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 Fibroids: The Common but Misunderstood Women's Health Issue

Fibroids Uterine fibroids or leiomyomas are non-cancerous growths that grow in or on the uterus wall, the organ in a woman's reproductive system where an enriched egg implants and grows into a fetus during pregnancy. These growths have muscle and connective tissue and can vary in size, number, and location within the uterus. While fibroids are not cancerous, they can cause many symptoms, such as heavy menstrual bleeding, pelvic pain or pressure, and infertility, depending on their size, location, and proximity to other organs. They are common in women of reproductive age, with estimates suggesting that up to 70% of women will develop fibroids at some point.

Happy Group after fibroid treatment

Fibroids can vary in size, location, and number. Women may have only one small fibroid, while others may have multiple large ones. In many cases, fibroids do not cause symptoms and may be discovered incidentally during a routine pelvic exam or imaging study. However, in some cases, fibroids can cause significant symptoms and complications, such as:

• Heavy or prolonged menstrual bleeding
• Pelvic pain or pressure
• Bladder or bowel dysfunction
• Infertility or pregnancy complications

The exact cause of fibroids is unknown, but factors such as hormonal imbalances, genetics, and environmental factors may play a role. Gynaecologists diagnose fibroids through imaging studies, such as ultrasound or MRI.

Treatment options for fibroids depend on the size and location of the fibroids and the severity of the symptoms. In many cases, treatment may not be necessary if the fibroids are small and not causing symptoms.

If symptoms are present, treatment options may include:

• Medications to manage symptoms, such as pain or heavy bleeding
• Hormonal therapies to shrink fibroids or reduce symptoms
• Doctors may work on Minimally invasive procedures to remove or shrink fibroids, such as myomectomy or uterine artery.
• Surgery to remove the uterus (hysterectomy), which is typically only recommended in severe cases or when fertility is not a concern,

Women with fibroids can discuss their symptoms and treatment options with their gynaecologist to determine the best action.

 

What are the types of Fibroids?

There are several types of fibroids, which are classified based on their location within the uterus. The different types of fibroids include:

• Intramural fibroids are the most common for about 70% of all cases. Intramural fibroids grow within the muscular wall of the uterus and can cause the uterus to become enlarged.
• Submucosal fibroids grow beneath the uterus linings and can protrude into the uterine cavity, causing heavy menstrual bleeding and other complications.
• Subserosal fibroids: These fibroids can grow on the outside of the uterus and can push on nearby organs, such as the bladder or rectum, causing pelvic pain or pressure.
• Pedunculated fibroids: These fibroids are attached to the uterus by a stalk or peduncle and can grow inside or outside the uterus.
• Cervical fibroids are rare fibroids that specifically develop on the cervix. The cervix is the lower part of the uterus that connects it to the vagina. Compared to other types of fibroids, cervical fibroids are relatively uncommon.

Fibroids can also be classified based on their size, with small fibroids measuring less than 5 cm in diameter, medium-sized fibroids measuring between 5 and 10 cm, and large fibroids measuring over 10 cm. The size and location of fibroids can impact the severity of symptoms and the treatment options available. Women with fibroids can work with their healthcare provider to determine the best action based on their situation.

 

What are the causes of fibroids?

The exact cause of fibroids is unknown, but research suggests that factors may contribute to their development. These factors include:

• Hormones: The levels of estrogen and progesterone in a woman's body influence the growth and development of fibroids, whereas these hormones promote hormone-dependent tumours.
• Genetics: Women with a family history of fibroids are more likely to develop them, suggesting that there may be a genetic component to their development.
• Age: Fibroids are most commonly diagnosed in women in their 30s and 40s, although they can develop at any age.
• Ethnicity: Studies have shown that African-American women are more likely to develop fibroids than women of other ethnicities.
• Obesity: Researchers often link Obesity to an increased risk of developing fibroids.
• Environmental factors: Some environmental factors, such as exposure to certain chemicals or toxins, may increase the risk of developing fibroids, although more research is needed to understand the exact relationship between these factors and fibroid development.

It's important to note that many women who develop fibroids do not have any known risk factors, and the exact cause of fibroids can be distinctive for women.

Who is at risk for uterine fibroids?

