Types of Fibroids
Medically Reviewed by Dr Sravya, MBBS, MS
Introduction
A uterine fibroid or leiomyoma is also called a fibroid; its growth appears in the uterus and is non-cancerous. There are several types of fibroids, including intramural, subserosal, submucosal, and pedunculated, each with distinct locations within the uterine wall. It’s quite common for women to have fibroids; many don’t even know it.
The size of a fibroid is tiny to large; it can change from nearly invisible to large masses that can even change the size of the uterus’s size and shape. The fibroid is made of connective tissue, and the fibroids can be from a single growth to many growths inside the uterus.
The actual cause of fibroid is unknown, and various factors like hormone imbalance and genetics play avital role in its development. They can usually be seen when the estrogen hormone is high, and the woman is fertile; let now discuss the types of fibroid.
Various fibroids
The different types of fibroids are
- Leiomyomas : This is a type of most prominent cancer that happens in women of reproductive age. It is also called uterine multiple fibroids. The types of fibroids are classified based on variations in the fibroid size and location.
- Intramural Fibroids: A type of tumor that grows inside the uterus. They are seen in diverse shapes and sizes, from tiny nodules to large masses. Pelvic pain, heavy or prolonged menstrual bleeding, and organ pressure are all possible indications of intramural fibroids.
- Submucosal Fibroids: When the fibroid protrudes into the cavity of the uterine and extends to the lining of the uterine, it is called submucosal fibroids. This fibroid is also linked to infertility, prolonged periods, and heavy bleeding during menstruation. This can also cause discomfort during pregnancy.
- Subserosal Fibroids:The type of fibroid can protrude from the outer surface of the uterus and continue to grow there. It will not damage the cavity of the uterus, and symptoms are not that noticeable. If the fibroid is large, you will experience symptoms like pelvic pressure and pain.
- Vaginal fibroids: Vaginal fibroids, although rare, are noncancerous growths that develop in or around the vaginal canal and may cause symptoms such as pain and discomfort.
- Pedunculated Fibroids: The type of tumors that grow on a stalk or stem connected to the uterus. Both submucosal and subserosal types are possible. When the fibroids hurt and occasionally twist on their branches, it can result in excruciating pain and other problems.is called Pedunculated fibroidThe type of tumors that grow on a stalk or stem connected to the uterus. Both submucosal and subserosal types are possible. When the fibroids hurt and occasionally twist on their branches, it can result in excruciating pain and other problems.is called Pedunculated fibroid.
- Fibroids in the Cervix or Area: Cervical fibroids cause complications in pregnancy and fertility issues and show symptoms like menstrual bleeding and trouble having sex.
- Intraligamentous Fibroids: Intraligamentous fibroids grow in the broad ligament that supports the uterus. They can cause massive and put strain on adjacent structures as well as produce pelvic pain and urinary problems. It is not possible to remove them surgically due to their position.intraligamentous fibroids grow in the broad ligament that supports the uterus. They can cause massive and put strain on adjacent structures as well as produce pelvic pain and urinary problems. It is not possible to remove them surgically due to their position.
- Fibroids with Calcium Deposition: When there is calcium deposition along with fibroids. It appears in the areas of increased density on imaging tests. Calcified fibroids may cause pelvic pain and discomfort.
Fibroid Necrotic
Fibroids that have undergone tissue death or necrosis are called fibroid necrotic. The symptoms can be degenerative alterations or insufficient blood flow. It is cured either surgically or medically. The size, location, symptoms, and patient’s goal for future fertility all play a role in determining the best course of treatment for fibroids. The range of treatment options includes minimally invasive techniques like uterine artery embolization, magnetic resonance-guided focused ultrasound, and laparoscopic or robotic-assisted surgeries, as well as more invasive interventions like surgery.
The origin of fibroid
However, a number of elements have been discovered that could support their growth. These consist of:However, a number of elements have been discovered that could support their growth. These consist of:
- Hormonal Factors:During the menstrual cycle, hormones like progesterone and estrogen are essential for the formation and development of the uterine lining. It is thought that hormonal imbalances, especially too much estrogen, may be a factor in the growth of fibroids. High estrogen levels have been linked to the emergence of fibroids because estrogen encourages the expansion of the uterine lining.
- Hereditary Predisposition: The fibroid development may have a hereditary component. An increased risk of fibroid production may be linked to specific genetic abnormalities and variants.
- Growth Factors: The development of fibroids may be influenced by growth factors, such as insulin-like growth factors. These elements affect the development and division of cells. The development of fibroids may be influenced by abnormalities in the control of growth factors.
