Uterine fibroids, also known as myomas or leiomyomas, are non-cancerous growths that develop in or around the uterus. Approximately 37% of Indian women aged 20-40, and 57% of those aged 40-59, have fibroids. While many fibroids are small and asymptomatic, untreated fibroids can lead to various health issues that impact quality of life.

Since 1990, the global cases of uterine fibroids have been rising. The age-standardized incidence rate grew by 6.87%, from 225.67 per 100,000 people in 1990 to 241.18 in 2019. In 2019, there were 9.64 million new cases of fibroids globally, bringing the total number of cases worldwide to 226.05 million.

These rising numbers of fibroids cases worldwide have also led to an increase in complications arising from untreated fibroids. So, let’s explain the importance of knowing the risks of ignoring fibroids, when to seek treatment for this problem, and the potential treatment options available. Understanding these factors can help you make better health choices and consider the various treatment options that exist for treating uterine fibroids.

What are Uterine Fibroids?

Uterine fibroids are non-cancerous growths that can form in or around the uterus, varying widely in size, number, and location. They can grow within the uterine wall (intramurally), on the outer surface (subserosally), beneath the uterine lining (submucosally), or on stalks extending from the uterus (pedunculated). 

Their effects depend on size and location, causing anything from no symptoms to severe discomfort, heavy menstrual bleeding, and other complications like pelvic pain, frequent urination, or fertility issues. While some women remain unaware of their fibroids, others may require treatment to manage these symptoms. Even for women with no symptoms, getting the condition diagnosed and being under medical guidance is required to prevent the risk of complications.

Potential Consequences of Untreated Fibroids

Leaving fibroids untreated can lead to a range of health issues, from mild to severe. Here’s a closer look at the potential risks and complications:

• Increased Pain and Discomfort: When fibroids grow larger, they can cause constant pain and pressure in the pelvic area. The persistent ache can also extend to the lower back or legs if the fibroids press on nerves, impacting your overall comfort and mobility. Fibroids often lead to severe menstrual cramps. The pain can be so intense that it interferes with your ability to work, attend school, or enjoy daily activities. These cramps can be more severe than typical menstrual pain and may last longer, making it difficult to maintain your usual routine during your period.
   
• Heavy and Prolonged Menstrual Bleeding: Fibroids can cause your periods to be much heavier and longer than usual. This condition, known as menorrhagia, can lead to significant blood loss. Over time, this heavy bleeding can result in anaemia, a condition where you don’t have enough red blood cells to carry oxygen throughout your body. Anaemia can cause you to feel very tired, weak, and short of breath, affecting your energy levels and ability to perform daily activities.
   
• Reproductive Challenges: Depending on where they are located and how big they are, fibroids can make it hard to get pregnant. They can block the fallopian tubes, preventing the sperm from reaching the egg, or they can distort the shape of the uterus, making it difficult for an embryo to implant and grow. This can lead to challenges in conceiving naturally and may require medical intervention. If you get pregnant with fibroids, they can lead to complications during pregnancy. Fibroids can increase the risk of miscarriage, where the pregnancy ends on its own, or lead to preterm birth, where the baby is born too early. They can also cause complications during labour, such as obstructing the birth canal or leading to a need for a cesarean section (C-section).
   
• Urinary and Bowel Problems: Large fibroids can press against your bladder, which can make you feel like you need to urinate frequently or cause difficulty in fully emptying your bladder. This can be similar to the problems experienced by men due to an enlarged prostate. This pressure can be uncomfortable and may lead to urinary tract infections (UTIs) if the bladder isn’t emptied completely. Fibroids pressing on the rectum can cause constipation and bowel discomfort, making it hard to have regular bowel movements and causing abdominal pain.
   
• Abdominal Swelling: As fibroids grow, they can cause your abdomen to swell or bloat, similar to the appearance of pregnancy. It can also make it hard to wear certain clothes or engage in physical activities comfortably. Abdominal swelling or bloating can also impact your mood and overall energy levels during the day.
   
• Impact on Quality of Life: The combination of chronic pain, heavy bleeding, and urinary or bowel issues can severely impact your daily life. You might find it hard to go to work, participate in social activities, or even perform simple tasks at home. The ongoing discomfort and disruption can also affect your emotional well-being, leading to stress, anxiety, or depression. Managing these symptoms and finding effective treatment can greatly improve your quality of life and overall health.

When to Seek Treatment

Given the potential complications of untreated fibroids, it’s essential to seek medical advice if you notice any symptoms that may indicate their presence. Early diagnosis and intervention can prevent further issues and significantly improve your quality of life. You should see top gynaecologists in Delhi in these situations if you monitor any of the symptoms mentioned below.

• Menstrual and Pelvic Symptoms: Heavy, prolonged, or painful menstrual periods might indicate fibroids in your uterine lining. These symptoms can cause significant blood loss, leading to anaemia and fatigue. Persistent pelvic pain or pressure in the lower abdomen may also suggest larger fibroids pressing on your pelvic organs. Such symptoms can disrupt daily life and highlight the need for medical evaluation and potential treatment.
   
