What Are Uterine Fibroids and Why Should You Care About Them?
The most prevalent gynecological condition is uterine fibroids. By the age of 50, it is estimated that 70% of people with a uterus will have one or more uterine fibroids, with around 30% of patients experiencing symptoms and seeking treatment.
- Uterine fibroids are common growths on your uterus.
- They can by symptomatic or asymptomatic, and the symptoms determine urgency for treatment.
- There are no current medications that remove uterine fibroids, but there are steps you can take to treat and prevent them.
Uterine fibroids are benign (non-cancerous) growths that form in the uterine muscle tissue. They are also known as leiomyomas or myomas. Uterine fibroids can vary widely in size, shape, and location.
They affect the uterus, a pear-shaped organ in your pelvis, which is normally about the size of a lemon. A woman may have one or more fibroids of varied sizes. A fibroid might be extremely tiny for a long time and then grow quickly, or it can grow slowly over the course of years. Uterine fibroids can grow on the outside or inside its wall, or connected to it via a stem-like structure.
The American College of Obstetricians and Gynecologists finds that uterine fibroids are most common in women between the ages of 30 and 40, but they can occur at any age. Though they affect people of every race, African American women are more likely than white women to have fibroids. They also appear to appear at an earlier age and develop faster in African American women. Other risk factors include age, genetic factors (family history of fibroids), early onset of period, caffeine and alcohol intake, obesity and hypertension.
Symptomatic vs Asymptomatic Uterine Fibroids
The majority of fibroids do not produce symptoms and do not require treatment other than regular monitoring by your healthcare physician. Typically, these are tiny fibroids. Asymptomatic fibroid refers to a fibroid that does not cause symptoms. Larger fibroids can cause a wide range of symptoms, including:
- Excessive pain and bleeding during periods
- Bleeding between your periods.
- Bloating in your lower abdomen
- Lower back pain
- Pain during sex
- Frequent urination/ inability to completely empty bladder
- Abdominal distention (abdomen appears pregnant)
Testing and Treatment
Fibroids are frequently discovered during a routine evaluation with your women's health professional. They can be felt during a pelvic examination and identified during a gynecologic checkup or prenatal care. Often, your description of excessive bleeding and other relevant symptoms will prompt your doctor to consider fibroids as part of the diagnosis.
Several tests can be performed to confirm fibroids and assess their size and location. These tests may involve the following:
- Ultrasound: This non-invasive imaging exam uses sound waves to build an image of your internal organs. The ultrasound may be conducted transvaginally or transabdominally, depending on the size of the uterus.
- Sonohysterography: In this imaging test, a tiny catheter is inserted transvaginally and saline is administered into the uterine cavity through the catheter. This additional fluid aids in creating a crisper view of your uterus than a typical ultrasound would.
- MRI: This test uses magnets and radio waves to obtain detailed pictures of your internal organs.
- CT scan: A CT scan uses X-ray pictures to create a detailed view of your inside organs from various angles.
- Hysterosalpingography (HSG): is a detailed X-ray in which a contrast substance is injected first, followed by X-rays of the uterus. This is more commonly used in women who are simultaneously being evaluated for infertility.
- Hysteroscopy: During a hysteroscopy, your physician will examine fibroids inside your uterus using a scope (a thin, flexible tube with a camera on the end). The scope is inserted into your vagina and cervix to view fibroids inside the uterus.
- Laparoscopy: Your provider will create a tiny cut (incision) in your lower abdomen during this examination. A small, flexible tube with a camera on the end will be implanted to examine the outside of your uterus.
After fibroids have been identified, there aren't a ton of options to get rid of them. Despite the high incidence of uterine fibroids, no viable pharmacotherapies have been approved. While some medication can help ease symptoms, surgery remains the primary treatment option of which there are two main types:
A procedure that removes fibroids while leaving the uterus intact. Myomectomy is the greatest treatment choice for women who have fibroid symptoms and wish to have children in the future. Although myomectomy is very efficient, fibroids can re-grow. The younger you are and the more fibroids you have at the time of myomectomy, the more probable it is that you may develop fibroids again. Women approaching menopause are the least likely to experience recurrence fibroids issues following a myomectomy.
The uterus is removed during a hysterectomy, which is a major surgical operation. Many women choose hysterectomy to end their fibroid issues for good. Menstrual bleeding ends after hysterectomy, pelvic pressure is alleviated, frequent urination improves, and new fibroids cannot form. After a hysterectomy, a woman is no longer able to become pregnant.
During a hysterectomy, the ovaries are not always removed. In general, if a woman is in or nearing menopause, her ovaries are removed. Additionally, if the ovaries appear abnormal or if the woman wishes to reduce her risk of getting ovarian cancer later in life, the ovaries may be removed.
Alternatively a relatively new procedure called a uterine fibroid embolization (UAE) causes fibroids to shrink by cutting off their blood supply. The doctor injects sand-sized particles into the arteries that feed the fibroids, these articles adhere to the vessel's wall. This causes a clot to form, cutting off the blood flow. The fibroids shrink when the blood supply is cut off.
Uterine fibroids are a common affliction that many women (or people who have a uterus) will have during their lives. In most circumstances, fibroids are so little that they do not produce any symptoms. Yet they can cause severe problems. If you are experiencing any discomfort or pain, contact your healthcare professional.
Written by Kiana St. Onge