Uterine Fibroids

UTERINE FIBROIDS: EVERYTHING YOU NEED TO KNOW

Do you always experience prolonged, heavy menstrual periods?

Does it sometimes cause abnormal bleeding?

Do you feel a sudden sharp pain in your pelvic area?

Do you seem to have a continuous urge to urinate as well?

If your answer to any of these questions is yes, then it is better to see you your doctor and have yourself checked because you may be experiencing the most common symptoms for uterine fibroids.

Curious about Uterine Fibroids? Read more to know everything about this condition!

What are Uterine Fibroids?

Uterine fibroids are non-cancerous growth that are made up of smooth muscle cells that develop in the uterus. Clinically, they are called leiomyomas or myomas, and though they may appear as tumors, these outgrowths are by nature benign and almost never develop into cancer—they usually develop slowly and eventually shrink after menopause.

Can I have Uterine Fibroids?

A lot of women have uterine fibroids sometime in their lifetime. In fact, uterine fibroids are considered as one of the most common gynecological condition.

Since uterine fibroids respond to levels of estrogen and progesterone production, these growths can develop during the onset of reproductive age when you start menstruating up until menopausal stage.

As mentioned above, the symptoms for uterine fibroids include:

Heavy and prolonged menstrual flow
Anemic symptoms caused by heavy flow
Abnormal bleeding
Frequent urinating and a continuous urge to urinate
Pelvic/abdominal pain
Bloated feeling
Constipation
Back and leg pain

How are Uterine fibroids detected?

Even though at least 40-60% of women affected, most women are not aware that they have uterine fibroids because most of the symptoms are silent. Sometimes, uterine fibroids are discovered during prenatal ultrasounds but most of the time, uterine fibroids are only discovered by accident during routine pelvic examinations when your doctor feels an irregular mass or unusually large uterus.

To know if you have uterine fibroids, your doctor may order you get an ultrasound (or other imaging tests if the result provides insufficient data) and additional diagnostic tests to determine the degree of the condition.

What are the different types of Uterine fibroids?

There are three major types of uterine fibroids that are classified depending on their location on the uterus.

Intramural fibroids are growths within the uterine muscle. Submucosal fibroids grow in the inner lining of the uterus (endometrium) while Subserosal fibroids are found in the outer surface of the uterus.

In some cases, the Submucosal or Subserosal fibroids tend to hang from a stalk-like structure inside or outside of the uterus. These are called pedunculated fibroids.

Additionally, uterine fibroids are also classified depending on their size. You can have one or many fibroids in your uterus.

Typically, many different types and sizes of fibroids can grow in one uterus.

What causes uterine fibroids?

Fibroids originate from a single stem cell where certain genes have been damaged. The changes in the genes make the cell multiply faster than usual. With the influence of hormones and other growth factors, the cells divide uncontrollably resulting to abnormal cell growth.

To this day, research has not yet confirmed the exact cause of genetic changes. This condition, however, can be influenced by different factors including your

family genetics
ethnicity

For example, studies show that there is a greater risk for uterine fibroids for women approaching or in menopausal stage due to high production of estrogen.

Additionally, for unknown reasons, African-American women have increased risk of having uterine fibroids.

This also seems to be true to women who are obese.

There is also a higher risk for you if you have family members (sisters or mother) who have uterine fibroids.

Can I still get pregnant if I have uterine fibroids?

There is no evidence that uterine fibroids cause infertility.

Unless they become so large enough to obstruct the fallopian tubes that can result to a high chance of preventing fertilization.

Also, fibroids found in the lining of the uterus may affect the proper settlement and passage of the embryo, which can reduce the chance of pregnancy and increase the risk of miscarriage.

Do you want to get pregnant with minimal gynecological concerns?

Then, it is important for you to get a fertility assessment with your gynecologist to detect and resolve any issues as early as now.

What if I’m already pregnant? Can fibroids harm my baby?

Typically, if the fibroids are small, rarely affect pregnancy and don’t cause harm to the developing baby inside your womb.

Many women who were diagnosed with uterine fibroid while pregnant had safe delivery and healthy babies.

Complications may only arise when fibroids continue to grow during pregnancy. If the baby is not yet due, large fibroids may cause uterine contractions, which can be very painful to the mother.

Also, these large fibroids can inhibit contractions right after pregnancy and may increase the risk of massive bleeding.

If you are pregnant and have uterine fibroids, it is always better to fully understand the condition and best to entrust your health to the hands of reliable obstetrician you could trust.

How can Uterine fibroids be treated?

Oftentimes, fibroids that are small (<4cm) does not cause symptoms and may not require treatment. However, if the symptoms tend to become bothersome and worse, it is highly recommended that you seek medical help.

Here we discuss the different treatment options your gynecologist can initiate depending on the severity of the condition:

1. Medication

This type of treatment only helps to:

reduce menstrual flow
relieve pelvic pain
shrink fibroids

Medications do not completely remove the tumors.

Medications like Tranexemic Acid and Progestin-releasing intrauterine device (IUD) are used to reduce menstrual flow.

GnRH (Gonadotropin-Releasing Hormone) injections inhibit the production of the hormones progesterone and estrogen causing you to be in a state of temporary menopause which causes the fibroids to shrink in size.

2. Non-invasive Treatment

If you are afraid of going under the knife, Uterine artery embolization (UAE) is also non-invasive treatment option that uses small particles (embolic agents) that are injected into the blood vessels of the uterus. This process cuts off blood flow and oxygen supply to fibroids, causing them to slowly shrink and eventually die.

3. Surgical Treatment

If your fibroids do not reduce in size with the help of medications, your doctor may recommend surgery.

There are several different surgical methods depending on the type of condition.

Less invasive treatments include:

Laparoscopic Myomectomy
Robotic Surgery

where the fibroids are removed using small instruments through small incisions in your abdomen. These methods are recommended for smaller and fewer fibroids in the uterus.

Another way of removing fibroids if through open surgeries like:

Laparotomy, Abdominal myomectomy
Hysteroscopic myomectomy

While Hysterectomy (removal of uterus) is considered as the permanent solution to removing fibroids, this procedure, however, will not permit you to get pregnant anymore.

In these situations, it is important that you discuss with your gynecologist for proper assessment, and recommendation of other new treatment technologies best suited for you.

Will my fibroids grow back after treatment?

Even after operation, there is still a chance (10-30%) that uterine fibroids may recur after any treatment (except hysterectomy) because some muscle cells could still undergo genetic changes that could lead to new abnormal growths.

Also, there might still be very small tumors that your doctor cannot detect during surgery which could develop to bigger fibroids.

Can my fibroids develop into cancer?

According to research and reported cases, uterine fibroids are naturally non-cancerous and the developing into a cancerous growth is really very low (less than 1%) and >99% of fibroids slowly shrink in the post-menopausal years.

However, there is a fibroid-like (but totally unrelated) cancer called leiomyosarcoma. This is a very rare condition that can occur with or without the presence of fibroids.

How can I prevent the development of fibroids?

Since the real cause of uterine fibroid development has not yet been determined, there is still no proven ways on how to prevent them.

To this day, prevention of fibroids is not yet possible, but early detection is a key to its cure.

And as our doctors always say, a healthy lifestyle can always help us decrease the chance of developing such conditions.