Uterine fibroids are benign tumours comprised of muscular and fibrous tissues. They develop from uterine tissue and vary in size, from microscopic to large growths, similar in size to a grapefruit.
Signs and symptoms of fibroids
The signs and symptoms can vary in strength and some women are unaware of having any issues. However, symptoms can include:
- Pain and anaemia – due to uterine cramping and heavy periods leading to low blood supply.
- Pregnancy complications – fibroids during pregnancy can be significant, including growth restriction, malpresentation, and post-partum haemorrhage.
- Pressure on other internal organs due to the fibroids pressing up against them, causing frequent urination or altered bowel habits.
It is unknown what directly links to the risk of developing fibroids. The correlation between tumours forming and alterations in growth have been shown to be a factor. Medication, diet and smoking are always factors in women’s health complications.
Fibroids tend to develop in women who have a family history of them. However, other factors can include:
- Women of African heritage are two to three times more likely to form fibroids earlier in their lives. In comparison to women of other races, they can develop later in their lives (30-40s).
- Beginning your first menstrual period before the age of 10
- Consumption of alcohol, beer in particular
- Infections in the uterus
- High blood pressure
Some tests used to identify fibroids are:
- Clinical examination
- Magnetic resonance imaging (MRI)
There is no single best approach to uterine fibroid treatment, but many options exist. If you have uterine fibroid symptoms, talk with your doctor about options for relief.
Some options include:
These do not get rid of fibroids but may potentially shrink them. They can treat symptoms such as heavy menstrual bleeding and pelvic pressure. Medications include:
- Gonadotrophin-releasing hormone (Gn-RH) agonists which block oestrogen production and progesterone, therefore, inducing a non-permanent postmenopausal state.
- Progestin-releasing intrauterine device (IUD) – This device only gives symptom relief.
- Oral contraceptives or progestins may be recommended by your doctor due to their ability to assist in controlling menstrual bleeding.
MRI-guided focused ultrasound surgery is a treatment performed while you are in an MRI scanner. This provides the doctor with images of the exact location of the uterine fibroids. The treatment does not require an incision, instead the process uses sound waves to heat and eliminate small areas of tissue.
Minimally invasive procedures
- Uterine artery embolisation – Blood flow to the fibroids are cut off, making them shrink and eventually resolve. The treatment is successful in relieving symptoms as well as shrinking fibroids.
- Laparoscopic or robotic myomectomy – A myomectomy involves the extraction of fibroids without removing the womb. For small and non-abundant growths, your doctor may choose to conduct a laparoscopic or robotic procedure.
- Hysteroscopic myomectomy – This procedure involves your surgeon inserting surgical instruments through the vagina and cervix into the womb to remove fibroids.
- Endometrial ablation – Surgical instruments are inserted into the womb to implement heat, microwave energy, electric current or hot water. This is done to denature the lining of the womb. This process either reduces your menstrual flow or ceases it. This treatment is not recommended for women who are still wanting to fall pregnant.
- Hysterectomy – Surgical removal of the uterus. This procedure is a definite, permanent solution for uterine fibroids. However, the removal of the uterus means you are unable to have children.