Who is at Risk of Fibroids?

Fibroids are non-cancerous growths on the uterus and are composed of tissues that resemble those of the muscular layer of the uterus called the myometrium. Fibroids mostly affect women in the reproductive age when the levels of estrogen in the body are high. They are rarely life-threatening and do not require treatment if they do not cause any symptoms.

The sizes of the fibroids vary from very small tumors to very large ones that may cause symptoms. You can also have one or multiple fibroids. It is estimated that about 30% of women who are below 35 years will have fibroids. Because fibroids do not cause symptoms, they may only be diagnosed by coincidence during an ultrasound in Lake Nona or during an examination of the pelvis.

What Are the Symptoms of Fibroids?

A large number of women who have fibroids are asymptomatic. The symptoms will depend on the size of the fibroid with larger fibroids causing more noticeable symptoms than smaller fibroids. The location of the fibroids and the number of the fibroids will also determine which symptoms the fibroids will present with.

Symptoms of fibroids include heavy menses because the fibroids interrupt the contraction of the uterine muscles and some may grow into the uterine vessels causing increased bleeding. This will prolong the duration of menses. The fibroids may also cause pain in the pelvis when they go through changes like red degeneration or when they cause nerve compression. Pedunculated fibroids may undergo torsion leading to pain due to lack of blood supply.

Large fibroids may cause the uterus to become bulky and press on the bladder leading to difficulty in passing out urine or frequent urination. They may also cause constipation due to the bulky uterus pressing on the rectum. Submucosal fibroids that are in the uterine cavity may cause infertility because they inhibit the implantation of the zygote. They can also cause backache.

Excess bleeding causes fatigue, dizziness, and headaches due to anemia. You should see a doctor if you experience heavy periods for long, if you experience severe pelvic pain that does not go away, if you spot between periods, and if you experience symptoms of anemia like dizziness and fatigue.

How Are Fibroids Treated?

Most fibroids do not require treatment because they are asymptomatic. The treatment modality that is used depends on the location and size of the fibroids, whether the patient is pregnant or whether she desires to conceive in the future. Treatment can, therefore, be observation, medications, or surgery.

Some of the medications used in treating symptomatic fibroids include agonists of the gonadotropin-releasing hormone-like leuprolide, hormonal contraceptives, tranexamic acid, and painkillers like NSAIDs. Fibroids can also be shrunk by embolizing the blood vessels that supply blood to them in a procedure called uterine fibroid embolization (UFE). They can also be treated by radiofrequency ablation or surgical removal via a procedure called a myomectomy.

Who Has a High Chance of Getting Fibroids?

Having a family history of fibroids increases the chances of getting fibroids. Women who have a longer reproductive period and those who do not conceive are also at a high chance of getting fibroids. Black women are more likely to develop fibroids than Caucasian women. Obesity and alcohol use also increases the chance of getting fibroids and so does taking a diet without vitamin D but with a lot of red meat.

Fibroids are benign masses of the uterus which can vary in size and location. They are more likely to occur in women with a genetic predisposition to fibroids, obese women, black women, and women with a long reproductive period. Treatment is only given to symptomatic fibroids and can be medical or surgical.

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