Uterine fibroids also called leiomyomas or myomas, are tumours made of muscle that grow on the uterus. These growths are typically not cancerous (benign), and do not become cancerous.
Fibroids vary a lot in size, shape, and location. It can grow on the uterus, uterine wall, or on its surface and attach to the uterus by a stalk – or stem – like structure. Some are so small that cannot be seen with the naked eye and others grow in big masses that can affect the size and shape of the uterus. This usually appears during childbearing age (30 – 40 years old) but can show up at any age. It’s more common in Black people and show up earlier and grow quicker than White people.
Types
The type of fibroids depends on where they grow or form;
- Intramural fibroid: This grows within the wall of the uterus.
- Submucosal fibroids: Grows into the uterine cavity.
- Sub-serosal fibroid: Grows outside of the uterus.
At times, submucosal or sub-serosal fibroids may hang from a stalk inside or outside of the uterus called pedunculated.
Causes
- Hormones. Estrogen and progesterone are the hormones that make the lining of the uterus thicken every month during period. This affects fibroid growth and as hormone production slows down during menopause, fibroids usually shrink.
- Genetics
- Other growth factors. Substances in your body that help with tissue upkeep, such as insulin-like growth factor, may play a part in fibroid growth.
- Extracellular matrix (ECM). This makes the cells stick together. Fibroids have more ECM than normal cells, which makes it fibrous or ropey. ECM also stores growth factors and causes cells to change.
Risk Factors
- Age
- Race
- Early Menarche
- Use of Birth Control Pill before age 16
- Vitamin D deficiency
- Eating too much red meat and not enough green vegetables, fruit, or dairy
- Alcohol
- Family history
Symptoms
Fibroids may cause very mild symptoms, no symptoms at all, or symptoms that are serious. The most common symptoms of uterine fibroids include:
- Bleeding between periods
- Heavy bleeding during your period, sometimes with blood clots
- Periods that may last longer than normal
- Discomfort in the rectum
- Needing to urinate more often
- Pelvic cramping or pain with periods
- Feeling fullness or pressure in your lower belly
- Pain during intercourse
Diagnosis
- Ultrasound
- MRI
- Hysterosonography is a saline infusion sonogram
- Hysteroscopy is a long, thin tube inserted through the vagina into the uterus to examine the inside of the uterus.
- Endometrial biopsy removes a small piece of the lining of the uterus to assess for cancer if there is unusual bleeding.
- Hysterosalpingography. If your doctor needs to see if your fallopian tubes are blocked, you might have a hysterosalpingography. Your doctor uses dye to highlight your uterus and fallopian tubes on an X-ray to see these areas better.
Treatment
- Watchful waiting. If only mild or no symptoms, the doctor may suggest a wait and see. Fibroids aren’t cancerous, and they may grow slowly or not at all. They shrink or go away after menopause.
- Medications such as: Birth control pills to reduce bleeding.
- Nonsteroidal anti-inflammatory medications such as ibuprofen to ease pain.
- Vitamins and iron supplements can help with energy if bleeding heavily and have anaemia.
- Gonadotropin-releasing hormone (GnRH) agonists blocks estrogen and progesterone, thereby shrinking the fibroids.
- Surgery
- Myomectomy. It involves the removal of fibroids
- Endometrial ablation. This involves using either a laser, wire loops, or freezing to remove or destroy the lining of the uterus. This stop menstruation and pregnancy.
- Uterine fibroid embolization (UFE), or uterine artery embolization (UAE). This involves blocking the flow of blood to the fibroids by inserting gel or plastic particles into the nearby blood vessels making it to shrink.
- Hysterectomy. This is a total removal of the uterus completely and is the only way to cure fibroids entirely.
Uterine fibroids are noncancerous tumours made of muscle that can grow on the uterus. Lifestyle habits such as a healthy diet and regular exercise may lower its chances.