Abnormalities in the extracellular matrix (ECM)
The extracellular matrix, an intricate web of proteins and other chemicals, gives tissues their structural support. Excess ECM components, primarily collagen, and other proteins, are what define fibroids. Fibroid formation may be influenced by changes to the ECM’s structure and content in uterine tissue. Other risk factors for fibroids development include obesity, race (women of African ancestry are more likely to have them), and age (they typically appear during the reproductive years and decline after menopause). In addition, although the evidence for these correlations is weak, certain lifestyle variables like food, stress, and exposure to environmental pollutants may affect the development of fibroids.
It is crucial to remember that while these factors may aid in the growth of fibroids, they do not ensure their presence. While some women without obvious risk factors may still create fibroids, many women with risk factors never acquire them. It’s believed that a complex interaction of genetic, hormonal, and environmental variables plays a role in the formation of fibroids.
Symptoms of fibroid
The symptoms of fibroids can vary widely among individuals, and some women with fibroids may not experience any noticeable symptoms. However, when symptoms do occur, they can range from mild to severe. Common symptoms of fibroids include:
1. Menstrual Changes:
- Heavy or prolonged menstrual periods (menorrhagia)
- Severe menstrual cramps (dysmenorrhea)
- Passage of blood clots during menstruation
2. Pelvic Pain and Pressure
- Dull or sharp pelvic pain
- A feeling of pressure or fullness in the lower abdomen or pelvisA feeling of pressure or fullness in the lower abdomen or pelvisA feeling of pressure or fullness in the lower abdomen or pelvis
- Pain during sexual intercourse (dyspareunia)
- Increased discomfort when lying on the abdomen
3. Urinary Symptoms
- Frequent urination
- Urgency to urinate
- Difficulty emptying the bladder completely
- Urinary incontinence (rare)
4. Bowel Symptoms
- Constipation
- Bloating or abdominal distension
- Difficulty with bowel movements
5. Reproductive Symptoms
- Infertility or difficulty conceiving
- Increased risk of miscarriage
- Complications during pregnancy, such as preterm labor, fetal malposition, or increased risk of cesarean delivery
6. Abdominal Enlargement
- In some cases, large fibroids can cause the abdomen to appear swollen or distended, increasing the waist size.
- It's important to note that fibroids' size, number, and location can influence the severity and type of symptoms experienced. Some women may have only one sign, while others may experience a combination of symptoms. Additionally, the presence of symptoms does not necessarily correlate with the size of the fibroids.It's important to note that fibroids' size, number, and location can influence the severity and type of symptoms experienced. Some women may have only one sign, while others may experience a combination of symptoms. Additionally, the presence of symptoms does not necessarily correlate with the size of the fibroids.
Treatment option for fibroid
The treatment options for fibroids can vary depending on the size, location, and symptoms associated with the fibroids and the patient’s desire for future fertility. Here are some standard treatment options:
1. Abdominal Enlargement
- If fibroids are small, asymptomatic, and not causing any complications, a "watchful waiting" approach may be recommended. It involves regular monitoring of the fibroids through check-ups and imaging tests to ensure they are not growing or causing significant symptoms.
2. Medications
- Medications - These may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) alleviate pain and reduce heavy menstrual bleeding.
- Hormonal birth control methods (e.g., oral contraceptives, intrauterine hormonal devices) regulate menstrual cycles and decrease bleeding.
- GnRH agonists or antagonists induce a temporary menopause-like state, shrinking the fibroids and relieving symptoms. These medications are typically used for short periods due to potential side effects and bone density concerns.
Minimally Invasive Procedures
Several minimally invasive procedures are available that aim to treat fibroids while preserving the uterus.
These include:
- Uterine artery embolization: A procedure where tiny particles are inserted into the blood vessels that supply the fibroids
- MRI-guided focused ultrasound surgery: Using high-intensity ultrasound waves destroys the fibroid tissue while leaving the surrounding healthy tissue intact.
- Laparoscopic or robotic-assisted surgeries: Minimally invasive surgical techniques that involve removing or shrinking the fibroids while preserving the uterus.
Surgical Interventions
Surgical interventions may be recommended in cases where fibroids are large, causing severe symptoms or impacting fertility. These include:
-
Myomectomy: A surgical method to clear the fibroids while preserving the uterus.
- Treatment choice depends on factors and should be discussed with a healthcare provider. They will look into factors such as the size and location of fibroids, the severity of symptoms, the desire for future fertility, and each patient's overall health.
- Hysterectomy for fibroids is a surgical procedure that involves the removal of the uterus and is often considered a last resort for treating severe cases of fibroids when other treatment options are ineffective.
Conclusion
Uterine fibroids have different types and symptoms depending on their size, location, and characteristics. It is essential for women experiencing symptoms associated with fibroids to consult with their healthcare provider for proper diagnosis and guidance on appropriate treatment options.