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September 4, 2024
Let’s talk about another common women’s health issue today – Uterine Fibroids. About 20% of women in their reproductive stage suffer from uterine fibroids in Malaysia. Around the world as well, the scenario is similar.
Also called leiomyomas, uterine fibroids occur when muscles and tissue develop in or on the wall of the uterus. In most cases, these growths are non-cancerous. It is the most common noncancerous tumour in women across the world.
The number and size of fibroids vary from one woman to another. A woman can have a single fibroid or multiple fibroids. Some can be too small to see with eyes, while others can be as large as an orange. A big fibroid can distort the inside and the outside of the uterus. In some cases, although not very common, fibroids can get so big that they fill the stomach or pelvis area, making the person look pregnant.
While many women suffering from uterine fibroids face symptoms such as pain and irregular or heavy vaginal bleeding, some women may not have any symptoms at all. The treatment depends on the kind of symptoms you are facing.
Fibroids are rounded growths, which look like smooth bumps. Sometimes, they can be attached to a thin step, resembling the appearance of a mushroom.
Uterine fibroids can be of different types depending on how they attach and where they are located.
Many women do not face any symptoms at all while suffering from uterine fibroids. In such cases, they may not need any treatment apart from regular checkups with the doctor. However, larger fibroids may lead to experiencing a variety of symptoms such as:
One of the primary symptoms of fibroids is pain during periods, but its intensity can differ based on the size of the fibroids. Women suffering from small fibroids may not face any pain at all or minimal pain.
Larger fibroids can lead to quite a lot of pain and discomfort. One may feel back pain and stabbing pains in the abdomen too. In many cases, a woman may feel pain during sex as well.
Most uterine fibroids don’t cause any complications. However, sometimes they can get serious and lead to complications such as:
Sometimes, although rarely, fibroids can develop into an emergency.
If you face sudden sharp pain in the abdomen which won’t go away with your regular pain medication or severe vaginal bleeding along with signs of anaemia such as extreme fatigue or weakness and lightheadedness, visit a hospital emergency unit immediately.
The exact cause of uterine fibroids is still unknown. But many factors are believed to play a role in their development including:
Two hormones play a crucial role in a woman’s reproductive system – oestrogen and progesterone. They help the tissue that makes the inner lining of the uterus thicker during each menstrual cycle to prepare for pregnancy. It has been seen that these hormones aid the growth of the fibroids. Fibroids have more cells for oestrogen and progesterone to bind, than typical uterine muscles. Fibroids usually shrink after menopause due to a drop in hormone levels.
Many fibroids have been identified as having gene changes that are different from those in typical uterine muscle cells.
Some substances help the body maintain tissues, which may affect fibroid growth. Such as insulin-like growth factors.
ECM or extracellular matrix works like cement between bricks, making cells stick together. Fibroids have a higher ECM content. ECM causes biological changes in the cells and stores growth factors.
Different women can have different growth patterns for uterine fibroids. In some they may grow very fast, and in others, slowly. Or they may not grow at all and remain the same size. In some cases, fibroids might shrink on their own. For some women, fibroids may develop during pregnancy, which in most cases go away or shrink automatically after pregnancy once the uterus gets back to its usual size.
Fibroids can vary in size from one woman to another. Small growths are usually between 1 to 5cm, similar in size to the seed of a fruit. Fibroids are considered to be medium-sized when it is 10cm or less or not bigger than an orange. Large fibroids measure above 10cm and can get as large as a watermelon.
It is most important to discuss treatment options with your gynaecologist as soon as you receive a fibroid diagnosis. While some fibroids may not need to be treated at all, others may need immediate attention.
While any woman in their reproductive age can be affected by fibroids, some factors increase the risk of having them, including:
It has also been seen that stress can lead to unusually fast development of fibroids. Even those who were asymptomatic can grow at an alarming rate due to stress.
While fibroids cannot be prevented per se, research suggests that certain lifestyle changes can reduce the chances of having them.
Several studies have been conducted in this regard. According to one, high-sugar diets are a major risk factor. A diet rich in cruciferous vegetables and fresh fruits can lower the risk. Cruciferous vegetables such as broccoli, cauliflower, cabbage, turnip greens and collard greens are rich in folate, vitamins C, E and K, beta carotene, fibre and other minerals.
Regular exercise can also lower the risk.
Usually, fibroids are found during a routine pelvic examination. Your doctor will press your abdomen during this test. If they feel a firmness, they may conduct further tests to check if there are uterine fibroids. Your doctor may conduct the following tests to diagnose uterine fibroid:
During this procedure, a small instrument, called a transducer, is either inserted into the vagina or pressed over the abdomen to produce pictures of the internal organs. This test helps the doctor to see the shape, size and texture of the uterus and evaluate any growths in them.
This imaging technology provides detailed images of the internal organs which help your doctor to determine the exact location and characteristics of the fibroids.
This is an X-ray exam of the uterus and fallopian tube where a special dye to inserted to visualise your uterus and determine whether fibroids are blocking your fallopian tubes.
This procedure helps in obtaining a visual examination of the canal of the cervix and the interior of the uterus by inserting a viewing instrument called a hysteroscope through the vagina.
It is difficult for a non-medical person to diagnose uterine fibroids at home. The symptoms are the key factors that you should watch out for. If you face any of the symptoms that we have discussed here, it is a good idea to meet your gynaecologist and have a discussion.
Uterine fibroids are treated in many ways. Your doctor will decide the treatment path based on the symptoms you are facing, the location of your fibroids, your age and other factors. Two treatment options are commonly used – medication and surgery.
Medications are used to treat your symptoms such as pain and bleeding. Some medications may also shrink fibroids.
Women having moderate to severe symptoms may need surgery for relief. Surgery options include:
Let’s talk about this important topic now, since this is a question that most women have in mind – whether they can get pregnant if they have fibroids. Most women can conceive normally and continue with the pregnancy even if they have fibroids. However, there can be certain challenges. Let’s break these down.
In most cases, fibroids don’t grow while you’re pregnant, but if it happens, it will happen during your first trimester, that is the first three months. This is because your body produces more oestrogen during this time, a hormone that promotes the growth of fibroids.
Some women who have fibroids may face both bleeding and pain during the first trimester. Women with fibroids are also more likely to miscarry than those without them.
The uterus expands during this time to make room for your baby. However, while growing, it can push against your fibroids which can lead to pain.
There’s also a higher chance of placental abruption which means placenta tearing away from the wall of the uterus before the baby is delivered. This can be very serious as the baby won’t get enough oxygen if this happens and you can experience heavy bleeding. Having fibroids also increases the risks of premature delivery.
Living with uterine fibroids can be a challenge, especially during your periods. Discuss pain management techniques with your doctor to make your life easy during those days. Your doctor may also give you options to help manage the flow.
Focus on diet and exercise. Some women have found relief by cutting down on caffeine. Make sleep a priority and practice de-stressing techniques. Taking care of your overall health can help you deal with this issue in a better manner.
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