Uterine fibroids, also known as leiomyomas or myomas, are non-cancerous growths that develop in or around the uterus. These tumors are relatively common and can vary significantly in size, number, and location.

Understanding the causes, signs, symptoms, and available treatment options for uterine fibroids is essential for managing this condition effectively. In this blog, we provide a comprehensive overview of uterine fibroids, including their causes, typical signs and symptoms, and available treatment options.

What Are Uterine Fibroids?

Uterine fibroids are considered the most common type of noncancerous tumor in women, affecting most women with a uterus at some point in their lives. These growths are made up of muscle and connective tissue that develop in or on the wall of the uterus.

Uterine fibroids can vary significantly in size, from as small as a seed to more than 20 centimeters in diameter, which is roughly the size of a watermelon. They may also grow as a single nodule or in clusters.

Fibroids can develop in various locations within the uterus, including:

• Intramural Fibroids: These are the most common fibroid and grow within the wall of the uterus.
• Submucosal Fibroids: These are located just underneath the inner lining of the uterus
• Subserosal Fibroids: These develop on the outer surface of the uterus.
• Cervical Fibroids: These are located in the cervix rather than the uterus

The location and size of fibroids can influence the symptoms experienced and the appropriate treatment options.

What Causes Uterine Fibroids?

Despite their prevalence, the exact causes of uterine fibroids remain not fully understood. Healthcare providers believe that a combination of hormonal, genetic, and environmental factors may contribute to their development and growth.

Some other risk factors include:

• Obesity
• Family history of fibroids
• Getting your period at a young age (<10 years old)
• Reproductive and endocrine factors

Signs & Symptoms of Uterine Fibroids

Most women will develop fibroids at sometime in their life – however, many uterine fibroids go undiagnosed because they often do not cause any symptoms. However, those who do experience symptoms may experience:

• Heavy menstrual bleeding
• Painful periods
• Longer or more frequent periods
• Pelvic pressure
• Pelvic and abdominal pain
• Urinary tract or bowel issues
• Growing or bloated stomach area
• Pain during sex
• Anemia from excess bleeding

Read More: Why Is My Period So Heavy? Understanding Heavy Menstrual Bleeding

How Are Uterine Fibroids Diagnosed?

As symptoms are not always present, uterine fibroids are often discovered incidentally during a pelvic examination or an ultrasound. If a healthcare provider suspects the presence of fibroids, they may use a variety of diagnostic methods to assess and confirm the diagnosis:

• Ultrasonography: This is the most common and preferred imaging technique to detect fibroids.
• MRI: MRI provides also provides a detailed image of the uterus and surrounding tissues. It is particularly useful for evaluating the size and location of fibroids, especially when the results of an ultrasound are inconclusive or if a more detailed assessment is needed.
• Hysteroscopy: This procedure involves inserting a thin, flexible tube with a camera (hysteroscope) into the uterus through the vagina and cervix. It offers a visualisation of fibroids that are inside the uterine cavity and can also be used for biopsy if necessary.
• Sonohysterography: This technique involves injecting a saline solution into the uterus during an ultrasound. The fluid helps to create a clearer image of the uterine lining and any fibroids present. This may be recommended when planning a hysteroscopic resection of the fibroid or evaluating the potential risks on fertility associated with a fibroid.

Treating Uterine Fibroids

The approach to treating uterine fibroids depends on your fertility desires as well as fibroid factors (such as the size, number, and location of the fibroids).

If fibroids are not causing symptoms, treatment may not be always be necessary, as regular monitoring can be sufficient. However, for those who experience symptoms, various treatment and management options are available to ease pain and discomfort.

Medications

• Over-the-Counter (OTC) Pain Medications: These can help manage pain and discomfort associated with fibroids.
• Iron Supplements: For those experiencing anaemia from heavy menstrual bleeding.
• Hormononal Therapy: Hormonal contraceptives can assist in managing symptoms such as heavy bleeding and menstrual cramps.
• Gonadotropin-Releasing Hormone (GnRH) Agonists: These are medications that can shrink fibroids by suppressing estrogen and progesterone levels. They are often used as a temporary measure before surgery but may lead to fibroid regrowth after they have been discontinued. They can be associated with many side effects which is why they are used for a short period of time.

Surgery

As mentioned above, various surgical options depend on whether or not you want more children and the type of fibroid.  

• Myomectomy: This procedure removes fibroids while preserving the uterus, which is suitable for women who wish to maintain their fertility. Types of myomectomy include:

• Hysteroscopically: This is where a scope is inserted through the vagina and cervix to remove fibroids inside the uterine cavity.
• Laparoscopically: This is also known as key-hole surgery, where small incisions are made abdominally to remove fibroids from within the uterine wall. Your gynaecologist should discuss how the specimen is removed and risks associated with this depending on your risk factors.
• Laparotomy: This involves a larger incision to remove fibroids, typically used for larger fibroids or in patients who are not candidates for the above 2 methods.
• Uterine Artery Embolization (UAE): This procedure blocks the blood supply to fibroids, causing it to shrink and decreases other fibroid symptoms such as heavy menstrual bleeding. If you think you might want to get pregnant in the future, let your doctor know before having this procedure.

Risks & Considerations

As with any medical treatment there are various risks and considerations. Not all medications are suitable and can cause various side effects. It is important to discuss a complete medical history with a healthcare provider before starting any new medication. Surgical options also carry risks such as infection, bleeding, and complications associated with anaesthesia. Additionally, some surgical procedures may affect future pregnancies. It is essential to consult with a healthcare provider to determine the most appropriate treatment based on your symptoms and reproductive plans.

Key Takeaways

While many fibroids may not require treatment, those that cause significant symptoms or complications often benefit from a range of medical and surgical interventions. It is essential to work closely with a healthcare provider to determine the most appropriate approach for managing fibroids effectively.

For those seeking expert care in the diagnosis and treatment of uterine fibroids, Dr. Nargis Noori offers specialised services as an Obstetrician & Gynaecologist. Renowned for her expertise in minimally invasive and advanced laparoscopic and hysteroscopic surgery, provides compassionate, cutting-edge care.

If you have concerns about uterine fibroids or need a comprehensive evaluation and personalised treatment plan, contact Dr. Nargis Noori for expert guidance and support. Your path to better health starts with a consultation.