Symptoms of fibroids
Medically Reviewed by Dr Sravya, MBBS, MS
Introduction
Fibroids are muscle tumors that form in the uterine (womb) wall. Fibroids are often non-cancerous. By the age of 50, around 20% to 80% of women will have fibroids. Fibroids are more frequent in women aged 40 to 50. Symptoms of fibroids are not found in most of the women. Women who do experience symptoms typically find it difficult to live with fibroids. Some women experience discomfort and excessive menstrual flow. The treatment for uterine fibroids is determined by your symptoms. It is unknown why they occur. However, they appear to develop when estrogen levels are greater. Frequently asked the question: What are fibroids, exactly? What are the signs and symptoms of fibroids? What are the causes of fibroids? How are fibroids diagnosed and treated?
Let’s ascertain about…..
- What are fibroids, exactly?
- What are the causes of fibroids?
- What are the signs and symptoms of fibroids?
- How are fibroids diagnosed and treated?
- What is a fibroid complication?
- Summary.
What exactly are fibroids?
Uterine fibroids are tumors that form within or on the uterine walls. Their structure is made up of smooth muscle cells and connective tissue.
Fibroids are sometimes called leiomyoma or “myoma”; in medical terminology.
- Fibroids can appear as a single tumor or in a cluster in the uterus. They can be as little as an apple seed and as huge as a grapefruit. In rare cases, they might grow to be rather large.
- By the age of 50, around 20% to 80% of women will have fibroids.
- Fibroids are more frequent in women aged 40 to 50.
- Fibroids can cause frequent urination or rectal pressure by putting pressure on the bladder or rectum. If the fibroids get very large, they can cause swelling in the abdomen (stomach area), giving a woman the impression of being pregnant.
Types of fibroids
- Fibroids are classified according to the location they grow in.
- Fibroids can form in a variety of places, both inside and outside of your uterus.
- The location, size, and number of fibroids you have will impact which type of therapy is best for you if treatment is even required.
- The locations of your fibroids in and on the uterus are known by many names. These names reflect not only the location of the fibroid but also how it is connected.
- Uterine fibroids can occur in the following locations:
- Submucosal fibroids: These fibroids grow inside the uterine cavity (where a baby develops during pregnancy). Consider the growths reaching down into the uterine cavity.
- Intramural fibroids: These fibroids are lodged within the uterine wall. Consider the uterine sides to be the walls of a home. Fibroids are forming within the muscle wall.
- Subserosal fibroids: These fibroids are located on the exterior of the uterus and are intimately attached to the uterine wall.
- Pedunculated fibroids: These fibroids are the least prevalent and are also seen on the exterior of the uterus. Pedunculated fibroids, on the other hand, are linked to the uterus by a slender stem. They are referred to as mushroom-like.
What causes fibroids?
It is yet unknown what produces fibroids. Their development might be connected to the individual’s estrogen levels.
- Hormones: During a person's reproductive years, estrogen and progesterone levels rise. When estrogen levels are high, especially during pregnancy, fibroids increase.
- Fibroid shrinking is connected with low estrogen levels. This can happen both during and after menopause. It can also occur when you take certain drugs, such as gonadotropin-releasing hormone (GnRH) agonists or antagonists.
- Genetic factor: It may also play a role in fibroids production. Having a close relative with fibroids, for example, increases one's chances of developing them.
A woman’s chance of having fibroids might be increased by many circumstances.(risk factor)
- Age: Fibroids grow increasingly frequently as women age, particularly in their 30s and 40s as they approach menopause. Fibroids usually diminish after menopause.
- A family tree. A family member with fibroids increases your chances. If a woman's mother has fibroids, she is three times more likely to get them herself.
- Ethnic background. African-American women are more likely than white women to acquire fibroids.
- Being overweight. Women who are overweight are more prone to have fibroids. The risk is two to three times higher in extremely obese women than in the general population.
- Childbirth: It is linked to a reduced chance of getting fibroids. Each time a person delivers birth, the risk decreases.
- Consumption: There is additional evidence to show that red meat, alcohol, and caffeine are linked to a higher incidence of fibroids. Higher consumption of fruits and vegetables may be linked to a decreased risk.
What are the symptoms of fibroids?
