Uterine fibroids, also known as leiomyomas or myomas, are extremely common in women. Fortunately, they are often asymptomatic and seldom proceed to cancer. In women who develop symptoms, due to fibroids, several treatment options are available.
What are fibroids?
Fibroids are growths that develop in the uterus (womb) of a woman. They are made up of muscle and fibrous tissue, and vary in size. Black women are more likely to have fibroids than are women of other racial groups. In addition, black women have fibroids at younger ages, and they are also likely to have more or larger fibroids, along with more-severe symptoms.
Types of fibroids
Fibroids can grow anywhere in the uterus and vary in size considerably. Some can be the size of a pea, whereas others can be the size of a football.
The main types of fibroids are:
• intramural fibroids – the most common type of fibroids which develop in the muscle wall of the uterus
• subserosal fibroids – fibroids that develop outside the wall of the uterus into the pelvis, and can become very large
• submucosal fibroids – fibroids that develop in the muscle layer beneath the uterus’ inner lining and grow into the cavity of the womb
In some cases, subserosal or submucosal fibroids are attached to the womb with a narrow stalk of tissue. These are known as pedunculated fibroids.
Why fibroids develop
The exact cause of fibroids is unknown, but they have been linked to the hormone oestrogen.
Oestrogen is the female reproductive hormone produced by the ovaries (the female reproductive organs).
Fibroids usually develop during a woman’s reproductive years (from around the age of 16 to 50) when oestrogen levels are at their highest.
Uterine fibroids tend to shrink when oestrogen levels are low.
Genetics might make a woman more likely to get them, as researchers have found genetic differences between fibroids and normal cells in the uterus.
What are the symptoms of uterine fibroids?
Some women may find out they have uterine fibroids because their gynaecologist discovers them during a routine exam or on an ultrasound scan of the uterus.
If you do have symptoms, they might include:
• Heavy bleeding or painful periods
• Bleeding between periods
• Pressure, pain, or fullness in your lower stomach
• Enlarged abdomen or uterus
• Constipation
• Needing to urinate (pee) often or trouble emptying your bladder
• Pain or discomfort during sex
• Miscarriages or infertility
Treatment
Fibroids do not need to be treated if they are not causing symptoms. Over time, many fibroids tend to shrink especially after the woman goes into menopause.
If you do have symptoms caused by fibroids, medication to help relieve the symptoms will usually be recommended first. If these prove ineffective, surgery or other, less invasive procedures, may be recommended.
Complications
Although uterine fibroids usually are not dangerous, they can cause discomfort and may lead to complications such as anaemia (drop in red blood cells) which causes fatigue from heavy blood loss.
Conclusion
Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Many black women have uterine fibroids sometime during their lives, but many do not cause any symptoms and you might not know you have them. Your gynaecologist may discover fibroids incidentally during a pelvic exam or during a pelvic ultrasound scan. Not all fibroids need to be treated, but your fibroids should be monitored closely by your gynaecologist during regular medical check-ups (at least yearly). You and your gynaecologist will decide on appropriate treatment options if treatment is warranted.
Ask Your Dr 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 MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-six years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5828).
