Uterine Fibroids: Exploring Treatment

Uterine fibroids are growths made up of muscle and tissue that form in or on the wall of the uterus and are considered the most common non-cancerous tumor in women. The exact cause for uterine fibroids is not clear but hormonal abnormalities and genetics cause the formation of fibroids. Not all uterine fibroids cause symptoms, but when they do the symptoms include heavy menstrual bleeding, back pain, frequent urination, bleeding after intercourse and bleeding in between periods, vaginal discharge, and bloating.

Pelvic examinations, ultrasounds, MRIs, hysteroscopy, and laparoscopy might help in diagnosing uterine fibroids. If you are diagnosed with uterine fibroids you may or may not require the treatment. This depends on the symptoms you are having. All uterine fibroids don’t grow, and even they show a tendency to shrink after menopause. If you experience severe bleeding or bleeding between periods, your doctor will examine the growth of the fibroid. Treatment depends upon the number, size, and location of the fibroid. Your doctor might advise you to take certain medications or to undergo certain surgical procedures to manage uterine fibroids. 

What Are The Symptoms Of Uterine Fibroids?

In the majority of the cases, small uterine fibroids don’t show any symptoms and they do not require any treatment other than regular health checkups. Large uterine fibroids can cause you to experience several symptoms such as:

• Heavy or painful bleeding during periods
• Bleeding between your periods or bleeding after intercourse
• Bloating
• Irregular periods
• Lower back pain
• Long-term discharge from the vagina
• Constipation
• Difficulty peeing or emptying your bladder completely
• Enlargement of the abdomen, causing your abdomen to look pregnant

What Causes Uterine Fibroids?

The exact cause leading to uterine fibroids is not clear. However, healthcare providers believe that hormones like estrogen and progesterone and genetics play a role in it. Most fibroids form in reproductive age. Several studies have shown that fibroids tend to grow when the hormone levels are higher (during pregnancy) and shrink when the hormone levels are lower (after menopause).

What Are The Risk Factors For Uterine Fibroids?

Even though the exact cause for the formation of uterine fibroids is unclear, several factors play a high role in developing uterine fibroids. These risk factors are:

• Obesity and high BMI(body mass index)
• Genetics or family history of fibroids
• Infertility
• Early onset of menstruation and later onset of menopause

What Are The Complications Of Uterine Fibroids:

In most cases, uterine fibroids don’t cause any complications. However, in some cases, they might show certain complications such as:

• Severe and unmanageable pain
• Excessive bleeding
• Anemia
• Swelling of your abdomen or pelvis
• Infertility (very rare complication)

Diagnosis Of Uterine Fibroids:

Regular pelvic examinations help to find uterine fibroids. Your doctor may feel irregular changes in the shape of your uterus, suggesting the presence of fibroids. If you experience any symptoms of uterine fibroids, your doctor might suggest you do the following tests.

• Ultrasound: Ultrasound helps to provide a clear view of the uterus. It can detect, measure, and map the fibroids. Transabdominal and transvaginal ultrasound are used.
• Lab tests: If you have severe bleeding, your doctor will ask you to do blood checkups for CBC to Czech for anemia, and thyroid tests.
• MRIs: MRIs help to provide a detailed view of the size and location of the fibroid
• Hysterosonography and Hysterosalpingography: Your doctor uses saline or dye to highlight the uterine cavity and fallopian tubes on X-ray images. Hysteroscopy: your doctor will insert a small, lighted telescope called a hysteroscope through your cervix into your uterus. Then saline is injected into your uterus. This allows the uterine cavity to expand and lets your doctor check the walls of your uterus and the openings of your fallopian tubes.

Management And Treatment Of Uterine Fibroids:

Treatment for uterine fibroids is dependent upon the number, size, and location of the fibroid as well as the symptoms it is causing. If you are not experiencing any symptoms, then you may not require any treatment. If the size of the fibroid is small, it can be left alone. Some people may not experience any symptoms or have any problems associated with fibroids. In these cases, your healthcare provider may recommend regular monitoring of your fibroids with pelvic exams or ultrasounds. If you are experiencing the symptoms and difficulties, your doctor will plan the treatment accordingly. The treatment methods include medications and surgery.

Medications:

Medicines for uterine fibroid target hormones that regulate the menstrual cycle. They treat heavy menstrual bleeding and pelvic pressure. They don’t allow the fibroid to be rid of but may help to shrink their size. Medications are:

• Gonadotropin-releasing hormone (GnRH) agonists and antagonists: these medicines work by blocking the body from making the hormones estrogen and progesterone. This puts you into a temporary menopause-like state. As a result, menstrual periods stop, fibroids shrink and anemia often gets better.
• Tranexamic acid to reduce the amount of blood flow.
• Intrauterine devices (IUDs) release hormones to help reduce heavy bleeding and pain.
• Iron supplements prevent or treat anemia due to heavy periods.
• Pain relievers, such as ibuprofen or naproxen, for cramps or pain.
• Oral contraceptives help to control heavy bleeding

Surgery:

Surgical procedures to manage uterine fibroid include:

• Hysteroscopy: the procedure helps to remove fibroids growing inside the uterus.
• Endometrial ablation: The procedure helps to stop the blood supply to the fibroid, leading it to shrink and die. It can be considered as an option if you wish to avoid surgery and are not planning to become pregnant.
• Myomectomy: This procedure helps to remove a fibroid from the uterus. It will not prevent the formation of new fibroids but can be considered as an option if you want to have children.
• Hysterectomy: this procedure removes the uterus completely. It is considered the last option if you do not want children, medicines fail to work, and you can’t have any other procedures.

Newer treatments, such as the use of focused ultrasound, are being evaluated in clinical studies.

Conclusion

Uterine fibroids are the common growths inside the uterus. In many cases, these can be asymptomatic but in some cases, they may show symptoms such as heavy bleeding, irregular periods, vaginal discharge, lower back pain, difficulty in peeing, constipation, etc. 

If you have uterine fibroids during pregnancy, you may have a preterm delivery, require a C-section for delivery, and you may experience severe bleeding after the delivery. Commonly uterine fibroids do not cause any complications, but heavy bleeding may cause anemia, urinary tract infections, severe pain, and in some rare cases infertility. 

If you are not experiencing any symptoms or your fibroid size is small, you can leave it untreated but advised you to have regular checkups. If you are experiencing heavy bleeding and other symptoms, your doctor will give certain medications like hormonal pills and in severe cases, they may advise you to undergo surgery.