fibroid

What are fibroids?

Fibroids are abnormal growths that develop in or inside a woman’s uterus. Sometimes these tumors become quite large and cause severe abdominal pain and heavy periods. In other cases, they cause no signs or symptoms. The growths are typically benign or non-cancerous. The cause of fibroids is unknown.

Fibroids are also known by the following names:

  • leiomyomas
  • fibroids
  • uterine fibroids
  • fibroma

According to the National Institutes of Health (NIH), about 80 percent of women get it by age 50. However, most women have no symptoms and never know they have fibroids.

What are the different types of fibroids?

The type of fibroid a woman develops depends on its location in or in the uterus.

Intramural fibroids

Intramural fibroids are the most common type of fibroid. These types occur in the muscular wall of the uterus. Intramural fibroids can grow and lengthen your uterus.

Subserosal fibroids

Subserosal fibroids are on the outside of the uterus, called serosa. They can grow large enough to make your uterus appear larger on one side.

Pedunculated fibroids

Subserosal tumors may develop a stem, which is a thin base that supports the tumor. When they do, they are known as pedunculated fibroids.

Submucosal fibroids

Tumors of this type develop in the middle muscle layer, or myometrium, of your uterus. Submucosal tumors are not as common as other types.

What causes fibroids?

It’s not clear why fibroids develop, but certain factors can influence their formation.

Hormones

Estrogen and progesterone are hormones produced by the ovaries. It causes the uterine lining to regenerate during each menstrual cycle and can stimulate the growth of fibroids.

family history

Fibroids can run in families. If your mother, sister or grandmother has a history of this condition, you may develop it too.

Pregnancy

Pregnancy increases the production of estrogen and progesterone in your body. During pregnancy, fibroids can develop and grow rapidly.

Who is at risk for fibroids?

Women are at greater risk for developing fibroids if they have one or more of the following risk factors:

  • pregnancy
  • family history of fibroids
  • 30 years and older
  • African American
  • high body weight

What are the symptoms of fibroids?

Your symptoms will depend on the number, location, and size of tumors you have. For example, submucosal fibroids can cause heavy menstrual bleeding and conception.

If your tumor is very small or you are entering menopause, you may not have any symptoms. Fibroids can shrink during and after menopause. This is because women entering menopause experience a drop in levels of estrogen and progesterone, which are hormones that stimulate fibroid growth.

Symptoms of fibroids can include:

  • heavy bleeding during or between periods involving blood clots
  • pain in the pelvis or lower back
  • increase in menstrual cramps
  • increased urination
  • pain during intercourse
  • menstruation that lasts longer than usual
  • pressure or fullness in your lower abdomen
  • abdominal swelling or enlargement

How are fibroids diagnosed?

For an accurate diagnosis, you need to see a gynecologist to conduct a pelvic exam. This exam is used to check the condition, size and shape of your uterus. You may also need other tests, including:

ultrasound

An ultrasound uses high-frequency sound waves to produce images of the uterus on a screen. This allows your doctor to view their internal structures and any fibroids present. A transvaginal ultrasound, in which the ultrasound wand is inserted into the vagina, can provide clearer pictures during this procedure as it is closer to the uterus.

Pelvic MRI

This in-depth imaging test produces pictures of the uterus, ovaries, and other pelvic organs.

How are fibroids treated?

Your doctor will develop a treatment plan based on your age, the size of your fibroids, and your general health. You may receive a combination of treatments.

Home remedies and natural treatments

Some home remedies and natural treatments can have a positive effect on fibroids, including:

  • acupuncture
  • yoga
  • massage
  • Gui Zhi Fu Ling Tang (GFLT), a traditional Chinese medicine formula
  • application of heat for cramps (avoid heat if you experience heavy bleeding)

Dietary changes can also help. Avoid meat and high-calorie foods. Instead, opt for foods high in flavonoids, green vegetables, green tea, and cold-water fish such as tuna or salmon.

Managing your stress levels and losing weight if you are overweight can also benefit women with fibroids.

Medicines

Medications to regulate your hormone levels may be prescribed to shrink fibroids. Gonadotropin-releasing hormone (GnRH) agonists such as leuprolide (Lupron) cause your estrogen and progesterone levels to drop. This eventually stops menstruation and shrinks the fibroids.

Other options that help control bleeding and pain but do not shrink or eliminate fibroids include:

  • an intrauterine device (IUD) that releases the hormone progestin
  • over-the-counter (OTC) anti-inflammatory pain relievers, such as ibuprofen (Advil)
  • birth control pills

Surgical treatment

Surgery may be done to remove very large or multiple growths. This is known as a myomectomy. An abdominal myomectomy involves making a large incision in the abdomen to access the uterus and remove the fibroids. The surgery can also be done laparoscopically using several small incisions into which surgical instruments and a camera are inserted. Fibroids can grow back after surgery.

If your condition worsens or no other treatment works, your doctor may perform a hysterectomy. However, this means that you cannot carry children in the future.

Minimally invasive procedures

A newer and completely non-invasive surgical procedure is mandatory ultrasound surgery (FUS). You lie inside a special MRI machine that allows doctors to visualize the inside of your uterus. High-energy, high-frequency sound waves are directed at the fibroids to destroy or destroy them.

Similarly, myolysis shrinks fibroids using electric current or laser, while cryomyolysis freezes fibroids. Endometrial ablation involves inserting a special instrument into the uterus to destroy the uterine lining using heat, electrical current, or hot water.

Another surgical option is uterine artery embolization. In this procedure, small particles are injected into the uterus to cut off the blood flow to the fibroids.

What can be expected in the long run?

Your prognosis will depend on the size and location of your fibroids. Fibroids may not need treatment if they are small or not producing symptoms.

If you are pregnant and have fibroids, or if you become pregnant and have fibroids, your doctor will monitor your condition carefully. In most cases, fibroids do not cause problems during pregnancy. Talk to your doctor if you’re considering getting pregnant and getting fibroids.

Resources:

BassJ, et al. (2015). Fibroids: advice and treatment options.

Dalton-Brewer N. (2016). The role of complementary and alternative medicine in the management of fibroids and associated symptomatology. DOI:

Fibroids causes, symptoms and treatment. (Nd).

Jacoby VL, et al. (2014). Use of medical, surgical and complementary therapies in women with fibroids [Özet]. DOI:

Mayo Clinic Staff. (2018). Uterine fibroids.

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