What are fibroids?
Varying in size from a pea to a watermelon fibroids are non-cancerous growths that develop in or around the womb.
Typically developing when women are in their 30’s or 40’s, they are made up of muscle and fibrous connective tissue.
It is estimated that 70% to 80% of women will develop fibroids in their lifetime but many are unaware of the fact.
Fibroids grow at different rates and there are three types:
- Suberosal: the most common – these push outside the uterus into the pelvis
- Intramural – developing in the muscular wall of the womb
- Submucosal – uncommon, growing into an open space outside the womb
What causes them and what increases your risk?
Although the cause is not yet known, we do know that there is a link to oestrogen. They will shrink as your periods stop and oestrogen levels lower.
There are some circumstances in which your fibroid risk is increased:
- Having a family member with fibroids. If your mother had them you are two to three times more likely than average to also get them
- Being overweight – very heavy women will double or even triple their risk of having fibroids
- There is more likelihood of having fibroids as you approach menopause
- Being of African-Caribbean origin
- You have not had children
- The most likely sign is heavy or prolonged periods with bleeding between periods
- Pain in the pelvis, lower back or even the legs
- Increased bloating
- Increased need to urinate
- An increase in bouts of constipation
- Pain during intercourse
- Sometimes they can lead to difficulty becoming pregnant
- Increased weight – larger fibroids can weigh as much as 20 to 40 lbs
Although fibroids don’t typically have severe health consequences you can become anaemic due to the heavy bleeding.
Diagnosis and Treatment
If you are experiencing symptoms it is likely that your doctor can tell you have fibroids through a simple pelvic examination. To confirm their diagnosis, you may be sent for an ultrasound, MRI or CT scan or a hysteroscopic or laparoscopic examination.
Treatment for thyroids is typically administered in five ways:
- Medication for symptoms
You can be offered treatment aimed at treating your symptoms. In order to reduce your heavy periods you are likely to be prescribed tranexamic acid; non-steroidal anti-inflammatory drugs (NSAIDs); a contraceptive pill or progestogen.
You may also be offered an intrauterine device which is not suitable for all women as it acts as also acts as a contraceptive too.
- Medication to shrink the fibroids
If the above have no effect you may be prescribed a medication called GnRHas which can only be prescribed for 6 months at a time and is sometimes used to shrink the fibroids before surgery.
As this can also cause hot flushes, stiff muscles, vaginal dryness and sweating a low dose of HRT may be given in parallel.
If your fibroids are severe and treatment has not been effective you may be recommended to have surgery in the form of a hysterectomy or, of you would still like to have children, a myomectomy (which removes the fibroids but maintains the wall of the womb).
Unfortunately the latter is not suitable for all fibroids depending on the size, type and position.
There is also a procedure called hysteroscopic morcellation which was introduced 5 years ago and is generally regarded as less invasive.
- Non surgical
Treatment can be provided through use of MRI guided laser or ultrasound treatment or something called endometrial ablation which is quick procedure used to remove the lining of the womb. There is very helpful information about this on the website belonging to the Royal College of Obstetricians and Gynaecologists.
5. Embolisation of Fibroids
This is a procedure to stop the blood flow to the fibroids. It can be done with local anaesthetic or sedation and inserting a small tube in through a blood vessel in the groin. For more information please see this website.
Do not put up with fibroids
They may not be life threatening, but fibroids can feel extremely debilitating so do visit your GP and ask to be tested to be referred to a gynaecologist if you feel your treatment is ineffective.
It is particularly important to be full acquainted with the treatment and their consequences if you are still trying to have a family.
I hope this has been helpful.
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