Uterine fibroids, also known as myomas or leiomyomas, are lumps or tumors found in the uterus. These growths occur in 50% of all women and are one of the leading causes of hysterectomy.
Fibroids could grow outside the uterine wall (“serosal”), within the uterine wall (“mural”), or inside the uterine cavity (“submucosal”). Although considered tumors, they are non-cancerous. Fibroids are responsive to hormonal stimulation and may continuously grow throughout the fertile period of a woman.
What are uterine fibroids filled with?
Uterine fibroids are firm, dense tumors composed of fibrous connective tissue and smooth muscle fiber. These tumors have a rich supply of blood vessels, mostly from the uterine artery.
Due to this, the tumor may continuously grow until menopause is reached—making them seem alive. Despite its continuous growth, it’s very rare for uterine leiomyoma to be cancerous (also called leiomyosarcoma). It also does not increase a woman’s chances of getting other forms of cancer in the uterus.
What causes uterine fibroids?
The exact reason for its development remains unknown. However, it has been found to grow in response to stimulation of the hormone estrogen. It has also been associated with obesity, onset of menstrual period before the age of 10, and a family history of fibroids.
What signs and symptoms do fibroids cause?
Uterine myomas usually present with pain during sexual intercourse, excessive vaginal bleeding, pelvic pressure, or a feeling of fullness of the abdomen or pelvis. It could also cause frequent urination or constipation if its size is compressing the urinary bladder or rectum. However, not all women show symptoms.
How are uterine myomas diagnosed?
As it usually shows no symptoms, it’s diagnosed during routine examinations most of the time. To specifically diagnose and detect these, and to rule out other conditions, an abdominal or vaginal ultrasound could be performed. Magnetic Resonance Imaging or MRI could also be requested for a clearer view on the size, quantity, and location of the fibroids.
Another diagnostic test is hysteroscopy, where a small device with a camera attached to it is inserted into the womb through the vagina and the cervix. A biopsy could be performed at the same time to confirm any cancerous cell in the area. Lastly, a laparoscopy could be performed so as to thoroughly examine all the layers of the uterus for any lumps and tumors.
How are fibroids treated?
Most women have no symptoms but for those who do, there are several treatments that could help. Before considering which treatment option is best, a few things need to be factored in such as what specific symptoms you are having, the size and location of the fibroids, your age, and how close you are to menopause.
The first line of treatment is medication. The most commonly used is a drug called Gonadotrophin-Releasing Hormone Agonist (GnRHa). This decreases the amount of estrogen and progesterone provided by the body, therefore stopping the menstrual cycle. As a result, the fibroids shrink or disappear completely. Other drugs that could be used include birth control pills and Nonsteroidal Anti-Inflammatory Drugs (NSAIDs).
If medications are ineffective and a continuous growth in the fibroids is observed, surgery may be necessary. A hysterectomy could be done wherein a part or the entire uterus is removed. Myomectomy is another option. This works by removing the tumors from the muscular walls of the uterus without affecting healthy tissues.
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