All about uterine fibroid

  • By Dr. T Deepa Porkodi

The exact cause of why a fibroid develops is not known. Almost 3 out of every 4 women, at some point in life, develop uterine fibroids.

The fibroids may be single or multiple. Sizes also vary in each case. Fibroids are usually painless. However, if their size is too big then they may cause various symptoms, abnormal menstruation, and infertility being the commonest of them all.

Symptoms that suggest the presence of a fibroid:

  1. Heavy menses
  2. Pelvic pressure
  3. Frequent urination
  4. Sensation of the bladder not being fully empty
  5. Constipation
  6. Backache and leg pains

Almost 77% of women of the child-bearing age have uterine fibroids without being aware of it.

Sometimes a fibroid can cause acute pain and fever. When the blood supply is restricted, the fibroid begins to die and the toxins from it are released into the nearby areas causing this pain and fever. This is commonly seen in a pedunculated fibroid where the fibroid hangs by a stem from the uterine wall.

Types of Fibroids and their characteristic symptoms-

  1. Submucosal Fibroid - These fibroids grow in the inner cavity of the uterine wall. They tend to cause heavy, prolonged menses and pose problems if the woman is trying to conceive.

  2. Subserosal Fibroids - The fibroids project outside the uterus and press upon the adjacent organs. If the fibroid is pressing the bladder in the front, one experiences the symptoms of frequent urination and sensation of bladder not being fully empty. If it is pressing behind on the rectum or a spinal nerve, one experiences constipation or backache.

  3. Intramural Fibroids - They grow within the walls of the uterus and can be big enough to distort the shape and structure of the uterus.

Why do fibroids happen?
The exact cause of fibroids is not known. The condition seems to run in families. Hormones also have an impact on fibroid growth especially oestrogen and progesterone, as fibroid size is seen to shrink significantly after menopause.

Uterine fibroids are benign tumors of the uterus that are generally asymptomatic.

What are the complications of fibroids?
Most of us would associate a growth of cells with cancer. This is not the case with fibroids. Fibroids are non-cancerous.
They can wreak havoc in your life if you are trying to get pregnant, though. Although they have nothing to do with conception, they interfere with the implantation of the fertilized zygote. This may be the cause for infertility or repeated miscarriages. Doctors often recommend removing the fibroid away before going for pregnancy.

How are fibroids detected?
Rarely are fibroid so big that they may be detected clinically on mere palpation. Usually it is the symptoms that guide the doctor and on pelvic examination or on ultrasonography the fibroids are spotted.

What are the treatment options for Fibroids?
The treatment options are varied. Mostly the wait-and-watch method is the one that suits best. If the fibroids are small and are causing no significant symptoms, it is best to leave them alone.
Medications like Gonadotropin releasing agonists are available to make the fibroids shrink in size.
Progestin releasing IUDs are also available to help in the heavy bleeding caused by the fibroids.
Other medications are symptom specific like painkillers and iron supplements to combat the anemia due to blood loss.
If the fibroid is too big and troublesome, it can be surgically removed too.

There was a time when uterine fibroids were considered dangerous and hysterectomy or removal of the uterus was the most sought after resort. With advances in medical science, it has become easier to understand the fibroids.