What are Uterine Fibroids?
Medically known as leiomyomas, uterine fibroids are growths commonly found in the womb. Fibroids are not cancerous and are the most common non-cancerous tumour in women. However, uterine fibroids can still cause health complications, especially when they swell in size and distort the womb.
There are several types of uterine fibroids:
- Intramural: The most common type, generally found in the womb.
- Subserosal: These form on the outside.
- Submucosal: Generally found growing in the cavity.
- Pedunculated: A variation of subserosal fibroids characterised by a pedicle that supports the fibroid.
Treating uterine fibroids will depend on your current health condition, the type of fibroids needing treatment, and other factors the medical team deems essential.
Common Symptoms of Uterine Fibroids
Uterine fibroids do not immediately cause symptoms. A routine medical examination will discover the presence of fibroids. Symptoms may also appear when you are older or when a fibroid’s growth physically affects your menses.
Some symptoms you may experience include:
- Excessive or painful bleeding during or between periods.
- Longer-lasting or more frequent periods.
- Frequent urination or the urge to urinate.
- Frequent constipation.
- Bloating in your lower body/abdomen.
- Abdominal distention caused by an unnaturally large fibroid, making you look like pregnancy.
What Causes Uterine Fibroids?
The exact cause of uterine fibroid formation is still unclear. It believed that the hormones estrogen and progesterone may influence fibroid growth. When hormone levels drop due to menopause or other reasons, the fibroids shrink in size.
Uterine fibroids also possess genetic changes that differ from those in normal uterine muscle cells, though why this occurs is still unknown. You may also be at risk if you have a family history of fibroids.
Uterine Fibroid Treatments
Once your diagnosis is confirmed, your doctor will outline your treatment plan based on the condition of your fibroids. Take the time to discuss treatment options and speak to your doctors if you have any doubts or concerns.
Watchful Waiting
If you are not experiencing symptoms, watchful waiting is the best course of action. You will regularly need follow-up sessions to allow doctors to determine whether your uterine fibroids have grown or shrunk. Pain relief medication may be prescribed to alleviate any pain or discomfort you experience.
Medications
Some medications can help to control some symptoms or shrink (but not remove) uterine fibroids.
Gonadotropin-Releasing Hormone (GnRH) Agonists
These medications prevent the body from producing estrogen and progesterone, leaving you in a temporary menopausal state. It may help to shrink fibroids and prevent symptoms like heavy menstrual bleeding from occurring. They may also be prescribed to shrink fibroids before a major surgery. You may experience side effects when taking these GnRH agonists, including frequent hot flashes.
Tranexamic Acid
If your symptoms include heavy menstrual periods, tranexamic acid is recommended to help slow and regulate menstrual flow. However, it only helps to manage its symptoms.
Surgery
Surgery is a last resort for more serious cases. If you plan to get pregnant in the near future, the surgical team will prioritise specific procedures over others to preserve your uterus.
Myomectomy
Myomectomy involves the surgical removal of fibroids and can be divided into three methods:
- Laparotomy: The surgeon cuts a incision in your abdomen to reach the womb and remove large or deep fibroids.
- Laparoscopy: The surgeon makes mini-incisions in your abdomen, then inserts slender instruments and a camera to remove fibroids.
- Hysteroscopic: The surgeon inserts surgical endoscope through the vagina and cervix to reach the womb and remove the fibroids.
Uterine Fibroid Embolisation
This minimally invasive procedure injects special embolic agents into the arteries that supply the womb with blood. These agents cut off blood flow to the fibroids to shrink them.
Hysterectomy
For severe cases of uterine fibroids, the entire womb may need to be removed. It is the only permanent method in which fibroids will never return, but you will no longer be able to become pregnant.
Endometrial Ablation
The surgeon will use a special tool to destroy the tissue lining the inside of the womb permanently. While it preserves the uterus, you will also no longer be able to become pregnant.
MRI-Guided Focused Ultrasound Surgery (FUS)
This non-invasive technique places you inside an MRI scanner to detect uterine fibroids. They will then use an ultrasound transducer to direct high-energy sound waves to heat and slowly destroy uterine fibroid tissue. It is typically an outpatient procedure.
At O&G The Women’s Specialist
Preventive care starts with an early screening, and here at O&G The Women’s Medical Specialist, we are ready to support your journey with a range of fertility care services dedicated to your well-being.
