Uterine Fibroids
What are Uterine Fibroids?
Uterine fibroids are non-cancerous growths that develop in or around the uterus (womb), affecting approximately 1 in 3 women in the UK. These growths consist of muscle and fibrous tissue and can vary greatly in size. Fibroids typically develop during a woman’s reproductive years and do not form before puberty (menarche) or after menopause. They are also referred to as uterine myomas or leiomyomas. Many women with fibroids may be unaware of their condition, as fibroids often do not cause noticeable symptoms.
The main types of uterine fibroids include:
Submucosal: Grow into the inner lining of the uterus.
Intramural: Develop within the muscular wall of the uterus.
Subserosal: Form on the outer surface of the uterus.
Pedunculated: Grow on a stalk-like structure, either inside or outside the uterus.
Symptoms of Uterine Fibroids
The symptoms of uterine fibroids can vary based on their size, location, and number.
Common symptoms include:
- Heavy or Painful Periods: Excessive menstrual bleeding and discomfort.
- Abdominal and Lower Back Pain: Persistent pain or pressure in these areas.
- Frequent Urination: Increased need to urinate caused by pressure on the bladder.
- Digestive Issues: Constipation, bloating, or discomfort due to pressure on the bowel.
- Pain During Intercourse: Discomfort or pain experienced during sexual activity.
- Abnormal Uterine Bleeding: Irregular bleeding or pain caused by fibroid growth.
- Enlarged Abdomen: Noticeable swelling or bloating of the abdomen.
In rare cases, fibroids may lead to complications such as pregnancy difficulties or infertility.
What Causes Uterine Fibroids?
The exact cause of uterine fibroids is not fully understood, but several factors may contribute to their development:
Elevated Estrogen Receptors: Congenital increases in estrogen receptors within the uterine muscle tissue (myometrium) may play a role.
Hormonal Changes: Fluctuations in hormones, particularly estrogen and progesterone, influence fibroid growth.
Ischemic Injury: A response to reduced blood flow (ischemic injury) during menstruation may trigger fibroid formation.
Treatments for Uterine Fibroids
Uterine fibroids often do not require treatment if they are not causing symptoms. In many cases, fibroids shrink naturally after menopause without intervention. The choice of treatment depends on the severity of symptoms, age, and future plans for pregnancy.
Anti-Inflammatory Medications: Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or meenamic acid, can help manage pain and reduce heavy bleeding. These are typically taken up to three times a day, starting from the first day of your period until bleeding becomes manageable or stops.
Hormonal Contraceptives: The contraceptive pill, in addition to preventing pregnancy, can make periods lighter and reduce menstrual pain. It works by stopping ovulation and regulating hormone levels.
Progestogen Therapy: Oral or injectable progestogen can be used to manage heavy menstrual bleeding associated with fibroids.
Medications to Shrink Fibroids: Certain medications may help reduce the size of fibroids. If these are ineffective, surgical or minimally invasive procedures may be considered.
Surgical Treatments:
- Hysterectomy: Removal of the uterus, often recommended for severe symptoms when childbearing is no longer a consideration:
- Myomectomy: Surgical removal of fibroids while preserving the uterus, an option for women who wish to have children.