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Understanding Uterine Fibroids And Women's Health

Up to 77% of women can have Fibroids at some point during their reproductive years.



The pear-shaped Uterus is a multi-talented organ in females. It plays a pivotal role in supporting the female body through many vital phases of life.

  • Ensuring timely monthly cycles

  • Offering a bed for egg implantation during pregnancy

  • Nurturing and developing the fetus till the time it matures for birth

  • Fostering a smooth delivery of your baby

So, it is natural to feel stressed when your Uterus is under any form of attack. More so if it has anything to do with unnatural lumps as is the case during Uterine Fibroids diagnosis. Now hold on, there's encouraging news.

Fibroids are tumors that about 80% of women get by their 50s. But they are usually harmless. At least, in approx. 99% cases. Nevertheless, these growths may still cause discomfort and interfere with daily living. So, awareness is crucial for a quick fix to the condition.


What are Fibroids?

Also known as Leiomyomas and Myomas, Fibroids are noncancerous tumors. These muscular lumps, made of smooth cells and fibrous tissues grow inside or on the wall of the Uterus. The rate of growth is different in each Fibroid. Even when there is more than one in a single Uterus, one may be pea-sized. While the other is a bulky mass enlarging the womb.

A woman can develop Fibroids at any time during their lifespan. But they are less frequent in expecting mothers. The chances are as low as 0.1% to 3.9%. That being said, if Fibroids in pregnancy occur, they show rapid growth. The changing hormonal state of the body is an obvious reason. The rise in estrogen and progesterone levels, for instance.


Types of Uterine Tumors

The Fibroids of Uterus are divided into different varieties. Depending on their location and attachment method.

  1. Intramural Fibroids - These are the most common sort that develop within the wall of the womb.

  2. Subserosal Fibroids - They project on the serosa, the outer lining of the Uterus.

  3. Pedunculated Fibroids - These are Submucosal Fibroids that form a thin base to hold the lump.

  4. Submucosal Fibroids - A rare kind that bulges inside the thick middle Uterine bed. That is the myometrium.

  5. Cervical Fibroids - Also rare, they grow on the cervix, the tiny canal linking your womb to the vagina.

Note: Some Fibroids, although very uncommon, can be malignant. But thankfully, those that start benign do not turn cancerous.


Fibroids Symptoms

Uterine tumors do not always come with symptoms.



Some women may not even require a Fibroids cure. But those less fortunate, usually share the following signs.

  • Heavy menstrual bleeding

  • Menstrual cycles lasting over a week

  • Pain/ pressure in the pelvic area

  • Frequent urination

  • Constipation

  • Trouble while emptying the bladder

  • Backache

  • Leg pains

In some cases, the symptoms are severe, leading to immediate doctor consultation.

  • Extreme vaginal bleeding

  • Prolonged monthly cycles

  • Long-lasting sharp pelvic pain

  • Painful periods

  • Bleeding/ spotting between two periods

  • Unexplained low count of red blood cells (Anemia)

  • Pain during intercourse

Fibroids during pregnancy also require extra caution. Given the expectant body is already sensitive, that helps avoid unwelcome complications.

Note: People often confuse Fibroids with cysts. But the latter is different despite sharing common traits. Like being benign, and symptom-free (often) to causing pelvic pains and menstrual changes.


Fibroids Causes

It is not clear why Fibroids occur. But a lot of factors influence the development.

  • Hormones- Estrogen and progesterone may lead to Fibroids. The fact that the tumors shrink during low hormone levels backs the statement.

  • Genetic changes- Changes in genes may be a factor. Scientists have found variations in genes between the normal Uterine cells and Fibroids.

  • Growth factors- Substances that take care of your tissues may play a part. The insulin-like growth factor, for instance.

  • Extracellular matrix (ECM) - ECM helps the cells stick together. In Fibroids, their amount is more than in normal cells. ECM also has growth factors that stir changes in cells.

To add to these, other elements increase a woman’s proneness to having Fibroids. They include:

  • Age (Fibroids are most common between 30-40 years. They are rare below 20 years.)

  • Family history

  • Birth control usage

  • Menstrual cycles at an early age

  • Vitamin D deficiency

  • A red meat-rich diet that also lacks green leafy veggies, fruits, and dairy

  • High blood pressure

  • Obesity

  • Alcohol intake

How to Diagnose Fibroids?

Fibroids are mostly spotted during routine pelvic/ abdominal checkups. If the doctors feel something unusual, they recommend tests like.

  1. Ultrasound (It involves using sound waves to detect Fibroids)

  2. Complete blood count (It helps spot Anemia and other blood diseases)

  3. MRI

In special situations, additional tests may be advised:

  1. Hysterosonogram - It uses saline to expand the space inside the Uterus. This helps to easily spot Submucosal Fibroids.

  2. Hysterosalpingogram (HSG)- It is used in infertility-related concerns. Results show whether the Fallopian tubes (ducts between your womb and ovaries) are blocked or open. Along with Submucosal Fibroids presence.

  3. Hysteroscopy - Physicians insert a thin instrument through the vagina into the Uterus. It helps spot Fibroids and polyps.


Fibroids Treatment

The process to treat the Fibroids of Uterus is not the same for everyone. There are a lot of parameters to consider like:

  • Number of Fibroids you have

  • Fibroid size

  • Tumor location

  • Fibroids symptoms

  • Your pregnancy plans for the future (decision on whether to keep the Uterus)

Coming to remedies, home methods like Acupuncture, Yoga, and dietary changes can work. But for serious Fibroids, you may require clinical treatment.


Medicines

  1. Gonadotropin-releasing hormone (GnRH) agonists - They limit estrogen and progesterone levels. This stops menstruation temporarily, thereby shrinking Fibroids.

  2. Progestin-releasing intrauterine device (IUD) - They give relief from signs like heavy bleeding. But prevent pregnancy too.

  3. Tranexamic acid - It’s nonhormonal and eases heavy periods.


Noninvasive Treatment Procedures

  1. Focused Ultrasound Surgery (FUS) - It is an MRI-guided noninvasive treatment. Meaning there is no incision required.


Minimally-Invasive Treatment

  1. Uterine Artery Embolization - Small particles are injected here. They cut the blood supply to the tumors, making them shrink.

  2. Radiofrequency Ablation - It uses heat to destroy Fibroids.

  3. Laparoscopic/ Robotic Myomectomy - Doctors make small incisions in the abdomen. Then they use slender instruments to remove the lumps.

  4. Endometrial Ablation - Heat/ electric current/ hot water is introduced via a unique tool that destroys the Uterus lining.

  5. Hysteroscopic myomectomy - It involves inserting tools through the vagina/ cervix. It is effective on Submucosal Fibroids.

Conventional Fibroids Surgery Methods

  1. Abdominal Myomectomy - An open abdominal surgery apt for multiple/ large/ deep tumors. But it affects fertility.

  2. Hysterectomy - A permanent solution that involves removing the Uterus. With this, you cannot have children anymore.

Final Thoughts

Uterine Fibroids, although benign can impact life when symptomatic. So, being aware of your condition is key to avoiding complications. That involves regular checkups and tailoring the management strategies as per individual needs. Also, have open conversations with your physician to ensure informed choices.

 

The Author : Dr. Sunil Khattri

sunilkhattri@gmail.com

+91 9811618704


Dr. Sunil Khattri MBBS, MS(General Surgery), LLB, is a Medical doctor and is a practicing Advocate in the Supreme Court of India and National Consumer Disputes Redressal Commission, New Delhi.

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