The majority of fibroids do not cause symptoms and do not require treatment other than regular monitoring by your doctor. These are often little fibroids. An asymptomatic
fibroid does not create symptoms. Larger fibroids can produce a variety of symptoms,
including:
Uterine fibroids symptoms
- Submucosal fibroid symptoms can cause the following symptoms:
1. Menstrual bleeding that is heavy and protracted between or throughout periods
2. Anaemia (severe anemia induced by excessive bleeding)
3. Pelvic or lower back discomfort
4. Passing blood clots on a regular or massive scale
5. Fatigue Dizziness
- Subserosal fibroids can cause the following symptoms:
1. Menstrual bleeding is a typical sign of uterine fibroids, however, it is less prevalent with subserosal fibroids.
2. A heaviness or fullness in the lower abdomen/pelvis
3. Urge to urinate often
4. Constipation
5. Bloating
6. Lower abdominal enlargement due to discomfort or cramping5
7. Pain when having sex
8. Leg and lower back discomfort
9. Inability to urinate/empty the bladder entirely
Fibroids in breast symptoms:
- Breast lumps or thickenings that blend with the surrounding tissue.
- Generalized breast pain, tenderness, or discomfort, including the breast's higher outer rim.
- Breast nodules or lumpy tissue grow and shrink during the menstrual cycle.
- Nonbloody green or dark brown nipple discharge that leaks without pressure or squeezing.
- Breast alterations in both breasts that are comparable
- Breast soreness or lumpiness increases monthly from mid-cycle (ovulation) to shortly before your period, then decreases after your period begins.
How to diagnose and treat fibroids?
1. Diagnosis:
:Uterine fibroids are commonly discovered by chance during a routine pelvic exam. Your doctor may see anomalies in the shape of your uterus, which might indicate the existence of fibroids.
If you experience symptoms of uterine fibroids, your doctor may order the following tests:
- Ultrasound. If more confirmation is necessary, your doctor may order an ultrasound. To confirm the diagnosis and map and quantify fibroids, a sound wave picture of your uterus is taken. A doctor or technician slips the ultrasound equipment (transducer) across your belly (transabdominal) or through your vagina (transvaginal) to take photos of your uterus.
- Magnetic resonance imaging is abbreviated as MRI. This imaging examination can show the size and location of fibroids in greater detail, detect different types of tumors, and aid in determining the best treatment choices. An MRI is most commonly utilized in women who have a bigger uterus or in women who are nearing menopause (perimenopause).
- CT scan: A CT scan employs X-ray images to get a comprehensive view of your inside organs from various angles.
- Hysterosonography. Hysterosonography also known as a saline infusion sonogram, employs sterile salt water (saline) to enlarge the uterine cavity, making pictures of submucosal fibroids and the uterine lining easier to get in women trying to conceive or experiencing excessive monthly flow.
- Hysterosalpingography. A dye is used to highlight the uterine cavity and fallopian tubes on X-ray pictures during hysterosalpingography. If infertility is an issue, your doctor may advise you to try it. This test can determine if your fallopian tubes are open or blocked, as well as discover submucosal fibroids.
- Hysteroscopy. For this examination, your doctor will insert a tiny, lit telescope known as a hysteroscope into your cervix and your uterus. Following that, your doctor will inject saline into your uterus, enlarging the uterine cavity and letting your doctor see the uterine walls and fallopian tube openings.
- Sonohysterography: A small catheter is placed transvaginally for this imaging examination, and saline is delivered into the uterine cavity through the catheter. This extra fluid helps to create a clearer image of your uterus than a standard ultrasound would.
- Laparoscopy: During this examination, your physician will make a small cut (incision) in your lower abdomen. A short, flexible tube with a camera on the end will be inserted to carefully study your inside organs.
2. Treatment and Management:
- If you have fibroids but no symptoms, you may not require treatment. During your routine checkups, your doctor will check to see if they have grown.
- If you are experiencing symptoms from your fibroids, such as anemia from heavy bleeding, moderate to severe pain, infertility issues, or urinary tract and bowel difficulties, treatment is usually necessary.
