Ask Your Doctor: UTERINE FIBROIDS by Dr. Brett Hodge

By anguillian January 30, 2012 10:10

Ask Your Doctor: UTERINE FIBROIDS by Dr. Brett Hodge

Many women inAnguillaare affected by uterine fibroids. While some might not be aware of their disorder and might not have any symptoms, many others have severe symptoms that severely affect the quality of their lives. The emotional effects of fibroids can be enormous as well.


What Are Uterine Fibroids?

Uterine fibroids, also known as leiomyoma or myoma, are noncancerous growths of the muscle tissue of the uterus. Fibroids can range in number and size from a single growth to multiple growths, and from very small to large. It is estimated that as many as 70% to 80% of all women will have fibroids by age 50.


What are the symptoms of Uterine Fibroids?

Fibroids may have very mild symptoms or none at all. In women who do feel symptoms, these uterine growths can cause:

•    Pressure on the bladder or rectum

•    Frequent urination

•    Constipation and/or rectal pain

•    Lower back and/or abdominal pain


If fibroids become very large, they can distend the stomach making a woman look pregnant.

Fibroids may also cause changes to a woman’s period, including:

•    Mild to severe cramping and pain

•    Heavier bleeding, sometimes with blood clots

•    Longer or more frequent menstruation

•    Spotting or bleeding between periods


Fibroids or Endometriosis?

Fibroids are one cause of severe menstrual pain, but the pain also can be caused by endometriosis. Endometriosis occurs when tissue from the inner lining of the uterus grows in other parts of the body.  This tissue breaks down and bleeds during your period, causing painful scar tissue. The pain of fibroids or endometriosis can also occur between periods.


What Causes Fibroids?

The exact cause of fibroids is unknown. Their growth has been linked to the female hormonesoestrogen and progesterone. Studies have found that women who start their periods at a younger age are more likely to develop fibroids. Although taking female hormones is linked to fibroids, the use of birth control pills is not.


Types of Fibroids

Many clinicians have ways of describing fibroids. There are several types of fibroids:

•    Intramural fibroids, the most common, grow in the wall of the uterus and can make it feel bigger.

•    Subserosal fibroids grow on the outside of the uterus. As they grow larger, they can cause pain due to their size or pressure put on nearby organs.

•    Submucosal fibroids grow just underneath the uterine lining, and can crowd into the uterus cavity and lead to heavy bleeding and other more serious complications.

•    Pedunculated fibroids grow on small stalks inside or outside the uterus. It’s possible to have more than one type.


Who Gets Fibroids?

While it’s unclear why women develop fibroids, some patterns have been observed.

•    They usually occur between the ages of 30 and 40.

•    They are more common in black women.

•    They grow more quickly and appear at a younger age in black women.

•    Having a family member with fibroids increases your risk.


Being overweight or obese and having high blood pressure also may increase your risk.


Complications of Fibroids

Some women may have fibroids for many years and do not have any complications, but fibroids are associated with complications some of which can be life threatening.



Fibroids and Anaemia

Some women with fibroids, who experience unusually heavy bleeding during their periods, may become anaemic. Many cases of anaemia, due to iron deficiency from periods, are mild and can be treated with a change in diet and iron supplement pills. Untreated anaemia can lead to fatigue and lethargy and, in severe cases, heart problems.


Getting Pregnant

Fibroids usually do not interfere with fertility and pregnancy. However, some women with fibroids experience more pregnancy complications and delivery risks. Fibroids may cause pelvic pain, and heavy bleeding after delivery, which may require surgery. In some instances, fibroids may block your fallopian tubes. Fibroids growing along the inner uterine wall may make it difficult for a fertilized egg to attach.


When to see your gynaecologist?

You should see your gynaecologist if you have the following fibroid symptoms:

•    Heavy menstrual bleeding

•    Periods that became more painful

•    Frequent urination or inability to control the flow of urine

•    A change in the length of your period over three to six cycles

•    New persistent pain or heaviness in lower abdomen or pelvis

How are fibroids diagnosed?

Your doctor may feel moderate and large uterine fibroids during a routine pelvic exam. Tests, such as an ultrasound, can show information about size and location of other fibroids. For women with fibroids who are trying to get pregnant, a test called a hysterosalpingogram will show an outline of the uterus and fallopian tubes and may detect abnormalities. Other procedures to visualize the inside of the uterus or abdomen may also be needed.


How are fibroids treated?

Treatment will vary from one woman to another and also on the type and number of fibroids. Some women may not require any treatment at all, but they should have regular medical check-ups.


Pain Medication

Pain medications such as acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, can help relieve menstrual cramping.


 Birth Control

Oral contraceptives manage levels of oestrogen and progestin. This usually leads to lighter periods and can alleviate some of the pain associated with fibroids, such as heavy bleeding and cramping. Other hormonal birth control methods that may lessen fibroid symptoms include progestin injections or progestin-releasing IUDs.


Other Hormone Therapies

Drugs called gonadotropin-releasing hormone (GnRH) agonists may offer temporary symptom relief from fibroids by stopping periods and shrinking fibroids. GnRH agonists block the production of oestrogen, so they can also cause bone loss, hot flashes, and vaginal dryness. Fibroids will return to their previous size once treatment ends. These may be used to shrink fibroids before fibroid removal surgery.



For mild to moderate symptoms, uterine fibroid embolization may be a good option. A catheter is guided to the uterine artery. Tiny particles of plastic or gelatin are then released into the blood vessels that feed the fibroid, causing it to shrink over time. This form of treatment is not available inAnguilla.



A myomectomy typically removes the largest fibroid, either through open surgery or small incisions. In some cases, fibroids grow back. Some women with severe symptoms or very large fibroids may choose to have a hysterectomy, a procedure that removes the uterus.


Fibroid and Exercise

Regular exercise may prevent fibroids. In one study, women who exercised seven or more hours a week had significantly fewer fibroids than women who exercised less than two hours a week. Obesity is also a risk factor for fibroids. So exercising regularly can help you maintain a healthy weight and reduce your fibroid risk.


Fibroids andAnaemia

Women with fibroids who are not getting enough iron through diet alone may develop anaemia, where the body has fewer red blood cells than normal. Symptoms include fatigue, chest pain, and shortness of breath. Treatment may include eating more iron-rich foods such as meats, poultry, fish, leafy greens, legumes, and iron-fortified breads and cereals. Your health care provider also may suggest iron supplements.



Uterine  fibroids are one of the leading female disorders that cause women to see their gynaecologist.  While some women with fibroids might not have any symptoms, many have a variety of symptoms some of which can become very severe, resulting in severe complications. There are many treatment options now available for uterine fibroids so that women do not need to suffer for years with this disorder.


Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over twenty eight years in clinical practice. Dr Hodge has a medical practice in theJohnsonBuildingin The Valley.



By anguillian January 30, 2012 10:10


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