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Uterine fibroids -

Fibroids are common growths that occur on the uterus. Many fibroids don't cause symptoms, but when they do, symptoms can be very painful.

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Uterine fibroids -

Fibroids are made of muscle and tissue, and can cause heavy menstrual bleeding, the need to pee frequently, pain during intercourse, and back pain.

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Estrogen -

They are also called leiomyomas or myomas, and their exact cause, despite how common they are, is unknown. It's believed their growth is linked to the hormone estrogen.

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Estrogen -

Obese women tend to have more frequent occurrences of uterine fibroids. When someone is overweight, there are higher levels of estrogen in the body.

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Presentation -

Fibroids generally appear in women between the ages of 30-40. They are believed to be present in around 70% of white women and more than 80% of black women by age 50.

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Presentation -

Fibroids can be as small in size as a seed, or as large in size as a watermelon. They can grow alone or in clusters, within the wall, the main cavity, or on the outer surface of the uterus.

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Types of fibroids -

There are different types of fibroids. Some hang inside or outside of the uterus via a stem of tissue.

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Intramural fibroids -

Intramural fibroids are the most common form of fibroid. They grow and develop in the muscular wall of the uterus, becoming embedded.

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Subserosal fibroids -

A subserosal fibroid grows under the lining of the outer surface of the uterus, which can become quite large and extend into the pelvis.

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Submucosal fibroids -

A submucosal fibroid develops in the muscle layer beneath the womb's inner lining. They can grow into the cavity of the womb.

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Pedunculated fibroids -

Pedunculated fibroids are complex, and the least common type. They are connected to the womb with a stalk, and are sometimes known as mushroom fibroids.

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Range of symptoms -

The location, size, type, and number of fibroids you have will influence the symptoms experienced, ranging from none at all to more severe.

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Bloating and extended abdomen -

Fibroids can cause a feeling of fullness in the abdomen, that leads to bloating or even an enlarged belly that looks pregnant.

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Heavy bleeding -

Other signs that you have a fibroid include bleeding between periods, excessive bleeding during your period, painful bleeding, and lower back pain.

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Bowel and urinary issues -

An inability to completely empty the bladder, constipation, and chronic vaginal discharge are also symptoms associated with fibroids.

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Anemia -

The heavy or excessive bleeding caused by large fibroids can lead to anemia, with symptoms of extreme fatigue, weakness, shortness of breath, pale skin, and cold hands and feet.

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Fibroid death -

If a fibroid outgrows its own blood supply and begins to die inside the body, it can cause the onset of sudden, severe pain.

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Quality of life -

The pain caused by fibroids can seriously impact a woman's quality of life, and affect fertility. Fibroids are the most common reason for hysterectomies in the US.

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Diagnosis -

Fibroids are typically diagnosed by pelvic or vaginal ultrasound scan. You could need a hysteroscopy, where a thin telescope examines inside the uterus, or laparoscopy (keyhole surgery), where a thin telescope is inserted to look at the reproductive organs.

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Diagnosis -

On average, it takes around four years after the onset of symptoms to receive a diagnosis. Several years more might pass between diagnosis and treatment.

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When to see a doctor -

If you experience a sharp pain that comes on quickly, or you experience extremely heavy bleeding from the vagina, see a doctor immediately.

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Risk factors -

Having a family history of fibroids, early onset periods, a late age of menopause, not having children, being low in vitamin D, drinking alcohol, and having a diet rich in red meat are risk factors. Black people have more fibroids, and tend to develop them at a younger age, than white people.

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Menopause -

It's unlikely one will develop fibroids after menopause. This is because the levels of hormones believed to be responsible for fibroid growth (estrogen and progesterone) drop. Existing fibroids may shrink upon menopause.

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Treatment -

An approach of "watchful waiting" is usually advised where symptoms aren't bothersome, and the patient is not suffering other complications due to the presence of a fibroid(s).

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Treatment -

Medicine and hormone treatments can be administered to patients to help shrink the size of their fibroid, to treat symptoms.

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Medicines and hormones -

These treatments can include the use of targeted medicines, implants, or the insertion of intra-uterine devices. The types of treatments offered will vary depending on the age of the patient, their desire to get pregnant in the future, and the size and number of fibroids present.

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Surgery and procedures -

Procedures such as high-intensity focused ultrasound treatment use ultrasound waves to shrink fibroids. Uterine artery embolization reduces the size of the fibroids by blocking their blood supply.

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Surgery and procedures -

Surgical removal of fibroids is called a myomectomy. A hysterectomy (removal of the uterus) may be an option for those who don't want children, or others who have completed their family.

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Prevention -

There is no known way to prevent uterine fibroids. Certain lifestyle factors have been suggested to help with prevention though, such as eating a diet rich in cruciferous vegetables, exercising, and not consuming too much sugar. However, more research is needed.

Sources: (National Geographic) (NHS) (WebMD) (Cleveland Clinic) (Healthline) (Healthdirect) (Mayo Clinic)

See also: From sclerosis to appendicitis—Diseases doctors often get wrong

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