Fibroids, or usually known as uterine fibroids because they develop in or around the uterus, are non-cancerous growths made up of muscle and fibrous tissue. They differ in size, and many women don’t know they have this condition because it doesn’t have any symptoms.
Let’s dive into more details regarding fibroids and how to minimise your risk during pregnancy.
More About Fibroids
Fibroids can develop anywhere in the uterus. They can be the size of a pea while others can grow as big as a melon.
The main kinds of fibroids are as follows:
- Intramural fibroids – This is the most common. They develop in the muscle wall of the uterus.
- Subserosal fibroids – These fibroids develop outside the womb’s wall into the pelvis and can grow big in size.
- Submucosal fibroids – They develop in the muscle layer beneath the inner lining of the womb and grow into the womb’s cavity.
In certain instances, submucosal or subserosal fibroids are attached to the uterine wall with a stalk-like growth called a peduncle. Hence its name pedunculated fibroids.
Its Signs and Symptoms
As previously mentioned, not all women with fibroids experience symptoms. If a person experiences them, then it might be due to the location, size and the number of fibroids present.
The most common signs of fibroids are as follows:
- Periods that are longer/heavier than usual,
- Bleeding that lasts more than a week,
- A feeling of fullness or pressure in your lower abdomen,
- Frequent urination/trouble urinating,
- An enlarged abdomen,
- Difficulty with bowel movement, and
- Pain during sex, in the lower back/legs
This is rare, but a person can feel sudden, serious pain when a fibroid outgrows its blood supply and begins to degenerate or die (hence the term fibroid degeneration).
What are the Causes and Risk Factors?
Fibroids usually develop in women of childbearing age. Scientific findings suggest that they shrink and cause fewer symptoms after menopause. There are quite a number of risk factors for developing uterine fibroids. These include:
- Age – Women who belong to the age range of 30-40 are at higher risk, compared to younger women.
- Race – African-American women have more severe symptoms, unique concerns, and are more likely to consult family, friends, and health brochures for information.
- Family History – You are at an increased risk if your mother or sister has fibroids. Research has shown that relying on what women report about their family history is not a reliable way to predict whether they are at higher risk.
- Obesity – Being obese increases the risk or prevalence of uterine fibroids. This association between the two factors is non-linear. It means that not because an obese person is heavier, they are also at higher risk than an obese person who is a tad bit lighter.
- Diet – The same with having low nutrient levels. Add both fresh and cooked green veggies, fish, legumes, and fresh fruit to your plate. Minimise your intake of beef, ham, or any other red meat as these increase your risk.
- Hypertension – According to recent research, those with untreated high blood pressure are 19% more likely to be diagnosed with fibroids than those without hypertension. And among the respondents with high blood pressure, those who take medication have a 37% lower risk than those who are not on treatment.
- No History of Pregnancy – Women who have never been pregnant do not experience the hormonal changes associated with pregnancy that can either regulate/reduce the growth of fibroids. Also, the risk decreases as the number of pregnancies increases.
Diagnosis of Fibroids
The doctor examines the pelvis and may suspect a UF or uterine fibroid if the uterus is found to be unusually larger in size than normal, or if the womb’s contour is irregular.
It’s confirmed through an ultrasound scan of the uterus and your doctor finds a growth. CT-scan or MRI scan of the pelvis and the abdomen also shows the presence of fibroids.
If you think you are at a high risk of developing fibroids, you should see a women’s clinic and have a pelvic examination and/or radiological imaging to confirm if you have fibroids.
Impact of Fibroids on Women’s Lives
Women not only suffer from physical symptoms like heavy menstrual bleeding, pelvic pain, and lower back pain, but they also suffer from the emotional and social impact of fibroids. They may experience symptoms that can isolate them from their social circles or affect their performance at work.
Uterine fibroids can also affect fertility and cause complications during pregnancy. They take a toll on the overall health of women, which is why early detection and treatment are important.
Fibroids and Pregnancy
Worse case scenario comes and you were diagnosed with fibroids while you’re pregnant, you may have difficulty during labour or concerns regarding the development of your baby. They most likely happen during your first three months or first trimester.
During the first trimester, the main areas of concern here are the bleeding and pain symptoms and miscarriage.