Your treatment strategy will be determined by some criteria, including:
1. The number of fibroids you have.
2. The dimensions of your fibroids.
3. The location of your fibroids.
4. What symptoms are you having as a result of the fibroids?
5. Your wish to become pregnant.
6. Your wish to keep your uterus
Medications
- OTC pain relievers: These drugs can relieve the discomfort and agony caused by fibroids. Acetaminophen and ibuprofen are examples of over-the-counter drugs.
- Iron supplements: If you develop anemia as a result of excessive bleeding, your provider may advise you to take an iron supplement.
- Birth control: It can also help with fibroids symptoms, including heavy bleeding during and between periods and menstrual cramps. Birth control can be used to control heavy menstrual bleeding. Birth control techniques include oral contraceptive pills, intravaginal contraception, injections, and intrauterine devices (IUDs).
- Agonists of gonadotropin-releasing hormone (GnRH): These drugs, which can be administered through a nasal spray or injection, operate by reducing your fibroids. They are occasionally used to reduce a fibroid before surgery, making removal easier. These treatments, however, are only temporary, and if you stop using them, the fibroids may reappear.
- Oral treatments: elagolix is a novel oral medicine approved for the treatment of excessive uterine bleeding in women who have not reached menopause and have symptomatic uterine fibroids. It is valid for 24 months. Consult your doctor about the benefits and drawbacks of this therapy. Tranexamic acid, another oral medication, is an antifibrinolytic oral medicine approved for the treatment of cyclic heavy menstrual bleeding in persons with uterine fibroids.
Fibroid removal surgery
- Myomectomy: It is a treatment that allows your doctor to remove fibroids without causing damage to the uterus.
- Hysterectomy: Fibroids can only be removed by a hysterectomy. In which the uterus is removed during the procedure. The fibroids will not return if your uterus is removed fully, and your symptoms should go away. If your uterus is removed, but your ovaries remain, you will not experience menopause following a hysterectomy.
- Ablation of the endometrium: If the fibroids are towards the inner surface of the uterus, removing the uterine lining may assist. For some women with fibroids, endometrial ablation may be a viable alternative to hysterectomy.
- Uterine fibroid embolisation: A tiny catheter is inserted into the uterine or radial artery, and minute particles are utilized to prevent blood from flowing from the uterine artery to the fibroids. The loss of blood supply causes the fibroids to shrink, alleviating your discomfort.
- Forced ultrasound surgery is a very new and entirely noninvasive surgical method. You lie down inside a specialized MRI scanner, which allows a specialist to see into your uterus. To ablate or eliminate the fibroids, high-energy, high- frequency sound waves are directed at them.
- Myolysis techniques (such as Acessa) decrease fibroids by employing heat sources such as an electric current or laser, whereas cryo-myolysis freezes the fibroids.
- Morcellation: This involves splitting fibroids into tiny pieces, which may increase the chance of cancer spreading if a previously undetected malignant tumor is morcellated during myomectomy. There are numerous techniques to lower that risk, including assessing risk factors before surgery, morcellating the fibroid in a bag, or extending an incision to avoid morcellation.
What is the complication of fibroids?
Complications from fibroids are uncommon. However, they do arise on occasion.
- Consistently heavy periods might have an impact on a person's quality of life. Anemia can also result from significant blood loss.
- Large fibroids can cause swelling and pain in the lower abdomen, as well as constipation or uncomfortable bowel motions.
- As a result of fibroids, some people may get urinary tract infections.
- Some folks may also have pregnancy issues. As estrogen levels grow dramatically during pregnancy, preterm birth, labor complications, and pregnancy loss may occur.
- There is insufficient data to establish that myomas, with or without fertility therapy, diminish the probability of becoming pregnant.
- Having said that, there is reasonable evidence that hysteroscopic myomectomy for submucosal fibroids increases clinical pregnancy rates.
Summary
Uterine fibroids are growths of smooth muscle cells and connective tissue in the uterine walls that afflict 20% to 80% of women by the age of 50. They might manifest as a single tumor or as a cluster and can put pressure on the bladder or rectum, resulting in frequent urination or rectal pressure. Large fibroids can induce abdominal swelling, mimicking pregnancy. In certain cases, fibroids are so little that they do not cause any symptoms. Fibroids can also cause unpleasant symptoms at times. Contact your healthcare provider if you are experiencing any
discomfort or pain.
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