Uterine Fibroid Tumors
Fibroid tumors are the most common benign (not cancerous) tumor of a
woman’s uterus (womb) that typically affect women in their reproductive
years.
Most fibroid tumors do not cause symptoms and are discovered
incidentally. Others may cause heavy periods, frequent urination,
painful intercourse and sensation of fullness in the lower abdomen.
Medications and less invasive surgical procedures are now available to
control the growth of fibroids.
In this article, I intend to
present concise medical information about the fibroid tumor, including
symptoms and treatments as well as the its relationship with pregnancy,
infertility, cancer and menopause.
What Are Fibroid Tumors?
Fibroids are benign growths of the uterine smooth muscle wall. Two
important features need clarification in this simple definition
1. Benign growths.
Growths in the body are often classified as benign growths or cancer.
The uterine fibroid tumor is a benign growth. It is not cancer.
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2. They are growths from the uterine smooth muscle. The uterus has |
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The name fibroids
is somewhat a misnomer because it somehow implies that fibroid tumors
are growths mainly made up of fibrous tissue, which is not true.
Though fibroids contain fibrous tissue, the main component is made of
smooth muscles. The medical term for fibroids is uterine leiomyoma or
fibromyoma.
Fibroids almost never develop into cancer. It is very rare and when it does happen, the cancer is called leiomyosarcoma.
Causes, Prevalence And Risk Factors
Uterine fibroid tumors are common. As many as 1 in 5 women may have
fibroids during their childbearing years (the time after starting
menstruation for the first time and before menopause). Half of women
have fibroids by age 50.
Unfortunately, the exact cause is not yet
known. That does not mean no treatment, though! It just means medical
doctors have not yet identified the precise cause.
However, some contributing factors include
- Hormones.
Estrogen and progesterone appear to favor the growth of fibroids. That
is why they are more prevalent in the menstruating years, especially
after 20 and turn to shrink after menopause. They are rare before 20
years. - Genetic predisposition in some individuals. In may run in some families.
Who is at risk of developing fibroids?Below are some factors that may put women at risk of developing fibroids,
- Overweight and obesity
- Advancing age. 4% of women 20 – 30 years, 18% between 30 – 40 years and 33% between 40 and 60 years develop fibroids.
- Nulliparity. This means never having given birth to a child.
- Early menarche. Onset of the menstrual period prior to age 10
- Black women. About 3- 9 times more common with larger fibroids and more symptoms compared to Caucasian women. Diabetes and hypertension Family history
- High estrogen states like pregnancy
However, the following factors somehow protect or lower the risk of fibroids
- Five pregnancies or more
- Menopause
- Oral Contraceptive or Depo Provera use
- Tobacco Abuse. This is however no match for the harmful effects of tobacco!
Types Of Fibroids
There are really not different “types” of fibroids but different
locations and sizes. All uterine fibroids are similar in their makeup:
all are made of abnormal uterus muscle cells growing in a tight bundle
or mass.
With respect to locations( see image above), fibroids can be classified as myometrial, submucosal, subserosal and pedunculated.
Uterine
fibroids can also vary in n size, from almost invisible to several
inches across and weighing tens of pounds. They may also be solitary(
just one) or more commonly more than one in the uterus.
Fibroid Symptoms & Complications
Many women with fibroids are not aware of it because most fibroids do
not cause symptoms. They may be discovered incidentally during a pelvic
exam or ultrasound. The symptoms depend on their size, number and
location. When they cause symptoms, they can lead to heavy and painful
periods, painful urination,a sense of urgency to pass out urine and a
feeling of fullness in the lower abdomen. Fibroids and back pain is a frequent combination when pain occurs.
Fibroids after menopause usually shrink, though some may persist and cause symptoms in a few cases.
Fibroids And Pregnancy
Three major questions often come up amongst women with regards to this-
can fibroids prevent pregnancy and cause infertility? Can fibroids
affect the development of pregnancy? What happens to fibroids during
pregnancy? The first two questions are still controversial amongst some
experts. Many though still believe that some fibroids, depending on
their location and size may cause infertility is few cases and pregnancy
complications.
Diagnosis
Most often, the diagnosis of fibroids is not difficult, except in
some women like those with obesity.The doctor often carries out a
routine clinical examination with a pelvic exam and then request
additional testing if necessary. Some more tests may be needed to
exclude other possible diseases the doctor is suspecting.
This may include
- Pelvic ultrasound.
This is a frequently used test. It may be done by putting the probe
over your belly wall( abdomen) or through your vagina to get a closer
look( transvaginal). - MRI( Magnetic Resonance Imaging. Nice but expensive test. Especially useful when a surgical operation is planned.
- Hysteroscopy.
This is visualizing the inside of the uterus using a camera attached
to a probe. It may be combine with ultrasound( sonohysteroscopy). - Laparoscopy may be used to look for fibroids outside of the uterus( Pedunculated).
Uterine Fibroids Treatment
Fibroid tumors are treatable. However,there is no single best treatment
for all women with all types of fibroids. Your doctor will discuss the
best options available for your situation which you may have to choose
from. Options include doing nothing, medications to reduce the size,
surgeries( hysterectomy and myomectomy) and minimally invasive surgery.
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