Come second and third trimesters, as the uterus expands to make room for the baby, it can push against the fibroids. You may experience pain here especially if they are large. It can get uncomfortable.
Studies also show that women with fibroids have a significantly greater chance of placental abruption (your placenta tears away from the uterine wall before you deliver your baby) than those without. The last issue during either of these terms is preterm delivery. You are more likely to deliver before you reach 37 weeks of your pregnancy.
Studies also show that having fibroids increases your odds of delivering via caesarean section. The reason could stem from the fact that fibroids keep the uterus from contracting and block the birth canal. It can slow down the labour’s progress, so you may have to deliver your baby via a C-section.
Treatment Options for Uterine Fibroids
You should know that there is no best treatment for fibroids. There are many choices to choose from. Discuss the most suitable option for you with a women’s health clinic.
The first recommended option is watchful waiting, since most fibroids are asymptomatic or if you have mildly uncomfortable symptoms that you can endure. In general, the majority of the women do not require treatment. It will depend on the decision of the patient and the treatment choice depending on their circumstances.
Here are more specific treatments:
Treating Heavy Menstruation
When the patient experiences heavy menstrual flow as the main symptom, medication can be prescribed, such as danazol, tranexamic acid, progesterone hormone, and gonadotropin-releasing hormone (GnRH) antagonists.
Take note that they only reduce the heavy menstrual flow. They don’t treat fibroids. These medications are appropriate when the fibroid is either small or moderate and when the patient is nearing menopause.
Hysteroscopic Resection/Myomectomy
Hysteroscopic resection and myomectomy are great options if the fibroids are located inside the uterus (called submucosal fibroids). It’s a minimally invasive procedure that removes the fibroid/s or fibroid polyp/s using tools placed through the vagina & cervix into the uterus. This is suitable for all women regardless of age, even those planning to get pregnant in the future.
Uterine Artery Embolisation
Embolic agents are injected into the arteries supplying blood to the uterus. These small particles cut off or block the blood flow (embolisation) to the fibroid (type: solitary fibroid of moderate/moderately large size), eventually leading them to shrink and die.
Through this technique, the symptoms that fibroids are causing are relieved, though reliable sources say that it’s not a complete cure. Good news is that the size can shrink by almost 60% and heavy menstruation can be reduced by roughly 80%.
This is an excellent option for those who want to avoid surgical risks.
Hysterectomy
This final option is for those who have no future plans of bearing children. Hysterectomy is the only proven permanent solution for this condition.
And if you decide to also have your ovaries removed, you will experience menopause immediately after the surgery. This is known as surgical menopause. Right then, you can choose if you want to take HRT to ease the side effects of menopause.
But you may be able to conserver your ovaries, depending on what the doctor advises you to do.
Lifestyle Management and Self-Care
Other people improve their symptoms by making changes to their lifestyle and routine. Here are some do’s and don’ts that you can follow to relieve the usual symptoms of fibroids.
Do’s
Aside from loading up on fresh fruits and veggies, monitor your blood pressure and as much as possible, try to manage your stress.
If you are having painful periods due to fibroids, consider lying down and elevate your legs using a pillow. You can also lie on your side and bring your knees onto your chest to relieve the pressure from your back.
And before you try any supplements like vitamin D, talk to your doctor if it’s safe for you to do so.
Don’ts
In addition to not eating processed foods, red meats, and high-fat dairy, don’t forget to skip physical activities, around seven hours a week can do to reduce your risk.
A high-sugar diet is also a big no-no. Firsthand smoking is also believed to increase your pain during menstrual period, so stop it before this symptom worsens.
When Should I See A Doctor?
It’s only in rare cases that women with fibroids need emergency treatment. You should immediately seek emergency care if you experience any of the following:
- Sharp and sudden pain in your abdomen that doesn’t go away with pain medication
- Severe vaginal bleeding accompanied by anaemia signs (like extreme fatigue, weakness, and lightheadedness).
Conclusion
Uterine fibroids are common growths in women and non-cancerous. It’s only natural that you feel concerned because it can affect your day-to-day life and overall health.
A women’s health clinic can reassure you that everything will be fine for as long as you stay proactive in deciding for your health and get regularly checked up.
Contact us right here for questions you have in mind or if you want to book an appointment with us. WS Law Women’s Clinic and Laparoscopic Surgery Centre is always ready for your health concerns.