Uterine Fibroids: Symptoms, Causes, Types & Treatment

Uterine fibroids are common tumors in the uterus. They usually show up during the years when you can get pregnant and have a baby. Uterine fibroids are not cancer, and they typically do not become cancer. They do not have a greater chance of causing other types of cancer in the uterus. They are also known as leiomyomas or myomas.

Fibroids can be different in terms of how many and significant they are. You can have one tumor or several. Some of these growths are too tiny to see. Some can grow as big as a grapefruit or even bigger. A large tumor can change the shape of both the inside and outside of the uterus. Some fibroids can become big enough to fill the pelvic or stomach area in severe cases. They can make someone appear as if they are pregnant.

Many people will have uterine tumors at some point in their lives. You may have them without realizing it because they usually don't show signs. Your doctor might discover fibroids during a pelvic check or an ultrasound done during pregnancy.

Symptoms of Uterine fibroids

Most tiny fibroids cause no symptoms and do not require treatment beyond frequent monitoring by your healthcare professional. Larger fibroids can lead to several symptoms, including:

• Heavy or severe bleeding throughout your menstruation.
• Bleeding in between periods.
• A sense of fullness or bloating in your lower abdomen.
• Frequent urination (may occur when a fibroid presses on your bladder).
• Pain during sex.
• Lower back discomfort.
• Constipation or experiencing pressure in your rectum.
• Long-term (chronic) vaginal discharge.
• Inability to urinate or fully empty your bladder.
• Increased abdominal distention (enlargement) makes your abdomen appear pregnant.

Uterine fibroid symptoms typically stabilize or disappear during menopause, when hormone levels in your body fall.

Causes of Uterine fibroids

The exact reason for uterine tumors is not known. These things could be significant:

• Changes in genes: Many fibroids have different gene changes from normal uterine muscle cells.
• Hormones:Oestrogen and progesterone are hormones that help thicken the tissue inside the uterus during each monthly cycle to prepare for pregnancy. These hormones may also promote the growth of tumors. Fibroids have more cells that attach to estrogen and progesterone than regular uterus muscle cells do. Fibroids usually get smaller after menopause because hormone levels decrease.
• Other things that help in growth: Substances that help keep the body's cells healthy, like insulin-like growth factors, may influence fibroids' growth.
• Extracellular matrix (ECM): This material helps cells stick together, similar to how glue holds bricks in place. ECM is higher in fibroids, which makes it denser. ECM also stores growth factors and causes biological changes in the cells themselves.

Doctors think that uterine fibroids might start from a stem cell in the smooth muscle tissue of the uterus. One cell keeps dividing repeatedly, eventually becoming a solid, rubbery lump different from the surrounding tissue.

Uterine tumors grow in different ways. They can develop quickly or slowly, or they could remain the same size. Some fibroids grow soon, and some can get smaller by themselves.

Fibroids that develop during pregnancy can get smaller or disappear after the pregnancy ends as the uterus returns to its standard size.

Types of uterine fibroids

Different types of uterine fibroids depend on where they are located and how they attach. Specific types of uterine fibroids include:

• Intramural fibroids: These fibroids are embedded into the muscular wall of your uterus. They're the most common type.
• Submucosal fibroids: These fibroids grow under the inner lining of your uterus.
• Subserosal fibroids: This type of fibroid grows under the lining of the outer surface of your uterus. They can become quite large and grow into your pelvis.
• Pedunculated fibroids: The least common type, these fibroids attach to your uterus with a stalk or stem. They're often described as mushroom-like because they have a stalk and then a wider top.

Risk Factors

Various risk factors can influence your chances of acquiring fibroids. These may include:

• Obesity and elevated body mass index (BMI). .
• There is a family history of fibroids
• Not having children.
• Menstruation begins early (you receive your period when you're young).
• Menopause occurs at a later age.

Pregnancy and fibroids

Fibroids seldom prevent pregnancy. Some fibroids, especially submucosal ones, might cause infertility or pregnancy loss.

Pregnancy problems may increase with fibroids. It includes:

• The placenta, which supplies oxygen and nutrition to the infant, separates from the uterine wall during placental abruption.
• Fetal growth limitation when a newborn grows poorly.
• A premature birth occurs before the 37th week of pregnancy.

