Not much is known about uterine fibroids, despite the havoc they cause – from difficulty in conceiving, heavy bleeding, severe abdominal pain to frequent urination and pain during sex, miscarriage, premature labour et al.
Uterine fibroids is perhaps the most common tumor in women. Uterine fibroids, also known as uterine leiomyoma. They are benign smooth muscle tumors of the uterus. Most women have no symptoms while others may have painful or heavy periods. If large enough, they may push on the bladder causing a frequent need to urinate. They may also cause pain during sex or lower back pain. A woman can have one uterine fibroid or many. Occasionally, fibroids may make it difficult to become pregnant, although this is uncommon.
The exact cause of uterine fibroids is unclear. Risk factors include obesity and eating red meat. Diagnosis can be performed by pelvic examination or medical imaging.
Some women with uterine fibroids do not have symptoms. Symptoms are:
- Abdominal pain,
- Increased bleeding can indicate the presence of fibroids
- Pain during intercourse, depending on the location of the fibroid.
During pregnancy, they may also be the cause of
- Premature labour
- Interference with the position of the foetus
- A uterine fibroid can cause rectal pressure.
- The abdomen can grow larger mimicking the appearance of pregnancy.
- Some large fibroids can extend out through the cervix and vagina.
Some risk factors associated with the development of uterine fibroids are modifiable. Fibroids are more common in obese women. Fibroids are dependent on oestrogen and progesterone to grow and therefore relevant only during the reproductive years.
Most fibroids do not require treatment unless they are causing symptoms. After menopause fibroids shrink and it is unusual for them to cause problems. Uterine fibroids treatment includes :
- medication to control symptoms.
- medication aimed at shrinking tumors
- myomectomy or radio frequency ablation
- uterine artery embolization
- Uterine artery embolization
- Surgical options
- Non surgical treatment includes – Magnetic resonance guided focussed ultrasound
Magnetic resonance guided focused ultrasound, is a non-surgical method that uses high intensity focused ultrasound waves to destroy tissue in combination with magnetic resonance imaging (MRI), which guides and monitors the treatment. During the procedure, delivery of focused ultrasound energy is guided and controlled using MR thermal imaging. Patients who have symptomatic fibroids, who desire a non-surgical treatment option and who do not have contraindications for MRI are candidates for MRgFUS. It takes one to three hours depending on the size of the fibroids. It is safe and about 75% effective. Need for additional treatment varies from 16-20% and is largely dependent on the amount of fibroid that can be safely ablated; the higher the ablated volume, the lower the re-treatment rate.
About 20% to 80% of women develop fibroids by the age of 50. They are typically found during the middle and later reproductive years. After menopause they usually decrease in size. Surgery to remove uterine fibroids occurs more frequently in women in "higher social classes” . Adolescents develop uterine fibroids much less frequently than older women. About half of the women with uterine fibroids have no symptoms. The prevalence of uterine fibroids among teenagers is very less.