Uterine fibroids can occur in any woman of reproductive age, but some factors may increase the risk of developing them. These risk factors include:

• Age: Women in their 30s and 40s are more likely to develop fibroids.
• Family history: Women with a history of fibroids are at a higher risk of developing them.
• Ethnicity: African-American women are more likely to develop fibroids than women of other ethnicities.
• Obesity: Women who are obese are at a higher risk of developing fibroids.
• Hormonal imbalances: Women with hormonal imbalances, such as those with polycystic ovary syndrome (PCOS), may be at a higher risk of developing fibroids.
• Early onset of menstruation: Women who started their periods before age 10 are at a higher risk of developing fibroids.
• Birth control use: Women who use birth control pills may have a slightly lower risk of developing fibroids, while women who use hormonal intrauterine devices (IUDs) may have a higher risk.

It's important to note that many women who develop fibroids do not have any known risks, do not necessarily mean women will develop fibroids. 

How are fibroids treated?

The treatment options for fibroids depend on the size and location of the fibroids, the severity of symptoms, and the woman's age and desire to have children in the future. Some treatment options include:

• Watchful waiting: If the fibroids are small and not causing any symptoms, a woman's doctor may recommend "watchful waiting," which means monitoring the fibroids over time to see if they grow or cause any symptoms.
• Medications: Certain medications, such as gonadotropin-releasing hormone (GnRH) agonists or birth control pills, can help shrink fibroids or reduce symptoms like heavy bleeding and pelvic pain.
• Uterine fibroid embolization (UFE): This is a minimally invasive procedure in which a radiologist uses a catheter to deliver small particles to block the blood supply to the fibroids, causing them to shrink.
• Myomectomy is a surgical procedure in which surgeons remove the fibroids while leaving the uterus intact. It is an option for women who wish to preserve their fertility.
• Hysterectomy is a surgical procedure in which the entire uterus, including the fibroids, is removed. A hysterectomy is an option for women who have completed their family planning and do not wish to have any more children.

The treatment choice depends on the woman's situation, and she must consult with her healthcare provider.

Uterine Fibroids can be Reduced with Green Tea and Vitamin D 

 

What is magnetic resonance imaging (MRI) in fibroids?

Magnetic resonance imaging (MRI) is a medical imaging technique that uses a powerful magnet and radio waves to create detailed images of the inside of the body. 

• In the context of fibroids, an MRI can be used to diagnose and monitor the growth and location of fibroids and to plan for surgical or non-surgical treatments.
• MRI is useful for imaging fibroids because it provides clear and detailed images of soft tissues, which is challenging to see with other imaging techniques like X-rays or ultrasound.
• MRI can also show whether a fibroid is pressing on other organs, such as the bladder or rectum, which can help doctors determine the best course of treatment.
• During an MRI, a woman lies on a table that slides into a large, tube-shaped machine.
• The machine uses a strong magnetic field and radio waves to create detailed images of the pelvic area.
• The procedure is painless and non-invasive, although some women may find the uncomfortable noise.
• MRI is a valuable tool for diagnosing and managing fibroids and can provide vital information for treatment planning.

However, like all medical procedures, there may be some risks and limitations associated with MRI, and patients can discuss them with a healthcare provider.

 

What are the recent updates in fibroids?

There have been several recent updates in the field of fibroids, including:

• New drug treatments: In 2021, the U.S. Food and Drug Administration (FDA) approved a new drug called Relugolix for uterine fibroids. Relugolix is a once-daily oral medication that works by blocking the production of certain hormones that can promote the growth of fibroids.
• Non-invasive treatments: Researchers continue to explore new non-invasive treatments for fibroids, including high-intensity focused ultrasound (HIFU) and magnetic resonance-guided focused ultrasound (MRgFUS). These techniques use focus on ultrasound waves to heat and destroy fibroids without the need for surgery.
• Artificial intelligence (AI): AI is being used to develop new methods for diagnosing and treating fibroids. For example, researchers are using machine learning algorithms to analyze MRI images and predict which fibroids are most likely to respond to different types of treatment.
• Patient-centred research: There is a growing focus on patient-centred research in fibroids, which aims to understand the experiences and needs of women with fibroids. This research is helping to inform the development of new treatments and interventions to the specific needs of individual patients.

These recent updates are promising for women with fibroids, as they offer new options, treatment, and care. As research in this area continues, we may expect even more advances in fibroids in the coming years.