More women than ever are suffering from these non-cancerous tumours which cause chronic pain and fertility issues. Here’s all you need to know!
Fibroids are the most frequently seen tumours of the female reproductive system. More and more women, especially black women are suffering from this problem which causes chronic pain and infertility issues. Here’s everything you need to know about fibroids!
Whether you already suffer from fibroids or are at risk from suffering from them, it’s important to know all the facts.
Though they can begin harmlessly enough, fibroids feed off blood and can grow into a larger problem, sometimes ending in fertility problems » and even leading to further health problems such as anaemia. In extreme cases, an otherwise benign tumour can even become cancerous.
What are fibroids?
Fibroids, also known as uterine myomas, leiomyomas, or fibromas, are firm, compact tumours that are made of smooth muscle cells and fibrous connective tissue that develop in the uterus. It is estimated that between 20 to 50 percent of women of reproductive age have fibroids, although not all are diagnosed. Some estimates state that up to 30 to 77 percent of women will develop fibroids sometime during their childbearing years.
In more than 99 percent of fibroid cases, the tumours are benign (non-cancerous). These tumours are not associated with cancer and do not increase a woman’s risk for uterine cancer. They may range in size, from the size of a pea to the size of a softball or small grapefruit.
What causes fibroid tumours?
While it is not clearly known what causes fibroids, it is believed that each tumour develops from an aberrant muscle cell in the uterus, which multiplies rapidly because of the influence of oestrogen.
Who is at risk for fibroid tumours?
Women who are approaching menopause are at the greatest risk for fibroids because of their long exposure to high levels of estrogen. Women who are obese and of black heritage also seem to be at an increased risk, although the reasons for this are not clearly understood.
Research has also shown that some factors may protect a woman from developing fibroids. Some studies, of small numbers of women, have indicated that women who have had two children have one-half the risk of developing uterine fibroids compared to women who have had no children. Scientists are not sure whether having children actually protected women from fibroids or whether fibroids were a factor in infertility in women who had no children.
There are factors that can increase a woman’s risk of developing fibroids.
- Age. Fibroids become more common as women age, especially during the 30s and 40s through menopause. After menopause, fibroids usually shrink.
- Family history. Having a family member with fibroids increases your risk. If a woman’s mother had fibroids, her risk of having them is about three times higher than average.
- Ethnic origin. Black women are more likely to develop fibroids than white women.
- Obesity. Women who are overweight are at higher risk for fibroids. For very heavy women, the risk is two to three times greater than average.
- Eating habits. Eating a lot of red meat (e.g., beef) and ham is linked with a higher risk of fibroids. Eating plenty of green vegetables seems to protect women from developing fibroids.
Fibroids are non-cancerous tumours that appear in the tissues around the womb.
There are four types of fibroid:
- Intramural: This is the most common type. An intramural fibroid is embedded in the muscular wall of the womb.
- Subserosal fibroids : These extend beyond the wall of the womb and grow within the surrounding outer uterine tissue layer. They can develop into pedunculated fibroids, where the fibroid has a stalk and can become quite large.
- Submucosal fibroids : This type can push into the cavity of the womb. It is usually found in the muscle beneath the inner lining of the wall.
- Cervical fibroids : Cervical fibroids take root in the neck of the womb, known as the cervix.
The classification of a fibroid depends on its location in the womb.
Around 1 in 3 with fibroids will experience symptoms.
These may include:
- heavy, painful periods, also known as menorrhagia
- anaemia from heavy periods
- lower backache or leg pain
- discomfort in the lower abdomen, especially in the case of large fibroids
- frequent urination
- pain during intercourse, known as dyspareunia
Other possible symptoms include:
- labour problems
- pregnancy problems
- fertility problems
- repeated miscarriages
If fibroids are large, there may also be weight gain and swelling in the lower abdomen.
Once a fibroid develops, it can continue to grow until menopause . » As oestrogen levels fall after menopause, the fibroid will usually shrink.
How are fibroids diagnosed?
Fibroids are most often found during a routine pelvic examination. This, along with an abdominal examination, may indicate a firm, irregular pelvic mass to the physician. In addition to a complete medical history and physical and pelvic and/or abdominal examination, diagnostic procedures for uterine fibroids may include:
- X-ray. Electromagnetic energy used to produce images of bones and internal organs onto film.
- Transvaginal ultrasound (also called ultrasonography). An ultrasound test using a small instrument, called a transducer, that is placed in the vagina.
- Magnetic resonance imaging (MRI). A non-invasive procedure that produces a two-dimensional view of an internal organ or structure.
- Hysterosalpingography. X-ray examination of the uterus and fallopian tubes that uses dye and is often performed to rule out tubal obstruction.
- Hysteroscopy. Visual examination of the canal of the cervix and the interior of the uterus using a viewing instrument (hysteroscope) inserted through the vagina.
- Endometrial biopsy. A procedure in which a sample of tissue is obtained through a tube which is inserted into the uterus.
- Blood test (to check for iron-deficiency anaemia if heavy bleeding is caused by the tumour).
Treatment for fibroids
Since most fibroids stop growing or may even shrink as a woman approaches menopause, the health care provider may simply suggest “watchful waiting.” With this approach, the health care provider monitors the woman’s symptoms carefully to ensure that there are no significant changes or developments and that the fibroids are not growing.
In women whose fibroids are large or are causing significant symptoms, treatment may be necessary.
Treatment will be determined by your health care provider based on:
- Your overall health and medical history
- Extent of the disease
- Your tolerance for specific medications, procedures, or therapies
- Expectations for the course of the disease
- Your opinion or preference
- Your desire for pregnancy
In general, treatment for fibroids may include:
- Hysterectomy. Hysterectomies involve the surgical removal of the entire uterus. Fibroids remain the number one reason for hysterectomies in the United States.
- Conservative surgical therapy. Conservative surgical therapy uses a procedure called a myomectomy. With this approach, physicians will remove the fibroids, but leave the uterus intact to enable a future pregnancy.
- Gonadotropin-releasing hormone agonists (GnRH agonists). This approach lowers levels of oestrogen and triggers a “medical menopause.” Sometimes GnRH agonists are used to shrink the fibroid, making surgical treatment easier.
- Anti-hormonal agents. Certain drugs oppose oestrogen (such as progestin and Danazol), and appear effective in treating fibroids. Anti-progestins, which block the action of progesterone, are also sometimes used.
- Uterine artery embolization. Also called uterine fibroid embolisation, uterine artery embolisation (UAE) is a newer minimally-invasive (without a large abdominal incision) technique. The arteries supplying blood to the fibroids are identified, then embolised (blocked off). The embolisation cuts off the blood supply to the fibroids, thus shrinking them. Health care providers continue to evaluate the long-term implications of this procedure on fertility and regrowth of the fibroid tissue.
- Anti-inflammatory painkillers. This type of drug is often effective for women who experience occasional pelvic pain or discomfort.
Can fibroids turn into cancer
Fibroids are almost always benign (not cancerous). Rarely (less than one in 1,000) a cancerous fibroid will occur. This is called leiomyosarcoma. Doctors think that these cancers do not arise from an already-existing fibroid. Having fibroids does not increase the risk of developing a cancerous fibroid. Having fibroids also does not increase a woman’s chances of getting other forms of cancer in the uterus.
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