Fibroids

Fibroids

By: letitiaspencer on (1 comment)

 

Fibroids are growths (tumors) that develop from the smooth muscle layer of the uterus. They are the most common growths of the uterus and female pelvic organs. One study found that approximately 50% of women have them. Most often they are benign. Very rarely they can become cancerous (less than 0.5% of the time).

The growth of fibroids is dependent on estrogen production. This is the reason why fibroids have the potential to enlarge during pregnancy (when increased levels of estrogen are present) as well as to regress after menopause (when there is decreased levels of estrogen). They can be multiple or exist as a single large growth. They can be located on the surface of the uterus, in the wall of the uterus, or in the uterine cavity.

Most fibroids do not cause any symptoms and many women are unaware that they have them. When they do cause symptoms, it ranges from abnormal bleeding to pelvic pressure.

Fibroids in African American women

Fibroids are more common in African American women than in women of other racial groups. One study showed that fibroids are three times more common in African American women than in Caucasian women. Additionally, fibroids tend to be larger and occur at an earlier age in African Americans. It is unclear as to why such differences exists.

What are the signs and symptoms of fibroids?

  1. Abnormal menstrual cycle

  • Abnormally heavy menstrual bleeding. 

  • Abnormally heavy menstrual periods that come more frequent than your normal cycle (less than every 28-30 days).

  1. Pelvic pain/pressure

  • Painful menstrual periods.

  • Pain during or after sexual intercourse.

  • Pressure on the bladder which can cause frequent urination.

  • Acute or severe pelvic pain from twisting of the fibroid on its stalk, or from degeneration of the fibroid.

Complications of fibroids

The most common complication is heavy bleeding which can lead to anemia. The anemia can be so severe as to necessitate blood transfusions, and/or an emergency surgery such as a hysterectomy.

Very infrequently, fibroids may be a cause of infertility and/or pregnancy loss.

How can you be evaluated for fibroids?

Fibroids can be diagnosed during a physical exam by your doctor. He or she can often feel an enlarged, irregular uterus. Your doctor may use other tests (ultrasound, hysterogram) to help confirm the diagnosis, and/or to determine the best treatment option for you.

Treatment options

There are many options for the treatment of fibroids. Treatment options will vary based on your symptoms, age, and desire to conceive. Further discussion with your doctor will help you decide which treatment is best for you.

  • Motrin or other anti-inflammatory medications may be prescribed for pain.

  • Birth Control Pills help to regulate the menstrual cycle, control heavy bleeding, and alleviate some of the pain and pressure.

  • Lupron: another type of hormone that may aid in shrinking the fibroids and stopping bleeding.

  • Ablation: a surgical procedure in which the lining of the uterus is destroyed to prevent further bleeding.

  • Uterine artery embolization: a procedure that destroys the blood supply to the fibroids thus causing them to shrink (resulting in less bleeding).

  • Myomectomy: a surgical procedure to remove the fibroids and to leave the uterus otherwise intact..

  • Hysterectomy: a surgical procedure that removes the uterus, and thus, the fibroids.

Empowerment Points

  • Fibroids are the most common growth (or tumor) of the female reproductive tract.

  • Many women who have them are unaware of them.

  • The most common symptoms are irregular bleeding and pelvic pain or pressure.

  • Initial management consists of medical therapy. If this is unsuccessful, there are many surgical options available, including options to preserve the uterus. Discussion with your doctor will help decide the best management for you.

References:

  1. Berek JS. Novak’s Gynecology. 12th ed. Baltimore: Williams and Wilkins

  2. Rock JA, Thompson JD. TeLinde’s Operative Gynecology. 8th ed. Lippincott- Raven

Letitia Spencer, M.D.

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