They’re a kind of noncancerous tumors popping up in the female reproductive system. Usually, they cause no pain and no major health issues.
Around 20% (up to 50%) of the female population of childbearing age have fibroids and, in most cases, they do not present symptoms.
However, a medical examination is necessary to determine its severity or if required to remove them.
The size of the fibroids can vary and be small (like a coin) or large (like a melon). In the latter case, it causes inflammation in the uterus, and it even seems that the woman was pregnant.
Fibroids can grow alone or as a conglomerate of several. They are the most common tumors in the female reproductive system.
These growths, also known as uterine fibroids or leiomyomas, are tumors or masses formed by muscle cells or other tissues that develop inside the wall of the uterus (or matrix).
Although fibroids are sometimes called tumors, in more than 99 percent of the cases they are benign (non-cancerous) and do not increase the risk of uterine cancer in women.
Some experts estimated that between 20 and 30 percent of women in their reproductive age have them, although not all are diagnosed. Fibroids can develop as individual masses or in clusters (or groups).
They may vary in size, but only a third of these are large enough to be detected by a physician during the physical examination.
Description and Symptoms
Fibroids are benign growths in the womb (uterus). They are divided into different types:
- Intramural fibroids grow within the walls of the womb. They are the most common type of fibroids and the most likely to give no symptoms.
- Subserosal fibroids grow just under the outer wall of the womb. They can grow outwards into the pelvis.
- Submucosal fibroids grow just under the inner lining of the uterus. They tend to expand into the womb.
- Pedunculated fibroids grow on a stalk attached to the inside or outside of the womb.
Symptoms of fibroids include heavy periods, abdominal pain, frequent urination, and discomfort during sexual intercourse. Many women with fibroids have no signs at all.
Fibroids do not usually interfere with pregnancy but can cause complications if they are large.
If you have a single symptom of those indicated above, it does not mean that you will inevitably have a fibroid. As it was stated, in most cases this pathology has no marked symptoms.
The diagnosis of fibroids is carried out through a study of the patient’s clinical history, a routine gynecological examination and, if doctors find the fibroma, studies such as laparoscopy, hysteroscopy or ultrasound can be performed.
If the fibroids are small and do not grow, the recommended treatment is to perform annual checks on the gynecologist.
If the woman observes any of the symptoms in that period, an additional consultation will be necessary.
If, on the other hand, the myoma is large or does not respond to the treatments, the doctor will indicate that surgery is performed.
This can be done in two ways: through a myomectomy (or laparoscopy) or removal of the uterus (called a hysterectomy).
Some women do not have symptoms, or have only mild symptoms, while in others they are more severe and disruptive.
What Is The Cause Of Uterine Fibroids?
The cause is not precisely known, researchers have some theories, but fibromas are most likely the result of several factors interacting with each other.
These factors can be hormonal (affected by estrogen levels), genetic (family), environmental, or a combination of the three.
Each tumor is believed to develop from a cell in the muscular layer of the uterus, which is rapidly multiplied by the influence of estrogen.
The cause of fibroids is unknown, although there may be some genetic factors that make them more likely.
African American women are more likely to get fibroids than Americans of European descent. Childless or obese women are more at risk, as are those with high blood pressure.
The growth of fibroids is promoted by the female hormones estrogen and progesterone. They tend to shrink after the menopause when hormone levels decrease.
Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be taken during periods to reduce pain and inflammation.
The Levonorgestrel Intrauterine System (LNG-IUS) is a contraceptive implant that secretes the hormone levonorgestrel. It is often used for relieving the symptoms of fibroids.
Tranexamic Acid reduces bleeding. The pills are taken during the period. It is not a contraceptive, so is useful for women who still wish to become pregnant.
Gonadotropin-Releasing Hormone Analogs (GnRHas), such as goserelin and leuprolide, shrink fibroids.
These drugs decrease the levels of the female hormone estrogen and produce an artificial (but reversible) menopause. They are not suitable for oral administration, so have to be given by injection.
Serious side-effects, such as bone thinning, can occur if the drugs are provided for more than six months. They are often used to shrink fibroids before surgery.
Sometimes a female hormone, or a related analog, is given alongside them, to reduce side-effects such as hot flushes.
Uterine Artery Embolization (UAE) is a procedure carried out in hospital under local anesthetic. The arteries supplying blood to the uterus are blocked using microscopic particles.
The reduced blood supply causes the fibroids to shrink. Although a subsequent pregnancy is usually possible, there is some uncertainty about the effect of the procedure on fertility.
Patients should discuss this issue with their physicians if there is a possibility they may wish to get pregnant in the future.
Endometrial Ablation is a procedure used to remove small fibroids in the inner lining of the womb. The womb lining is removed, using either lasers, a hot wire, microwaves, or hot fluid in a balloon.
The procedure sometimes produces sterility. It also increases the chance of subsequent miscarriage if pregnancy does occur, so is not recommended for women who wish to become pregnant at a later date.
Surgery can be used to remove fibroids. Individual fibroids can be removed (myomectomy). Such operations can only remove fibroids that are in a suitable position.
A more radical solution is a hysterectomy (removal of the womb), although nowadays this is usually a last resort when other treatments have failed. The operation can result in early menopause.