What are Fibroids?

Fibroid are Non-cancerous growths in the uterus that can develop during a woman’s childbearing years. Sometimes these tumors become quite large and cause severe abdominal pain and heavy periods. The cause of fibroids isn’t well understood. Risk factors include a family history of fibroids, obesity or early onset of puberty.

Other names of Fibroids are:

• leiomyomas
• myomas
• uterine myomas
• fibromas

Many women have uterine fibroids sometime during their lives. But you might not know you have uterine fibroids because they often cause no symptoms. Your doctor may discover fibroids incidentally during a pelvic exam or prenatal ultrasound.

Symptoms

Many women who have fibroids don’t have any symptoms. In those that do, symptoms can be influenced by the location, size and number of fibroids.

In women who have symptoms, the most common signs and symptoms of uterine fibroids include:

• Heavy menstrual bleeding
• Menstrual periods lasting more than a week
• Pelvic pressure or pain
• Frequent urination
• Difficulty emptying the bladder
• Constipation
• Backache or leg pains

Rarely, a fibroid can cause acute pain when it outgrows its blood supply, and begins to die.

Causes of Fibroids

• Genetic changes: Many fibroids contain changes in genes that differ from those in normal uterine muscle cells.
• Hormones:Estrogen and progesterone, two hormones that stimulate development of the uterine lining during each menstrual cycle in preparation for pregnancy, appear to promote the growth of fibroids.
• Other growth factors:Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth.

Types of Fibroids

Along with the size and number of fibroids, the type can also affect treatment recommendations. The three main types of fibroids include:

• Subserosal fibroids: These are the most common fibroids. They can push outside of the uterus into the pelvis. Subserosal fibroids can grow large at times and sometimes have a stalk that attaches to the uterus (pedunculated fibroid).
• Intramural fibroids: These fibroids develop in the muscular wall of the uterus.
• Submucosal fibroids: These fibroids are uncommon. They can grow into the open space inside the uterus and may also include a stalk.

Factors that can increase the risk of developing Fibroids:

• Age: Fibroids become more common as women age, especially during their 30s and 40s and up to menopause. After menopause, fibroids are much less likely to form and usually shrink if they’re present.
• Family history: Having a family member with fibroids increases your risk. If a woman’s mother had fibroids, her risk of having them is about three times higher than average.
• Ethnic origin: African-American women are more likely to develop fibroids than other ethnicities .
• Obesity: Women who are overweight are at higher risk for fibroids. For very heavy women, the risk is two to three times greater than average.

How are Fibroids diagnosed?

For a proper diagnosis, you’ll need to see a gynecologist to get a pelvic exam. This exam is used to check the condition, size, and shape of your uterus. You may also need other tests, which include:

Ultrasound

An ultrasound uses high-frequency sound waves to produce images of your uterus on a screen. This will allow your doctor to see its internal structures and any fibroids present. A transvaginal ultrasound, in which the ultrasound wand is inserted into the vagina, may provide clearer pictures since it’s closer to the uterus during this procedure.

Pelvic MRI

This in-depth imaging test produces pictures of your uterus, ovaries, and other pelvic organs.

What Prevention should be taken?

Although researchers continue to study the causes of fibroid tumors, little scientific evidence is available on how to prevent them. Preventing uterine fibroids may not be possible, but only a small percentage of these tumors require treatment.

But, by making healthy lifestyle choices, such as maintaining a normal weight and eating fruits and vegetables, you may be able to decrease your fibroid risk.

Also, some research suggests that using hormonal contraceptives may be associated with a lower risk of fibroids.

Treatment & Medication

Medications to regulate your hormone levels may be prescribed to shrink fibroids.

Gonadotropin-releasing hormone (GnRH) agonists, such as leuprolide (Lupron), will cause your estrogen and progesterone levels to drop. This will eventually stop menstruation and shrink fibroids.

GnRH antagonists also help to shrink fibroids. They work by stopping your body from producing follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Examples include:

• ganirelix acetate, an injectable drug
• cetrorelix acetate (Cetrotide), an injectable drug
• elagolix, which is present in the oral drug elagolix/estradiol/norethindrone acetate (Oriahnn)

Other options that can help control bleeding and pain, but won’t shrink or eliminate fibroids, include:

• an intrauterine device (IUD) that releases the hormone progestin
• over-the-counter (OTC) anti-inflammatory pain relievers, such as ibuprofen (Advil)
• birth control pills

Surgery

Surgery to remove very large or multiple growths may be performed. This is known as a myomectomy. An abdominal myomectomy involves making a large incision in the abdomen to access the uterus and remove the fibroids. The surgery can also be performed laparoscopically, using a few small incisions into which surgical tools and a camera are inserted. Fibroids might grow back after surgery.

If your condition worsens, or if no other treatments work, your physician may perform a hysterectomy. However, this means that you won’t be able to bear children in the future.

Noninvasive or minimally invasive procedures

A newer and completely noninvasive surgical procedure is forced ultrasound surgery (FUS). You lie down inside a special MRI machine that allows doctors to visualize the inside of your uterus. High-energy, high-frequency sound waves are directed at the fibroids to ablate, or destroy, them.

Myolysis procedures (such as Acessa) shrink fibroids using heat sources like an electric current or laser, while cryomyolysis freezes the fibroids. Endometrial ablation involves inserting a special instrument into your uterus to destroy the uterine lining using heat, electric current, hot water, or extreme cold.

Another nonsurgical option is uterine artery embolization. In this procedure, small particles are injected into the uterus in order to cut off the fibroids’ blood supply.

What can be expected in the long term?

Your prognosis will depend on the size and location of your fibroids. Fibroids may not need treatment if they’re small or don’t produce symptoms.

If you’re pregnant and have fibroids, or become pregnant and have fibroids, your doctor will carefully monitor your condition. In most cases, fibroids don’t cause problems during pregnancy. Speak with your doctor if you expect to become pregnant and have fibroids.