Uterine fibroids are non-cancerous growths that form in or on the uterus, affecting millions of women worldwide. These growths are also known as uterine fibroids or simply fibroids. Although fibroids are usually not life-threatening, they can cause a variety of symptoms that may affect a woman’s quality of life. The impact of fibroids can range from mild discomfort to significant health issues, including fertility problems, depending on their size, number, and location within the uterus.
The global number of women with uterine fibroids has been rising over the past few decades. A 2019 study found a 78.82% rise in cases from 1990 to 2019, highlighting this as an important public health concern. In India, about 37.65% of women have uterine fibroids. The most common types are submucosal fibroids (38.6%), intramural fibroids (19.3%), submucosal polyps (14.5%), seedling fibroids (13.9%), and subserosal fibroids (10.2%).
This blog will explore what fibroids are, the potential causes of fibroids, the different types of fibroids, common fibroid symptoms, and available fibroid treatment options.
Understanding Uterine Fibroids
Fibroids are benign tumors that form in the muscle tissue of the uterus. They are also known by other names such as myomas or leiomyomas. Despite being called tumors, fibroids are almost always benign, meaning they are not cancerous. Many women with fibroids do not have any symptoms and may not even know they have them. However, fibroids can sometimes cause severe symptoms and require treatment.
Fibroids can vary in size, from small, seed-like growths to large masses that can distort the shape of the uterus. In some cases, they can grow so large that they reach the rib cage, causing significant discomfort and other complications. One of the most common problems women have due to uterine fibroids is pregnancy complications or fertility issues. Since these growths are often asymptomatic, they are only diagnosed when the person is trying to get pregnant or experiencing any complications during pregnancy.
What Causes Uterine Fibroids?
The exact causes of fibroids are not entirely understood, but research suggests that several factors may contribute to their development. Here are the most commonly recognized causes:
- Hormonal Imbalances: Hormones such as estrogen and progesterone, which regulate the menstrual cycle, are thought to promote the growth of fibroids. These hormones cause the uterine lining to regenerate during each menstrual cycle and can stimulate the growth of fibroids. This is why fibroids tend to shrink after menopause when hormone levels decrease.
- Genetic Factors: Research indicates that fibroids may be hereditary. If your mother or sister had fibroids, you're more likely to get them too. Certain genetic mutations are also more common in fibroid cells compared to normal uterine muscle cells.
- Growth Factors: Certain substances that help maintain body tissues, such as insulin-like growth factors, may play a role in fibroid development. These factors can influence how fibroids grow, though the exact details are still being studied.
- Other Risk Factors: Early onset of menstruation, obesity, and a diet high in red meat and low in green vegetables have also been linked to an increased risk of developing fibroids. Additionally, consuming alcohol and caffeine can increase estrogen levels, which may contribute to fibroid growth.
Types of Uterine Fibroids
Fibroids are classified based on their location in or on the uterus. The main types of fibroids are:
- Submucosal Fibroids: These fibroids develop just under the lining of the uterus and can grow into the uterine cavity. They are less common than other types but can cause severe symptoms, including heavy menstrual bleeding and fertility issues. Because they protrude into the uterine cavity, they can also make it difficult for a woman to become pregnant or carry a pregnancy to term.
- Intramural Fibroids: The most common type of fibroid, intramural fibroids grow within the muscular wall of the uterus. As they enlarge, they can cause the uterus to stretch and become larger than usual. This can lead to symptoms such as pelvic pain, heavy periods, and a feeling of fullness in the lower abdomen.
- Subserosal Fibroids: These fibroids grow on the outside of the uterus and can extend into the pelvic cavity. They may press on surrounding organs, such as the bladder or rectum, causing symptoms like frequent urination or constipation. Subserosal fibroids can become quite large and are often responsible for the bulk symptoms associated with fibroids.
- Pedunculated Fibroids: A type of subserosal fibroid, pedunculated fibroids grow on stalks that extend from the surface of the uterus. These stalks can sometimes twist, causing severe pain and potentially leading to complications that may require surgical intervention.
