Uterine fibroids, also known as leiomyomas or myomas, are non-cancerous growths that develop within the uterus. They are common, especially in women of reproductive age, and vary in size, number, and location within the uterus. While many women with fibroids experience no symptoms, others may face significant health issues.
Types of Uterine Fibroids:
- Intramural Fibroids: Grow within the muscular wall of the uterus. These are the most common type.
- Subserosal Fibroids: Develop on the outer surface of the uterus, potentially pressing on surrounding organs.
- Submucosal Fibroids: Found just under the lining of the uterus and can protrude into the uterine cavity, often causing heavy bleeding.
- Pedunculated Fibroids: Attached to the uterus by a thin stalk, they can be either subserosal or submucosal.
Symptoms:
- Heavy Menstrual Bleeding: Prolonged or heavy periods, sometimes with blood clots.
- Pelvic Pain and Pressure: A sensation of fullness or pressure in the lower abdomen.
- Frequent Urination: Caused by fibroids pressing on the bladder.
- Constipation: If fibroids press on the rectum.
- Back or Leg Pain: Larger fibroids may cause discomfort in the back or legs.
- Pain During Intercourse: Particularly if the fibroids are near the cervix or within the uterine cavity.
- Reproductive Issues: Some women with fibroids may experience difficulties with fertility, recurrent miscarriages, or complications during pregnancy.
Causes and Risk Factors:
- Hormones: Estrogen and progesterone, hormones that regulate the menstrual cycle, appear to promote the growth of fibroids.
- Genetics: A family history of fibroids increases the likelihood of developing them.
- Age: Fibroids are more common in women in their 30s and 40s.
- Ethnicity: African-American women are more likely to develop fibroids and tend to do so at a younger age and with more severe symptoms.
- Obesity: Higher body weight is associated with an increased risk of fibroids.
- Diet: A diet high in red meat and low in green vegetables can contribute to the risk.
Diagnosis:
- Pelvic Exam: Often the first step in diagnosing fibroids, where a doctor may feel abnormalities in the shape of the uterus.
- Ultrasound: A common imaging test that uses sound waves to create pictures of the uterus and detect fibroids.
- MRI: Provides detailed images to assess the size and location of fibroids.
Impact on Fertility:
- Submucosal Fibroids: Are most likely to cause fertility issues by interfering with the uterine lining or blocking the fallopian tubes.
- Myomectomy: May improve fertility by removing fibroids while preserving the uterus.
When to Seek Treatment:
- Symptoms are significantly affecting your quality of life (e.g., heavy bleeding, severe pain).
- You’re planning pregnancy, and fibroids might impact your fertility.
- Fibroids are growing rapidly or have reached a large size.
Prognosis:
Many women with fibroids experience manageable symptoms or none at all, and treatment options are effective in alleviating symptoms or removing fibroids. However, fibroids can recur after treatment, especially if the uterus is preserved. Regular follow-ups with a healthcare provider are important for monitoring fibroid growth and managing symptoms.