• Urinary and Bowel Symptoms: Fibroids can press against your bladder and rectum, causing significant urinary and bowel issues. If you have trouble emptying your bladder or feel the need to urinate frequently, fibroids might be pressing on your bladder, increasing the risk of urinary tract infections. Similarly, frequent urination or constipation could indicate fibroids impacting the bladder or rectum, leading to abdominal discomfort. These symptoms highlight the need for medical evaluation and treatment to manage the pressure and improve your quality of life.
   
• Abdominal Changes: Fibroids can cause your abdomen to swell, altering your body shape and making it hard to fit into your clothes. Large fibroids may create a noticeable bulge, resembling pregnancy, which can affect your comfort and self-esteem. These changes highlight the need for medical evaluation and possible treatment to manage symptoms.

With timely diagnosis, it is possible to manage uterine fibroids with medical treatment. Surgical intervention is not mandatory and the condition can often be treated medicinally as well. Here are some of the most common treatment options for fibroids.

Treatment Options for Fibroids

Managing fibroids involves various treatments, from medication to surgery. The best option depends on the severity of symptoms, fibroid size and location, and the patient's fertility goals. 

Medication

Treating fibroids often starts with medications based on symptoms, fibroid size, and fertility goals. Medicines that work as hormonal therapies are commonly used in this treatment process. Some of the examples of medicines used to treat fibroids include:

• Birth control pills help regulate menstrual cycles and reduce heavy bleeding, making periods more manageable, though they don’t shrink fibroids.
   
• GnRH agonists lower estrogen and progesterone levels in your body to temporarily shrink fibroids. They’re used short-term or before surgery but can cause side effects like bone thinning and menopause-like symptoms.
   
• SPRMs (Selective Progesterone Receptor Modulators) control fibroid growth and reduce heavy bleeding without inducing a menopause-like state. They maintain balanced hormone levels while shrinking fibroids.

Non-Surgical Procedures for Managing Fibroids

For those seeking to manage fibroids without surgery, non-surgical options like Uterine Fibroid Embolization (UFE) and MRI-guided Focused Ultrasound Surgery (FUS) can offer relief from the symptoms with quick recovery for patients.

• UFE is a minimally invasive procedure where tiny particles are injected into the blood vessels, feeding the fibroids. These particles cut off the blood supply of the fibroids and cause them to shrink. This helps reduce heavy bleeding and pelvic pain while preserving the uterus, allowing you to get back to your normal activities quickly.
   
• FUS uses high-frequency ultrasound waves guided and directed by an MRI machine to accurately target and destroy fibroid tissue. This non-invasive procedure lets you return to your daily activities quickly with minimal downtime.

Medicinal and non-invasive treatments are becoming more readily available for uterine fibroids. However, for complex cases or larger fibroids, surgical intervention is still the standard treatment procedure recommended to patients. Here is a look at the different surgical treatment options for uterine fibroids.

Surgical Options for Treating Fibroids

Myomectomy: A myomectomy removes fibroids while preserving the uterus, making it ideal for women who wish to keep their fertility. This procedure can be performed using various methods:

• Hysteroscopic Myomectomy: This minimally invasive procedure removes fibroids through the vagina and cervix without any external incisions. It’s typically done on an outpatient basis and is used for fibroids located inside the uterine cavity.
   
• Laparoscopic Myomectomy: This procedure involves making small incisions in the abdomen and using a camera and surgical tools to remove fibroids. This approach offers a shorter recovery time compared to open surgery and is suitable for smaller fibroids.
   
• Abdominal Myomectomy: Abdominal Myomectomy requires a larger incision in the abdomen to access and remove larger or multiple fibroids. This method allows for thorough fibroid removal but has a longer recovery period.

Hysterectomy:  A hysterectomy involves removing the uterus. It is a surgical option for treating fibroids, particularly in severe cases or when other treatments haven’t worked. This procedure permanently treats uterine fibroids but also ends the possibility of conceiving as the entire uterus is removed. Additionally, a hysterectomy can be an essential part of endometriosis treatment, providing relief from chronic pain and other symptoms by removing the uterus and affected tissues. If other treatment procedures have not been able to treat your condition, you can check out MASSH, as we provide the best hysterectomy surgeries in Delhi.

Conclusion

Untreated fibroids can lead to a range of complications, from minor discomfort to severe health issues. Timely diagnosis and treatment are essential to managing fibroids effectively and maintaining an optimal quality of life. If you suspect you have fibroids or are experiencing the symptoms mentioned here, it is recommended you consult with your healthcare provider to explore the underlying cause of your symptoms and the various treatment options. Taking proactive steps toward your health and well-being can help you prevent medical complications in the future. For personalised advice and to discuss the best treatment plan for you, schedule an appointment with the best gynaecologist in Delhi at MASSH through our website. Request a callback today.