Cut down on alcohol to keep uterine fibroids at bay. © Shutterstock
Most gynaecological issues are asymptomatic in nature and come to the fore only when things have escalated to an extent. Uterine fibroids are just like that. Many women who develop uterine fibroids suffer in silence as the symptoms overlap with period problems or PMS. They usually ignore it, till it gets too much to handle. Here Dr Bandita Sinha, gynaecologist and fertility specialist, director, World of Women, Navi Mumbai answers questions on uterine fibroids that everybody needs to know.
What are uterine fibroids?
Uterine Fibroids are noncancerous growths of the uterus. They grow within the uterine wall in varying sizes. It can be like a seedling or the size of large mass that can distort and enlarge the uterus. However, most women are not aware that they have uterine fibroids as it often causes no symptoms. They are also called leiomyomas or myomas. They usually affect women in the age group of 35 to 54 years. However, contrary to the popular belief, uterine fibroids aren't associated with an increased risk of uterine cancer; they usually never develop into cancer. Read to know the difference between uterine fibroids, polyps and cysts.
How do these fibroids manifest?
One can have a single fibroid or multiple ones in the uterus. Sometimes, when multiple fibroids develop, they can expand the uterus so much that it reaches the rib cage, in extreme situations. These fibroids are discovered incidentally during a pelvic or prenatal examination. Since they are asymptomatic, it becomes difficult to identify them otherwise. The most common symptoms of fibroids include heavy menstrual bleeding, menstrual periods lasting more than a week, pelvic pressure or pain, frequent urination, difficulty emptying the bladder, constipation and backache or leg aches. Since these symptoms are misleading, the diagnosis usually happens late. Moreover, no two women with fibroids might suffer from similar symptoms. The symptoms of fibroids manifest depending on the location, size and number of fibroid growths. Here are few reasons for heavy bleeding during periods that you should know.
Are fibroids painful?
Fibroids, in general, are not painful. But when it starts to grow in size it ceases to draw enough blood and slowly starts to turn into a dead cell. This is when it causes acute pain. Intramural fibroids usually grow within the muscular uterine wall, and as the tumour expands, it tends to make the uterus larger than normal, which can sometimes be mistaken for pregnancy or weight gain whereas sub mucosal fibroids bulge into the uterine cavity and subserosal fibroids project to the outside of the uterus.
What are the symptoms one should watch our for?
If one notices sudden severe vaginal bleeding or sharp pelvic pain that refuses to fade away, including heavy or prolonged painful periods, spotting or bleeding between periods or difficulty emptying the bladder, then one should immediately seek prompt medical care. Fibroids that are visible during pregnancy often shrink or disappear after pregnancy, as the uterus goes back to its normal size. Even after menopause, these fibroids tend to shrink as the hormone production (estrogen and progesterone) decreases. Here are six things that are increasing health risks for women.
What causes uterine fibroids?
The exact cause of is not known yet. But there are certain markers and risk factors. At times, fibroids could be hereditary. If your mother or sister had fibroids, you could be at risk. Early onset of menstruation, use of birth control pills, obesity, vitamin D deficiency, a diet rich in red meat and low in green vegetables, fruit and dairy; alcohol, including beer; could be a few reasons to increase one s risk of developing fibroids. But some clinical research and experienced doctors believe that fibroids are developed from a single stem cell that belongs to the smooth muscular tissue of the uterus. This single cell divides repeatedly, eventually creating a firm, rubbery mass distinct from nearby tissue.
These fibroids are genetically different from the cells present in the uterine lining. The two female hormones, estrogen and progesterone stimulate the development of the uterine lining during each menstrual cycle. It is these hormones that also promote the growth of the fibroids as they contain more estrogen and progesterone receptors compared to the cells of the uterine lining. These fibroids grow slowly or quickly or sometimes remain the same size for a really long period depending on their genetic mutation.
How are fibroids treated?
If the uterine fibroid is less than 4cm, it can be treated with medication. However, if the fibroid is bigger and is symptomatic, then it may require surgery. Myomectomy is the laparoscopic removal of fibroid done among young women. Women who aren t planning babies and are above the age of 45 years can go for complete uterus removal too. A treatment method is decided after a detailed diagnosis and taking into consideration the patient s consent. Read to know more about treatments for fibroids.
Will I be able to conceive if I have fibroids?
Usually, fibroids are very small, and if there isn't any symptom, they are less likely to cause problems while conceiving. It is rare to find a big fibroid which is symptomatic and may create a problem during conception. In such situations, it is advisable to consult a doctor to know its impact on pregnancy. As most fibroids are asymptomatic, women can conceive despite the small fibroids.
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