Are you wondering if you need to visit a gynaecological oncology clinic to get tested for uterine fibroids? Here is some information about uterine fibroids to help you decide.

Uterine Fibroids: What They Are and Their Characteristics

The following are five fundamental characteristics of uterine fibroids.

1.    They are a type of tumour.

A uterine fibroid is an abnormal growth (i.e., neoplasm) or tumour of the uterus. Doctors also call a uterine fibroid a leiomyoma (a combination of ‘leio’ or ‘smooth’ and ‘myoma’ or ‘tumour of muscle’). A leiomyoma, therefore, is a ‘smooth muscle tumour’.

Specifically, a uterine fibroid is a smooth muscle tumour that grows or develops in the uterus wall.

These are the specific types of uterine fibroids, according to their location.

●      Intramural fibroid

Intramural fibroids are tumours that grow within the uterine wall.

According to an article published in the International Journal of Women’s Health in 2016, intramural fibroids are the most prevalent type of uterine fibroids. Among the researcher’s study population of women with observable myomas, 58% to 79% had intramural myomas.

●      Submucosal fibroid

Submucosal fibroids grow within the uterine wall underneath the inner lining of the uterus, so they bulge into the uterus’ internal cavity.

●      Subserosal fibroid

A subserosal fibroid grows within the uterine wall but underneath the outer lining. It bulges towards the outside of the uterus.

●      Pedunculated fibroid

Pedunculated fibroids do not grow within the uterus walls but on stalks inside or outside the uterus.

2.    They are benign.

Most of the time, uterine fibroids are benign or non-cancerous tumours. They are not a cause for concern, and they generally do not require treatment unless you suffer from extreme pain or have significant symptoms.

3.    They can be big or small, one or many.

Uterine fibroid sizes are highly variable. Fibroids can be as small as seeds, undetectable by the human eye. Or they can be as big as grapefruits, enlarging and distorting the walls of the uterus and adding a significant amount of weight.

A woman can have from one to several uterine fibroids.

4.    They are quite common.

By the time women turn 50 years of age, 20% to 80% of them develop uterine fibroids, says the U.S. Department of Health and Human Services’ Office on Women’s Health. Uterine fibroids, moreover, are prevalent among women in their 40s and early 50s.

5.    They may or may not cause symptoms.

Even if you have uterine fibroids, you may not experience any symptoms.

Symptoms of Uterine Fibroids

These are some common symptoms of uterine fibroids.

• Heavy menstrual bleeding
• Painful menstrual periods
• Prolonged menses
• Frequent urination
• Urinary retention
• Pain during sexual intercourse
• Pain of the lower back, pelvis, or legs
• Pelvic pressure or feeling of fullness
• Abdominal enlargement or distension (i.e., looks pregnant)
• Constipation

In rare cases, uterine fibroids can lead to infertility or the inability to conceive.

Causes and Risk Factors Uterine Fibroids

What causes uterine fibroids? No one truly knows. However, based on studies of this condition, it appears that hormones and genes are their most common determinants.

Hormones unquestionably play a role. During pregnancy, when a woman’s oestrogen and progesterone levels are high, fibroids grow at an accelerated pace. During menopause, when a woman’s hormone levels are low, fibroids shrink.

Genetics also matter. If women in your family, such as your mother or sister, have fibroids, you are more likely to develop fibroids yourself.

Other factors seem to increase one’s risk for fibroids. Such factors include obesity and vitamin D deficiency. Diet also seems to play a role. Alcohol drinkers and red meat eaters seem to be at a greater risk of developing fibroids.

Uterine Fibroids Treatment

Uterine fibroids may be treated in two primary ways: medication and surgery. Note that treatment may or may not be indicated. It depends on your symptoms and risk factors.

Your doctor will know whether or not to prescribe treatment after giving you a thorough check-up.

Treatment Through Medication

Some medications are intended for symptomatic relief. Tranexamic acid, for instance, provides relief from heavy menstrual bleeding. Pain relievers can provide relief from extreme menstrual cramps or pain.

However, doctors may prescribe gonadotropin-releasing hormone (GnRH) agonists for actual fibroid treatment. These stop the body from producing oestrogen and progesterone, which induces a menopausal state. This, in turn, causes fibroids to shrink.

Treatment Through Surgery

These are some of the surgical procedures used in treating uterine fibroids.

1.     Myomectomy

This is the surgical removal of the myoma. The doctor removes only the fibroids, leaving the uterus intact.

2.     Abdominal myomectomy

This is an open abdominal procedure. Your doctor might recommend an open-abdominal myomectomy if you have large, deep, or multiple fibroids.

3.     Laparoscopic myomectomy

This is a minimally invasive procedure. Through tiny incisions on the abdomen, the surgeon inserts surgical tools and a camera. Guided by the video feed from the camera, the doctor uses a robotic controller to manipulate the surgical instruments and operate on the fibroids.

4.     Myolysis

This minimally invasive surgical procedure destroys the fibroid tissue through electricity (electromyolysis), freezing (cryomyolysis), or radiofrequency energy (radiofrequency ablation). A camera and an ultrasound tool, inserted through small incisions on the abdomen or via the cervix, are used to locate the fibroids.

Next, the doctor inserts a needle into the fibroid. Electricity or radiofrequency energy is passed through the needle, heating it and subsequently destroying the fibroid. Alternatively, the needle is cooled to an extremely low temperature, freezing the fibroid and destroying it.

5.     Uterine artery embolization

In this minimally invasive procedure, the surgeon identifies the blood vessels that supply blood to fibroids. Using a thin tube, the doctor delivers particles to these blood vessels to cut off the fibroid blood supply. Without a blood supply, the fibroids eventually shrink.

6.     Endometrial ablation

This procedure destroys the uterus lining through laser energy, freezing, electricity, microwave energy, boiling water, or some other method.

Endometrial ablation provides relief against heavy bleeding. One in two women who have had this surgery cease to have menstrual periods altogether, while three in ten report much lighter menstrual bleeding.

A woman who has had an endometrial ablation done is unlikely to get pregnant. Even so, she must take appropriate birth control measures to prevent the possibility of ectopic pregnancy.

7.     Hysterectomy

In this procedure, the surgeon removes the uterus. This is a permanent solution to uterine fibroids. However, the removal of the uterus will lead to the patient’s permanent inability to conceive.

Uterine Fibroids: Do You Need Treatment?

While pretty common among women of reproductive age, uterine fibroids are typically harmless and cause no pain or symptoms in most women.

If you have symptoms, consult your doctor for a definite diagnosis. If you are pregnant, special care from a foetal medicine specialist can ensure that fibroids will not interfere with a healthy pregnancy.