What Causes Uterine Fibroids? How Are They Treated? Is Surgery Necessary?

Uterine Fibroids (Myoma Uteri or Uterine Fibroid) – A Common but Often Overlooked Threat

Uterine fibroids are a common health concern for women, with approximately 25% of women over the age of 35 and 1 in 3 women of reproductive age developing this condition. Despite its high prevalence, many women tend to overlook the symptoms.

But how can you tell if you have uterine fibroids? What exactly are they? Are they cancerous? Can they be treated? And what causes them? Let’s find out.

Uterine Fibroids: A Common Condition in Women of Reproductive Age

Uterine fibroids are a type of tumor commonly found in women of reproductive age, primarily developing within the uterus. They originate from abnormal growth in the uterine muscle cells and can be located within the uterine wall, inside the uterine cavity, or protruding outward from the uterus. In some cases, the fibroids can grow large enough to be felt as a lump.

Most uterine fibroids are benign (non-cancerous). They can appear as a single large tumor or multiple smaller ones. As they grow, they may press against nearby organs, potentially leading to complications.

However, some fibroids remain small and do not cause any noticeable symptoms. This condition is most commonly observed in women aged 25–50 years. For women over 50, fibroids may naturally shrink on their own.

The uterus is one of the strongest organs in a woman's body, as it consists of three layers of overlapping muscles. It is shaped like a pear and has three connecting passages: the vagina, the left fallopian tube, and the right fallopian tube. The uterine muscles can expand significantly to accommodate the growth of a fetus during pregnancy.

1. Genetics
   If there is a family history of uterine fibroids, other women in the family may have a higher risk of developing this condition.

2. Hormones
   Certain female hormones, such as estrogen, can stimulate the growth of cells. When muscle cells in the uterus respond abnormally to hormonal activity, it can lead to the formation of abnormal cells.

3. Medication Use
   Some medications, such as birth control pills, can stimulate and promote the growth of uterine fibroids.

4. Physical Differences
   Women who experience early menstruation, are obese, or have a vitamin D deficiency are at a higher risk of developing this condition compared to others.

• Intramural Fibroid
  This type of fibroid develops within the muscular wall of the uterus, interfering with uterine contractions. If the fibroid is large or located near the uterine cavity, it may cause severe menstrual cramps and heavy menstrual bleeding. In some cases, large fibroids can lead to an enlarged uterus, pressing against other organs and causing further complications. This is the most common type of uterine fibroid.

• Subserosal Fibroid
  These fibroids grow on the outer surface of the uterus and usually do not cause symptoms unless they become large. When they grow significantly, they may press against surrounding organs, leading to symptoms such as frequent urination (if pressing on the bladder), constipation (if pressing on the large intestine), or kidney dysfunction and swelling of the ureter (if pressing on the ureter), which may eventually lead to kidney failure.

• Submucosal Fibroid
  This type of fibroid develops beneath the uterine lining, causing an uneven surface in the uterine cavity. It often leads to abnormal bleeding, irregular or heavy menstrual periods, and severe menstrual cramps. Submucosal fibroids are also a common cause of infertility.

The symptoms that may indicate uterine fibroids are as follows:

• Abnormal vaginal bleeding and unexplained anemia

• Feeling fatigued, easily tired, or frequently fainting

• Frequent urination or incomplete urination, possibly caused by fibroids pressing on the bladder

• Constipation, which may occur if the fibroid presses on the lower large intestine or the rectum

• Bloating or a sensation of the abdomen getting progressively larger

• Pain during intercourse

• The presence of a lump, even without symptoms, may be felt in the pelvic or abdominal area as fibroids grow in size

• Infertility or miscarriage due to fibroids protruding into the uterine cavity, obstructing the fallopian tubes, or interfering with embryo implantation

If you experience any of these symptoms, it is important to see a doctor as leaving it untreated for a long time may lead to other complications.