- Cervical Fibroids: Although rare, these fibroids develop in the cervix, the lower part of the uterus that connects to the vagina. Cervical fibroids can cause symptoms such as pain during intercourse and difficulties during childbirth.
Common Symptoms of Uterine Fibroids
Many women with fibroids experience no symptoms at all, especially if the fibroids are small or located in a part of the uterus where they do not interfere with normal functions. However, when symptoms do occur, they can range from mild to severe and may include the following:
- Heavy Menstrual Bleeding: One of the most common symptoms of fibroids is heavy or prolonged menstrual periods, known as menorrhagia. Some women may experience such heavy bleeding that it causes anaemia, leading to fatigue and weakness.
- Pelvic Pain: Large fibroids can cause pain or a sense of pressure in the pelvic region. This pain may be constant, or it might come and go. Women may also feel pressure in the lower abdomen or a sense of fullness that is sometimes mistaken for weight gain or pregnancy.
- Frequent Urination: When a fibroid presses on the bladder, it can lead to an increased urge to urinate. This pressure may cause discomfort and can interfere with daily routines or sleep.
- Pain During Intercourse: Some women with fibroids, especially those with submucosal or cervical fibroids, experience pain during sexual intercourse. This can be due to the fibroids’ location near the cervix or the uterine lining.
- Lower Back Pain: Fibroids that expand toward the back of the uterus can put pressure on spinal nerves, leading to back pain. This discomfort can vary from mild to severe and may even extend down the legs.
- Reproductive Issues: In some cases, fibroids can interfere with conception, leading to infertility. They can also raise the risk of miscarriage, preterm birth, and complications during childbirth. Women with fibroids who become pregnant may require closer monitoring throughout their pregnancy.
Fibroid Treatment Options
The treatment for fibroids depends on several factors, including the size and location of the fibroids, the severity of the symptoms, and the woman’s desire to have children in the future. Some of the most common fibroid treatment options are:
- Watchful Waiting: If fibroids are not causing significant symptoms, a "wait and see" approach may be recommended. This involves regular monitoring of the fibroids to check for growth or the development of symptoms. Fibroids often shrink after menopause, so if a woman is approaching menopause, her doctor may suggest waiting to see if the fibroids decrease in size on their own.
- Medications: Medications can be used to manage fibroid symptoms. Hormonal treatments, like birth control pills or gonadotropin-releasing hormone (GnRH) agonists, can help manage the menstrual cycle and lessen heavy bleeding. However, these medications do not eliminate fibroids and are often used as a temporary solution or to shrink fibroids before surgery.
- Non-Invasive Procedures: Uterine artery embolization (UAE) is a less invasive treatment that works by blocking the blood flow to the fibroids, leading to their shrinkage. Another option is magnetic resonance-guided focused ultrasound (MRgFUS), which uses high-frequency sound waves to destroy fibroid tissue. These procedures are less invasive than surgery and can be effective in reducing symptoms.
- Surgical Options: Surgery may be required for women experiencing severe symptoms or dealing with large fibroids. A myomectomy is a surgical procedure that removes fibroids while preserving the uterus, making it a preferred choice for women who want to maintain their fertility. In more serious cases, doctors may recommend a hysterectomy, a procedure that involves removing the uterus. Although this procedure offers a permanent solution to fibroids, it is not an option for women who wish to have children in the future.
- Lifestyle Changes: Although lifestyle changes cannot cure fibroids, maintaining a healthy weight, eating a balanced diet, and managing stress can help reduce symptoms and improve overall health. Women who smoke or drink alcohol heavily should consider quitting, as these habits can contribute to fibroid growth.
Conclusion
Uterine fibroids are a common condition that affects many women, often without causing any symptoms. However, when symptoms arise, they can severely disrupt a woman’s daily life and well-being. Understanding the uterine fibroid causes, recognizing the fibroid symptoms, and knowing the fibroid treatment options available can empower you to make informed decisions about your health. If you're experiencing symptoms of fibroids, it's essential to consult a gynecologist in Delhi for an accurate diagnosis and tailored treatment options. So, be sure to check out MASSH and consult with our expert gynaecologists to get an accurate diagnosis and detailed treatment plan today. All you need to do is request a callback from our website to get started.