances, genetic factors, and lifestyle factors may all play a role in their development. There are several treatment options available for fibroids, including medications, surgery, and non-invasive options such as magnetic resonance-guided focused ultrasound and acupuncture.
The specific treatment recommended will depend on individual circumstances, and a healthcare provider can help determine the best course of action for each individual case. With proper diagnosis and management, many women with fibroids are able to effectively manage their symptoms and improve their quality of life.