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Uterine fibroids

Uterine fibroids, also known as leiomyomas or myomas, are noncancerous growths of the uterus that often appear during childbearing years. These growths can vary in size and number and may cause a range of symptoms or go unnoticed entirely.

Here is some essential information about uterine fibroids:

1

Types of Uterine Fibroids

  • Intramural Fibroids: These are the most common and develop within the muscular uterine wall.
  • Submucosal Fibroids: These grow just beneath the uterine lining and may protrude into the uterine cavity, potentially causing heavy menstrual bleeding and other symptoms.
  • Subserosal Fibroids: These develop on the outer uterine wall and may press on nearby organs, leading to symptoms like pelvic pain or urinary issues.
  • Pedunculated Fibroids: Subserosal fibroids with a stalk (peduncle) that connects them to the uterine wall or nearby structures.

2

Symptoms of Uterine Fibroids

  • Heavy Menstrual Bleeding: Excessive menstrual bleeding, prolonged periods, and the need for frequent pad or tampon changes.
  • Pelvic Pain and Pressure: Pelvic pain, discomfort, or a feeling of fullness in the lower abdomen.
  • Pelvic Pain During Sex: Pain or discomfort during sexual intercourse.
  • Frequent Urination: Pressure on the bladder can lead to a frequent urge to urinate or difficulty emptying the bladder fully.
  • Constipation: Large fibroids pressing on the rectum can cause constipation.
  • Backache or Leg Pains: Rarely, fibroids can press on nerves in the back and cause back pain or leg pains.
  • Enlarged Abdomen: Large fibroids can make the uterus appear larger than normal, leading to an enlarged abdomen.

3

Diagnosis

Uterine fibroids are typically diagnosed through:

  • Physical Examination: Your healthcare provider may detect an enlarged uterus during a pelvic exam.
  • Ultrasound: Imaging tests like transvaginal ultrasound or pelvic ultrasound can confirm the presence of fibroids and provide details about their size and location.
  • Magnetic Resonance Imaging (MRI): In some cases, an MRI may be ordered to get more detailed information about the fibroids.

4

Treatment Options

  • Watchful Waiting: If fibroids are small and not causing symptoms, no treatment may be necessary, and your healthcare provider may recommend regular monitoring.
  • Medications: Hormonal medications like birth control pills, hormonal IUDs, or GnRH agonists may be used to manage symptoms such as heavy bleeding and pain.
  • Minimally Invasive Procedures: For symptomatic fibroids, minimally invasive procedures like uterine artery embolization (UAE), myomectomy, or radiofrequency ablation can be considered to shrink or remove the fibroids while preserving the uterus.
  • Hysterectomy: In severe cases or when other treatments have failed, a hysterectomy (removal of the uterus) may be recommended. This is a definitive treatment for uterine fibroids but means you can no longer become pregnant.
  • Focused Ultrasound Surgery (FUS): This non-invasive procedure uses high-intensity focused ultrasound waves to destroy fibroids.

The choice of treatment depends on the severity of symptoms, the size and location of fibroids, and a woman’s reproductive goals. It’s essential to discuss your options with your healthcare provider to determine the most suitable approach for your individual case.

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