Fibroids are the most common growths in a woman’s reproductive system. Many women with fibroids have no symptoms at all, while others have symptoms ranging from heavy bleeding and pain to incontinence and infertility.
Basically they are tumours that grow in the uterus (womb). They are benign - which means they are not cancerous and are made of muscle fibre. Fibroids can be as small as a pea and can grow as large as a melon. It is estimated that 20-50 per cent of women will have fibroids at some time in their lives. They are rare in women under the age of 20, most common in women in their 30s and 40s and tend to contract after menopause.
No one is certain what causes uterine fibroids but changing oestrogen levels seem to play a part in their growth. When oestrogen levels are high - as a result of pregnancy or contraceptive pills, for example - the rate of fibroid growth increases.
About one-quarter of women belonging to the childbearing age have uterine fibroids, the section most susceptible to these are women between 30-50 years of age. . As a woman approaches menopause and her oestrogen levels get lower, uterine fibroids are likely to shrink or almost disappear. Besides being a woman of reproductive age, no other risk factors for fibroids have been found.
How are they diagnosed?
Most uterine fibroids are found during a routine internal examination when your doctor notices a lumpy or irregular uterus. If you have painful or recurring symptoms, your doctor may arrange for an ultrasound to distinguish fibroids from cysts, tumors and other pelvic masses.
How are they treated?
Most fibroids do not need to be treated. Your doctor will make a recommendation based on:
* The amount of pain or blood loss during menstrual periods
* How quickly the fibroid is growing
* Your age, since fibroids shrink with the onset of the menopause
* Your desire to bear children, since fibroids can — in rare cases - contribute to infertility and some surgery options cause sterility
“Heavy bleeding due to fibroids may be reduced by taking tablets and hormonal pills,” says gynecologist Nina Mansukhani. However, the size of the fibroid does not usually change, according to her. There are specific injections (GnRh analogues) available, which do reduce the size of fibroids. But these are usually used prior to a planned surgery to facilitate easier removal. “Due to side affects, these injections are not used as a long-term treatment,” she adds.
According to Dr Jyothi Unni, head of the Department of Obstetrics and Gynecology at Jehangir Hospital, there are two kinds of surgeries to consider. The first procedure, called myomectomy, removes the fibroids but leaves the uterus intact. The operation is used for women who still plan to have children.
A myomectomy may also be done by keyhole surgery that is laparoscopy. If the fibroid is found to be protruding into the uterine cavity, it can be tackled hysteroscopically. A hysteroscope is a telescope, which is inserted into the uterus through the vagina.
The other major treatment available for removal of fibroids is hysterectomy. Dr Unni adds that there is a newer technique to treat fibroids,known as Selective Arterial Embolization available in select centers. Here an angiography of the blood vessels supplying the fibroid is performed and the blood supply to the fibroid is cut off.
What are the symptoms?
Many women do not even know they have uterine fibroids. If symptoms do exist, they may include:
*Painful periods
*Heavy menstrual bleeding (may lead to iron deficiency or anaemia)
*More frequent or uncomfortable urination
*Feeling of fullness or pressure in the lower abdomen
*Backache
*Constipation
*Infertility
*Miscarriage