Fibroids: Symptoms, Causes and Treatment

What are uterine fibroids?

Uterine fibroids, also known as leiomyomas or myomas, are non-cancerous growths from the muscle tissue of the uterus (myometrium). They can be as small as a pea or as large as a grapefruit. Fibroids can appear as a single growth or multiple ones and can be located in different parts of the uterine wall.

Types of fibroids

1. Subserosal fibroids

   • These grow on the outer surface of the uterus and may push outward, putting pressure on nearby organs like the bladder or intestines. 

2. Intramural fibroids

   • These develop within the uterine muscle wall and can enlarge the uterus, causing symptoms like pelvic pain and heavy menstrual bleeding.

3. Submucosal fibroids

   • These grow into the uterine cavity and can lead to heavy menstrual bleeding and fertility issues such as infertility or repeated miscarriages.

What causes fibroids?

Several factors can increase the risk of fibroids, including:

• Age (most common in women aged 30-40)
• Family history of fibroids
• African American ethnicity (fibroids tend to occur more frequently and are often more severe in African American women)
• Hormonal factors (e.g., oestrogen and progesterone levels)
• Obesity
• Diet (e.g., consumption of red meat and processed foods)
• Reproductive factors (e.g., nulliparity, early age at menarche)

What are the signs and symptoms of fibroids?

Symptoms of uterine fibroids can vary based on their size, number, and location, but may include:

• Heavy or prolonged menstrual periods (menorrhagia)

• Pelvic pain or pressure

  

• Pain during intercourse
• Frequent urination or difficulty emptying the bladder
• Constipation or difficulty with bowel movements
• Abdominal bloating or enlargement
• Backache or leg pains

FAQs

What are the complications of fibroids?

Though usually benign, fibroids can cause complications based on their size, number, and location. Potential issues include:

1. Menstrual irregularities

   • Heavy or prolonged periods, irregular cycles, and anaemia, low red blood cell count due to excessive menstrual bleeding (menorrhagia), causing fatigue and weakness.

2. Pelvic pain and pressure

   • Large fibroids can press on pelvic organs, causing pain and discomfort.

3. Urinary symptoms

   • Pressure on the bladder can cause frequent urination, urgency, or incontinence. Severe cases may lead to urinary retention (inability to empty the bladder completely).

4. Bowel symptoms

   • Pressure on the rectum or intestines can cause constipation or rectal pain.

5. Infertility and pregnancy complications

   • Submucosal fibroids (located within the uterine cavity) or large intramural fibroids can affect fertility and increase the risk of miscarriage, preterm birth, and complications during pregnancy.

6. Degeneration

   • Fibroids can outgrow their blood supply, leading to degeneration, which can cause severe pain and discomfort.

7. Obstetric complications

   • Fibroids may increase the risk of certain obstetric complications during pregnancy, including placental abruption (early detachment of the placenta from the uterus), foetal malpresentation (abnormal foetal position), or caesarean delivery.

8. Complications of fibroid treatment

   • Treatments like surgery (myomectomy or hysterectomy) or uterine artery embolization (UAE) have their own risks, such as bleeding, infection, or injury to surrounding organs.

9. Psychological impact

   • Chronic symptoms and complications associated with fibroids, such as pain, heavy bleeding, or infertility, can significantly impact a person's quality of life and mental health.

How are fibroids diagnosed?

1. Pelvic examination

   • A healthcare provider may perform a pelvic examination to feel for any abnormalities in the size or shape of the uterus.

2. Ultrasound

   • Transvaginal or abdominal ultrasound imaging can help visualise the size, number, and location of uterine fibroids.

3. MRI (Magnetic Resonance Imaging)

   • MRI may be used to provide detailed imaging of the uterus and fibroids, especially in cases where ultrasound results are inconclusive or further evaluation is needed.

What are some treatments for fibroids?

Treatment depends on symptoms, fibroid size and location, and personal reproductive goals. Options include:

1. Watchful waiting

   • In cases where fibroids are small and asymptomatic, regular monitoring without active treatment may be recommended.

2. Medications

   • Hormonal medications such as gonadotropin-releasing hormone (GnRH) agonists, birth control pills, or nonsteroidal anti-inflammatory drugs (NSAIDs) may help relieve symptoms such as heavy menstrual bleeding and pelvic pain.

3. Minimally invasive procedures

   • Procedures such as uterine artery embolization (UAE), myomectomy (surgical removal of fibroids), or endometrial ablation can relieve symptoms and preserve fertility. 

4. Hysterectomy

   • In cases of severe symptoms or when fertility is not a concern, surgical removal of the uterus (hysterectomy) may be recommended as a definitive treatment for uterine fibroids.

Can fibroids become malignant?

While uterine fibroids are typically benign (non-cancerous) growths, in rare cases, they can undergo malignant transformation and become cancerous. The risk of fibroids developing into malignant tumours, known as leiomyosarcomas, is extremely low, estimated to be less than 1%.

How do I know if I need to remove a fibroid?

If you are experiencing symptoms of fibroids, it’s important to seek professional advice. Our team includes specialists who are highly experienced in diagnosing and treating fibroids.

Additional Support

If you have any concerns about uterine fibroids, feel free to reach out to Thomson Medical. Our team is here to assist you with any questions and provide the support you need.