Those at risk of developing uterine fibroids include:

1. Women aged 25 – 50 years: This is the age range where fibroids are most commonly found. However, after menopause, fibroids typically shrink in size.

2. Family history of uterine fibroids: Individuals with a family history of fibroids are more likely to develop them themselves, as this genetic risk is linked to estrogen levels and hormonal function.

3. History of taking hormone-based medications: Women who have used medications or substances containing estrogen, which can stimulate the growth of uterine fibroids, are at higher risk.

Uterine fibroids are often discovered accidentally during a pelvic examination. The doctor may feel an abnormal mass within the uterus, and they might recommend further tests, such as:

1. Ultrasound Examination: The doctor will use both abdominal and transvaginal ultrasound to get a clear view of the uterine fibroids. This allows them to measure the size and identify the location of the fibroids accurately.

2. Laboratory Tests: If the patient experiences excessive menstrual bleeding, the doctor may conduct blood tests to check the blood count, which helps determine if the patient has anemia caused by chronic blood loss.

1. Monitoring Treatment
   In cases where the fibroid has no complications and is not in a dangerous position, it can be monitored with ultrasounds. The doctor will schedule check-ups every 3-6 months to track the fibroid’s condition.

2. Medication for Uterine Fibroids

• Birth Control Pills: These help reduce the amount of menstrual bleeding and alleviate menstrual pain but do not shrink the size of the fibroid. Birth control may include low-dose oral contraceptives, injectable contraceptives, implants, or hormone-releasing intrauterine devices (IUDs).

• Injection to Shrink Fibroids: Injections are used to shrink the fibroids and decrease blood flow to them. These injections affect the hormones from the pituitary gland, which in turn control the ovarian hormones. However, these injections should not be used continuously for more than 6 months due to the potential risk of bone thinning. They are typically used before surgery to shrink the fibroids and reduce blood loss during the operation.

1. Surgical Treatment for Uterine Fibroids

• Hysteroscopic Surgery: Hysteroscopy is a minimally invasive surgical method that uses a camera to access the uterus through the cervix, entering the uterine cavity. Electric wires are used to remove fibroids, particularly those within the uterine cavity or pressing on it. There are no incisions made, allowing for faster recovery.

• Laparoscopic Surgery: This involves using a camera inserted through small incisions (0.5-1 cm) in the abdomen to remove fibroids, especially those outside the uterine cavity. Laparoscopy offers benefits over traditional open surgery, including smaller incisions, less pain, and faster recovery. After surgery, special procedures are used to prevent the fibroid tissue from spreading into the abdomen. This method allows quicker return to normal daily activities.

The ways to prevent the risk of uterine fibroids are as follows:

1. Regular Health Check-ups
   Have an annual physical examination, even if there are no symptoms, to detect any early signs of uterine fibroids.

2. Behavioral Adjustments
   Avoid alcohol consumption and smoking, as these habits can increase the risk of fibroids.

3. Avoid Low-Fat Foods
   Avoid a low-fat diet because consuming foods with high-fat content can increase the levels of estrogen in the body, which may promote the growth of fibroids.

4. Control Body Weight
   Fibroids are more common in individuals who are overweight. Therefore, maintaining a healthy weight within the normal range is essential.

5. Regular Exercise
   Exercise 3-4 times a week. Regular physical activity helps to balance hormones in the body, potentially reducing the risk of developing fibroids.

Uterine fibroids are growths that are commonly found in the uterine cavity. If the fibroids grow large enough, they may press against other organs. The causes of uterine fibroids include genetics, hormonal imbalances, and the use of certain medications. This condition is often found in women between the ages of 25 and 50. For women who enter menopause, uterine fibroids may shrink on their own.

Treatment options include monitoring symptoms, medication, and surgery. To stay informed, it is important for women to undergo regular annual check-ups. If any abnormalities are detected, doctors can provide timely advice and treatment. If you have any questions, feel free to reach out via Line: @beyondivf