Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyoma/ myoma, fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer.
Types of fibroids
- Location wise: submucosal, intramural, serosal
- Size wise: small to large
- Pedicle wise: sessile or pedunculated
Most women with uterine fibroids have no symptoms and are found accidentally on an ultrasound. However, fibroids can cause a number of symptoms depending on their size, location within the uterus, and how close they are to adjacent pelvic organs. These are the most common abnormal bleeding, pain and pressure. Symptoms include:
- Heavy bleeding or painful periods (60-70%)
- Bleeding between periods(15-20%)
- Pressure, pain, or fullness in your lower stomach
- Enlarged abdomen
- Needing to pee often or trouble to empty your bladder
- Pain during sex
Miscarriages or Infertility
What causes them
- Hormones. Estrogen and progesterone are the hormones that make the lining of your uterus thicken every month during your period. They also seem to affect fibroid growth. When hormone production slows down during menopause, fibroids usually shrink.
- Genetics. Researchers have found genetic differences between fibroids and normal cells in the uterus.
Diagnosis and management
- Uterine fibroids are diagnosed by pelvic examination and by ultrasound
- Most of the fibroids do not require treatment as they are asymptomatic
- If treatment for uterine fibroids is necessary, there are several options available that include
1) Conservative management includes treatment to reduce bleeding and pain during periods
2) Medical management such as mifepristone, danazol, GnRH analogues, low-dose oral contraceptives, LNG- intrauterine device, etc depending upon the case
3) Surgery (hysterectomy, myomectomy)
4) Non-surgical MRI-guided high-intensity focused ultrasound (MRgFUS or HIFU), and uterine artery embolization (UAE)