We often hear of women getting fibroids in the uterus, but most people are not sure of what they are or how they happen. HEALTH investigates.
Uterine fibroid tumors are defined by Specialist Obstetrician and Gynecologist Dr. Iliana Dmitrieva as nodules composed of smooth muscle cells and fibrous connective tissue. It is important to note that most fibroids are benign and malignant fibroids are rare. She says that 20 to 50 percent of women in childbearing age have uterine fibroids.
According to Dr. Dmitrieva, the cause of the myomas is unknown. “In some racial groups, myomas are more frequent and even heredity may also possibly play a role,” she says. “It is also suggested that fibroids may enlarge with estrogen therapy (such as oral contraceptives) or with
pregnancy.” Their growth seems to depend on regular estrogen stimulation, showing up only rarely before age 20 and shrinking after menopause.
More than 50 percent of fibroids are asymptomatic. “Symptoms of uterine fibroids depend on the location and the size of the tumor,” stresses Dr. Dmitrieva. She adds that the most common symptoms include pronged menstrual periods, intermenstrual bleeding, heavy menstrual bleeding with clots, lower abdominal pains, pelvic pain and pressure, backache and leg pains. There may also be pressure on the bladder, which leads to frequent urination, urinary incontinence, or urine retention, pressure on the bowel, which leads to constipation or bloating, and/or an enlarged abdomen. “However, most women with fibroids are asymptomatic; with only 10 to 20 percent of patients require treatment,” she tells.
DIAGNOSIS OF FIBROIDS
Doctors usually detect uterine fibroids during a pelvic examination. Ultrasound examination helps to localize the tumor and to check the size. Fibroids do not have to be removed unless they are causing symptoms such as heavy periods, irregular bleeding, or severe cramps with periods. In addition, sometimes the size alone causes enough discomfort so that removal is necessary. Once women go through menopause, fibroids do not usually cause any further problems.
Medications for uterine fibroids are used to target hormones that regulate the menstrual cycle, and while they do not eliminate fibroids, they may shrink them. These cause estrogen and progesterone levels to fall, menstruation to stop, fibroids to shrink and thereby anemia often
improves. Myomectomy, says Dr. Dmitrieva, is a surgical procedure when the surgeon removes the fibroids, leaving the uterus in place. Endometrial ablation is a treatment that involves the removal of the lining of the uterus, either ending menstruation or reducing menstrual flow.
IF YOU HAVE FIBROIDS
- Keep your follow-up appointments so that your doctor can check your fibroids regularly.
- Take your iron supplement if one has been recommended. This will prevent anemia. It is also helpful to eat a diet rich in iron in addition to the iron supplement.
- If your period cramps are uncomfortable, over the-counter Ibuprofen can be very effective in relieving the cramps. You should always take Ibuprofen with some food on your stomach to avoid stomach irritation.
WHEN TO CALL YOUR DOCTOR
- If periods become heavier, either heavier flow or more or larger clots.
- If you have irregular periods or bleeding.
- If the ibuprofen does not relieve enough of the cramps and there is still severe pain.
- If you feel that the fibroids are suddenly larger, or the mass causes discomfort.