Treatment for Fibroids

The treatment for uterine fibroids on how big they are, how many there are, where they are located, and what symptoms they are causing. You might not need treatment if you don't have any signs of fibroids. Small tumors can usually be ignored. Some people with fibroids don't have any signs or issues. Your doctor may suggest watching your fibroids through pelvic checks or ultrasounds in these situations.
If you have symptoms from your fibroids, like heavy bleeding that causes anemia, mild to severe pain, or issues with your urinary tract or bowels, you will need treatment to get better. Your treatment plan will be based on a few things, including:

• How many fibroids do you have?
• The size of your tumors.
• The location of your fibroids.
• What symptoms do you have linked to the fibroids?
• Your wish to keep your uterus.

The best treatment for you depends on whether you hope to get pregnant. Discuss your childbearing goals with your doctor when talking about treatment choices. You can treat uterine fibroids in several ways, including:

• Over-the-counter (OTC) pain medicines, such as acetaminophen and ibuprofen, can help relieve pain and discomfort from fibroids.
• Iron supplements: If you have anemia caused by excessive bleeding, your doctor might recommend an iron supplement.
• Birth control can help with signs of fibroids, hefty bleeding during and between periods, and menstrual cramps. There are different types of birth control you can choose from, like birth control pills, rings, shots, and IUDs.
• Gonadotropin-releasing hormone (GnRH) agonists: These medicines help reduce the size of fibroids. They are sometimes used to make a tumor smaller before surgery, which helps remove it more easily. These medicines are only a short-term solution; if you stop using them, the fibroids might return.
• Oral therapies: Elagolix is a new oral therapy for controlling heavy uterine bleeding in people who haven't experienced menopause and have symptomatic uterine fibroids. It can be taken for a maximum of 24 months. Discuss the advantages and disadvantages of this treatment with your provider. Another oral treatment, tranexamic acid, helps reduce heavy monthly bleeding in people with uterine fibroids.

It's important to discuss any medications you're taking with your doctor. Before starting any new medicine, talk to your doctor to review any possible issues.

Fibroid surgery

When discussing the different types of treatment for removing fibroids, there are several essential things to consider. The size, location, and amount of fibroids can affect the type of surgery you need. Also, if you want to have children in the future, that will be an essential part of your treatment plan. Some surgeries can keep your uterus, allowing you to have children later, while other surgeries can harm or take out your uterus.

Myomectomyis a surgery where the doctor removes tumors. There are different kinds of myomectomy. The best procedure for you will rely on where your fibroids are, their size, and how many there are. There are various types of myomectomy treatments for removing fibroids, including:

• Hysteroscopy: Your provider places a scope (a thin, flexible, tube-like tool) through your vagina and cervix and into your uterus. Your provider uses the scope to cut away and remove the tumors.
• Laparoscopy: In this process, your provider will use a scope to remove the fibroids. This treatment is different from hysteroscopy because it requires making a few minor cuts in your abdomen. This is how the scope will enter and exit your body.
• Laparotomy: In this operation, the doctor makes a single large cut in your abdomen to remove the fibroids.

If you're not trying to get pregnant in the future, your doctor may suggest other options. These choices work well, but they usually stop future pregnancies. These can include:

Hysterectomy: During a hysterectomy, your doctor takes out your uterus. A hysterectomy is the only way to obliterate fibroids. Removing your uterus entirely will prevent the fibroids from coming back and should relieve your symptoms. If you keep your ovaries during surgery, you won't go through menopause. This treatment may suggest if you have heavy bleeding from your fibroids or if your fibroids are large. Minimally invasive hysterectomies can be done using vaginal, laparoscopic, or robotic techniques.

Uterine fibroid embolizationis a treatment done by an interventional radiologist with support from your gynecologist. A small tube is placed in either your uterine artery or radial artery, and tiny particles are injected to stop blood flow to the tumors. Reduced blood flow makes the tumors smaller and helps with your symptoms. This process might not be suitable for everyone.

Radiofrequency ablation (RFA) is a safe and effective way to treat uterine tumors using microwave energy. It's suggested for those who have not gone through menopause. It helps with smaller tumors.

Risks Factor In Uterine Fibroid Treatment

Every treatment comes with risks. Some medicines can have side effects or might not be safe for people with specific health issues. Surgical risks include infection, bleeding, and problems with anaesthesia. A myomectomy helps maintain the ability to have children, but it might require a caesarean section for later births.

If you have symptoms of uterine fibroids and need expert help, contact a Uterine Fibroids Specialist in Mumbai , like Dr. Sudha Tandon, for tailored treatment options.