What's A Fibroid? A Guide
The exact cause of fibroids is unknown. However, they're linked to the hormone oestrogen. Oestrogen is the female reproductive hormone.
Fibroids are muscular tumors that grow in the wall of the uterus (womb). Another medical term for fibroids is leiomyoma or just "myoma". Fibroids are almost always benign (not cancerous). Fibroids can grow as a single tumor, or there can be many of them in the uterus. They can be as small as an apple seed or as big as a grapefruit. In unusual cases, they can become very large. The causes of fibroid are generally unknown, but experts say they involve the hormones in your body.
About 20 percent to 80 percent of women develop fibroids by the time they reach age 50. Fibroids are most common in women in their 40s and early 50s. Not all women with fibroids have symptoms. Women who do have symptoms often find fibroids hard to live with. Some have pain and heavy menstrual bleeding. Fibroids also can put pressure on the bladder, causing frequent urination, or the rectum, causing rectal pressure. Should the fibroids get very large, they can cause the abdomen (stomach area) to enlarge, making a woman look pregnant.
Causes of Fibroid: Signs And Symptoms
Most fibroids do not cause any symptoms, but some women with fibroids can have:
- Heavy bleeding (which can be heavy enough to cause anemia) or painful periods
- Feeling of fullness in the pelvic area (lower stomach area)
- Enlargement of the lower abdomen
- Frequent urination
- Pain during sex
- Lower back pain
- Complications during pregnancy and labour, including a six-time greater risk of cesarean section
- Reproductive problems, such as infertility, which is very rare
No one knows for sure what causes fibroids. Researchers think that more than one factor could play a role. These factors could be:
What Are The Causes Of Fibroid?
Because no one knows for sure what causes fibroids, we also don't know what causes them to grow or shrink. We do know that they are under hormonal control — both estrogen and progesterone. Fibroids grow rapidly during pregnancy when hormone levels are high. They shrink when anti-hormone medication is used. Also, they stop growing or shrink once a woman reaches menopause.
Talk to your obstetrician if you have fibroids and become pregnant. All obstetricians have experience dealing with fibroids and pregnancy. Most women who have fibroids and become pregnant do not need to see an OB who deals with high-risk pregnancies.
How Do Doctors Diagnose Fibroids?
Your doctor may find that you have fibroids when you see him for a regular pelvic exam to check your uterus, ovaries, and vagina. The doctor can feel your fibroid with his fingers during an ordinary pelvic exam, as a (usually painless) lump or mass on the uterus. Often, a doctor will describe how small or how large the fibroids are by comparing their size to the size your uterus would be if you were pregnant. For example, you may be told that your fibroids have made your uterus the size it would be if you were 16 weeks pregnant. Or the fibroid might be compared to fruits, nuts, or a ball, such as a grape or an orange, an acorn or a walnut, or a golf ball or a volleyball.
Your doctor can do imaging tests to confirm that you have fibroids. These are tests that create a "picture" of the inside of your body without surgery. These tests might include:
- Ultrasound – Uses sound waves to produce the picture. The ultrasound probe can be placed on the abdomen or it can be placed inside the vagina to make the picture.
- Magnetic resonance imaging (MRI) – Uses magnets and radio waves to produce the picture
- X-rays – Uses a form of radiation to see into the body and produce the picture
- Cat scan (CT) – Takes many X-ray pictures of the body from different angles for a more complete image
- Hysterosalpingogram (HSG) or sonohysterogram – An HSG involves injecting x-ray dye into the uterus and taking x-ray pictures. A sonohysterogram involves injecting water into the uterus and making ultrasound pictures.
You might also need surgery to know for sure if you have fibroids. There are two types of surgery to do this:
- Laparoscopy – The doctor inserts a long, thin scope into a tiny incision made in or near the navel. The scope has a bright light and a camera. This allows the doctor to view the uterus and other organs on a monitor during the procedure. Pictures also can be made.
- Hysteroscopy – The doctor passes a long, thin scope with a light through the vagina and cervix into the uterus. No incision is needed. The doctor can look inside the uterus for fibroids and other problems, such as polyps. A camera also can be used with the scope.
Causes of fibroid: How To Treat Symptoms
Most women with fibroids do not have any symptoms. For women who do have symptoms, there are treatments that can help. Talk to your doctor about the best way to treat your fibroids. She or he will consider many things before helping you choose a treatment. Some of these things include:
- Whether or not you are having symptoms from the fibroids
- If you might want to become pregnant in the future
- The size of the fibroids
- The location of the fibroids
- Your age and how close to menopause you might be
If you have fibroids but do not have any symptoms, you may not need treatment. Your doctor will check during your regular exams to see if they have grown.
If you have fibroids and have mild symptoms, your doctor may suggest taking medication. Over-the-counter drugs such as ibuprofen or acetaminophen can be used for mild pain. If you have heavy bleeding during your period, taking an iron supplement can keep you from getting anemia or correct it if you already are anemic.
Several drugs commonly used for birth control can be prescribed to help control symptoms of fibroids. Low-dose birth control pills do not make fibroids grow and can help control heavy bleeding. The same is true of progesterone-like injections (e.g., Depo-Provera®). An IUD (intrauterine device) called Mirena® contains a small amount of progesterone-like medication, which can be used to control heavy bleeding as well as for birth control.
If you have fibroids with moderate or severe symptoms, surgery may be the best way to treat them. Here are the options:
- Endometrial ablation
- Uterine Fibroid Embolization (UFE), or Uterine Artery Embolization (UAE)