Uterine Fibroids

Uterine fibroids are one of the most common health problems in women of reproductive age, with symptoms ranging from mild to moderate and severe. Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years.

Many women have uterine fibroids sometime during their lives. But you might not know you have uterine fibroids because they often cause no symptoms. Your doctor may discover fibroids incidentally during a pelvic exam or prenatal ultrasound.

When treatment is necessary, there are various treatment options including drug therapy, surgery or a minimally invasive procedure. In severe and advanced cases, a hysterectomy is performed. There are few known risk factors for uterine fibroids, other than being a woman of reproductive age. 

If your mother or sister had fibroids, you’re at increased risk of developing them. Other factors include starting your period at an early age, obesity, a vitamin D deficiency; having a diet higher in red meat and lower in green vegetables, fruit and dairy; and drinking alcohol, including beer, appear to increase your risk of developing fibroids. Estrogen and progesterone, two hormones that stimulate development of the uterine lining during each menstrual cycle in preparation for pregnancy, appear to promote the growth of fibroids.

Fibroids contain more estrogen and progesterone receptors than typical uterine muscle cells do. Fibroids tend to shrink after menopause due to a decrease in hormone production.

In women who have symptoms, the most common signs and symptoms of uterine fibroids include:

• Heavy menstrual bleeding
• Menstrual periods lasting more than a week
• Pelvic pressure or pain
• Frequent urination
• Difficulty emptying the bladder
• Constipation
• Backache or leg pains

Fibroids are generally classified by their location. There are fibroids located inside the uterine cavity and cause vaginal bleeding between periods as well as severe pain. This type of fibroid can be removed with hysteroscopy through the cervix without laparoscopy.

In some other cases, part of the fibroids is inside the uterine cavity and the other part is in the uterine wall and cause thick blood loss during the period, and it is accompanied by vaginal bleeding between periods. This type of fibroid can be removed with hysteroscopy and there is no need for traditional surgery and making a large incision.  Fibroids located inside the uterine wall range in size; they can be so small and not visible to the naked eye or large and accompanied by several symptoms. There are several ways to treat this type of fibroid, but most of them do not need any treatment.

There are fibers that are present outside the uterine wall or are attached to the uterus; these do not need treatment if they become large, and may lead to pain if a twisting occurs, but it is one of the easiest types that can be removed through laparoscopy. 

Treatment

Treatment methods vary according to the size of the tumor. If the fibroid is small, the patient can live with it or stop its growth with drug therapy. Surgical intervention may be required to remove the tumor or remove the uterus whenever it becomes large and depending on its location. 

Radiotherapy can also be adopted if the first two treatments were unsuccessful. 

If the size of the fibroid is less than 3 cm and there are no symptoms, it does not need treatment, and if the woman suffers from severe pain, painkillers, hormonal drugs or monthly injections can be used.  When the tumor is large and causes discomfort and health problems, then surgical intervention is needed in order to remove it. Recent developments in the medical field have allowed doctors and surgeons to perform minimally invasive operations (laparoscopic or robotic) which contributed to a quicker recovery and less postoperative complications.