Uterine Fibroids

indexUterine fibroids are growths out of the uterus which are non-cancerous and which are often seen during childbearing years of a woman.They are also known as fibromyomas, leiomyomas or myomas.Uterine fibroids aren’t associated with an increased risk of uterine cancer and never develop into cancer. Around 3 out of 4 women have uterine fibroids during their lives, but most of them are completely unaware of them because they have no symptom. They may be discovered incidentally during a pelvic exam or prenatal ultrasound. In general, uterine fibroids cause no problems and hardly require any treatment. Medical therapy and surgical procedures can shrink or remove fibroids if there is any kind of discomfort or troublesome symptoms. Rarely, fibroids can require emergency treatment if they cause sudden, sharp pelvic pain or profuse menstrual bleeding.

Symptoms :-The most common symptoms of uterine fibroids are:

  • Heavy flow during menstrual cycle
  • Feeling of pressure or pain in the pelvis
  • Prolonged menstrual periods — seven days or more of menstrual bleeding
  • Urination at frequent intervals
  • Difficulty in emptying the urinary bladder
  • Constipation
  • Backache
  • Cramps in legs

Rarely, a fibroid can cause acute pain when it outgrows its blood supply. When a fibroid is deprived of nutrients, it begins to die. Fibroid location alsoaffects signs and symptoms in some of the manner such as:

  • Submucosal fibroids. Fibroids that grow into the inner cavity of the uterus are called submucosal fibroids which are considered responsible for prolonged, heavy menstrual bleeding that can ultimately prevent the pregnancy in some women.
  • Subserosal fibroids. Fibroids that project to the outside of the uterus are known as subserosal fibroids which can sometimes press on urinary bladder, causing urinary symptoms. If fibroids bulge from the back of the uterus, they occasionally can press either on the rectum, causing constipation, and if they press the spinal nerves, they can cause severe backache.

One should take it seriously and consult a doctor if:

  • Pain in pelvic areapersists for a longer period.
  • Excessive flow or painful periods
  • Spotting or bleeding in between periods
  • Pain while doing intercourse
  • Difficulty in emptying urinary bladder
  • Constipation
  • Severe vaginal bleeding or sharp pelvic pain that comes on suddenly

Causes

  1. 1. Genetic causes: Many fibroids contain alterations in genes that code for uterine muscle cells.
  2. 2. Hormonal causes: Estrogen and progesterone are two hormones which stimulate the development of the uterine lining in preparation for pregnancy. They can appear to promote the growth of fibroids. Fibroids contain more estrogen and estrogen receptors than normal uterine muscle cells.
  3. 3. Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth.

Risk factors

  1. 1. Heredity: If a woman shows family history of fibroids, she is at higher risk of also developing them.
  2. 2. Race: Black women are more likely to develop fibroids than are women of other racial groups. In addition, black women have fibroids at younger ages, and they’re also likely to have more or larger fibroids.
  3. 3. Overweight Women: Some studies have suggested that obese women are at higher risk of fibroids.

Complications If uterine fibroids show their concerned symptoms, they can cause complications such as anemia from heavy blood loss. Rarely, fibroids can grow out of your uterus on a stalk-like projection. If the fibroid twists on this stalk, there may be a sudden, sharp, severe pain in lower abdomen as aresult surgery may be required Pregnancy and fibroids

  • Fibroids usually don’t interfere with conception and pregnancy.  But if they incidentally blockthe fallopian tubes, or interfere with the passage of sperm from the cervix to fallopian tubes, they can interfere pregnancy.
  • Submucosal fibroids may prevent implantation and growth of an embryo.
  • Research indicates that pregnant women with fibroids are at slightly increased risk of miscarriage, premature labor and delivery, abnormal fetal position, and separation of the placenta from the uterine wall.
  • A more common complication of fibroids in pregnancy is localized pain, typically between the first and second trimesters. This is usually easily treated with pain relievers.

Tests and diagnosis Ultrasound Confirmation is done by an ultrasound — a painless exam that uses sound waves to obtain a picture of the uterus.It also helps in measuring the size of the fibroids. It can also be done transvaginally to see clearly the exact location of the fibroids. Other imaging tests Hysterosonography. This ultrasound variation uses sterile saline to expand the uterine cavity, making it easier to obtain interior images of the uterus. This test may be useful if the patient is having heavy menstrual bleeding despite normal results from traditional ultrasound.

  • Hysterosalpingography. This technique uses a dye to highlight the uterine cavity and fallopian tubes on X-ray images. This is done to rule out the possible causes of infertility. In addition to revealing fibroids, it can help the doctor determine if your fallopian tubes are open.
  • Hysteroscopy. A small, lighted telescope called a hysteroscope is inserted through the cervix to the uterus. Doctor injects (instills) saline in the uterus expanding the uterine cavity and allowing the doctor to examine the walls of the uterus and the openings of the fallopian tubes. Imaging techniques that may occasionally be necessary include computerized tomography (CT) and magnetic resonance imaging (MRI).

Other tests Ifthe patient is experiencing abnormal vaginal bleeding, the doctor may want to conduct other tests to investigate possible causes. He or she may order a complete blood count (CBC) to determine if the patient has developed iron deficiency that is anemia because of chronic blood loss. The doctor may also order blood tests to rule out bleeding disorders and to determine the levels of reproductive hormones produced by the ovaries. Prevention Although researchers continue to study the causes of fibroid tumors, little scientific advice is available on how to prevent them. Preventing uterine fibroids may not be possible, but one can take comfort in the fact that only a small percentage of these tumors require treatment.

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