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What Are Uterine Fibroids?
Uterine fibroids are non-cancerous growths in the uterus that may appear during the time of pregnancy. This condition is also known as leiomyomas or myomas. Uterine fibroid does not come with a risk of uterine cancer and rarely develops into cancer.
These fibroids can be of different sizes from seedlings that are undetectable by the human eye, to bulky masses that can distort and lead to enlargement of the uterus. You can have a single fibroid or multiple ones. Multiple fibroids can expand the uterus to such an extent that they can reach the rib cage and add additional weight to it.
Symptoms of uterine fibroids
Many women have fibroids but don’t have any symptoms. But the fibroids which come with symptoms increases by the location, size, and number of fibroids.
However, for the women who have symptoms, the most common signs include:
- Heavy menstrual bleeding
- Menstrual periods lasting for more than a week
- Pelvic pressure or pain
- Frequent urination
- Difficulty in emptying the bladder
- Backache or leg pains
In some rare cases, a fibroid can cause acute pain when it overgrows in its blood supply and begins to die.
Fibroids are generally distinguished by their location. Intramural fibroids grow within the muscular uterine wall and the submucosal fibroids grow into the uterine cavity. Subserosal fibroids projects outside the uterus.
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What are the causes of uterine fibroids?
Many of the doctors are still not able to figure out the cause of uterine fibroids, but research and clinical experience point to these factors:
- Genetical changes – Many fibroids come with changes in genes that are different from the ones present in normal uterine muscle cells.
- Hormones – Oestrogen and progesterone are the two hormones that control the development of the uterine lining during menstrual cycles resulting in preparation for pregnancy, which later appear to promote the growth of fibroids in the urinary tract.
Fibroids contain more levels of estrogen and progesterone receptors than the normal uterine muscle cells. However, fibroids tend to shrink soon after menopause due to a decrease in hormone production.
- Other growth factors – Substances and fluids that help the body to maintain the tissues, such as insulin-like growth factor, may also affect fibroid growth.
- Extracellular matrix (ECM) – ECM is the material that helps the cells to stick together. An increase in the level of ECM in fibroids makes them fibrous. ECM also stores growth factors or hormones that cause biological changes in the cells of the body.
The growth patterns of the uterine fibroids are different from one another. They may grow slowly or rapidly, or they may remain of the same size. Some fibroids go through growth spurts, and some may shrink on their own.
How are uterine fibroids treated?
Whenever you develop a fibroid make sure you immediately consult your doctor. Your doctor will advise you with a treatment plan based on the size of your fibroid and your health condition.
Gonadotropin-releasing hormone agonists, such as leuprolide will cause your estrogen and progesterone hormone levels to drop. This will eventually stop your menstruation and shrink the fibroids. These hormones will stop your body from producing follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
Other options that are available to control bleeding and pain are:
- An intrauterine device (IUD) that releases the hormone progestin.
- Over-the-counter (OTC), which are anti-inflammatory pain relievers, such as Ibuprofen.
- Birth controlling pills.
To remove very large or multiple growing fibroids, surgery may be performed. This surgery is known as a Myomectomy. It involves making a large incision right in the abdomen to access the uterus and remove the fibroids. The surgery can also be performed laparoscopically, by using a few small incisions into which surgical tools and a camera are inserted. Fibroids might grow back after surgery.
However, if your condition gets worse and if no other treatments work, your physician may perform a Hysterectomy. This means that you won’t be able to bear children anymore.
Uterine fibroids are the most common pelvic tumors in women. These are usually diagnosed late in a woman’s reproductive life. Common symptoms include abnormal uterine bleeding, pelvic pressure and pain, infertility, recurrent pregnancy loss, and decreased quality of life. You will need immediate medications or surgical treatment if you’re facing any of the symptoms.
Dr. Kaurabhi Zade
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