Uterine fibroids, also known as leiomyoma or myoma, are noncancerous growths found in many women in Anguilla. Some women might not have any problems but others might have severe symptoms and complications that can negatively impact their lives.
What are uterine fibroids?
Uterine fibroids 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 very large (as big as a football). As many as 70% to 80% of all women will have fibroids by age 50. Fibroids are often described depending on where they are located in the uterus (womb). 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. 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. One woman might have more than one type of fibroid.
What causes fibroids?
The exact cause of fibroids is unknown. Their growth has been linked to the female hormones oestrogen 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.
Who gets fibroids?
Many researchers continue to work to determine why certain women get fibroids and others do not. There are certain facts that we do know for certain and these include the following:
• Fibroids are exceedingly more common in black women
• Fibroids usually occur between the ages of 30 and 40
• If a woman has a family with fibroids her risk of getting fibroids increases
What are some symptoms of fibroids?
Some women might have very large fibroids and have little or no symptoms, while other women might have small fibroids associated with severe symptoms.
Fibroids might cause pressure effects and women might experience the following:
• 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 might also cause changes related to a woman’s menstrual period and she might experience the following:
• Heavier bleeding, sometimes with blood clots
• Longer or more frequent menstruation
• Spotting or bleeding between periods
• Moderate to severe pain with periods
Complications of uterine fibroids
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.
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. Fibroids growing along the inner uterine wall may make it difficult for a fertilized egg to attach.
When to see a doctor
If you have symptoms suggestive of uterine fibroids you should see your gynaecologist as the symptoms might be caused by other conditions such as endometriosis or cancer of the uterus. You are advised to see your healthcare provider if you have the following 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
Diagnosis
Your gynaecologist will take a detailed history and carry out a physical exam to include a pelvic exam. An experienced gynaecologist 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. Other procedures to visualize the inside of the uterus or abdomen may also be needed.
Treatment
Treatment will vary from one woman to the next, and also depends on other associated health conditions. Pain medications, such as acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs), like as ibuprofen, can help relieve menstrual cramping. Various medications are available to manage symptoms associated with the woman’s menstrual periods.
Other therapies
For mild to moderate symptoms, uterine fibroid embolization may be a good option. Embolization should not be an option for women wanting to get pregnant at some point after treatment.
Surgery
A myomectomy typically removes the largest fibroid. 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.
Ultrasound is one way to destroy fibroids without risk of damaging the uterus. The treatment uses high-intensity ultrasound waves that kill the fibroid tissue. Most women recover quickly from this procedure and can return to regular activities within 24 hours. The long-term effects are still being studied, and it is not recommended for women who want to become pregnant.
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.
Conclusion
Uterine fibroids are very common in women in Anguilla and are a common cause for women to visit their gynaecologist. The symptoms might vary but pressure symptoms and symptoms associated with a woman’s menstrual cycle are very common. Treatment options are available in Anguilla and all women with symptoms suggestive of uterine fibroids are encouraged to see their healthcare provider.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
