What are fibroids?

Also known as uterine leiomyomas or myomas, fibroids are non-cancerous tumours that develop in the muscular wall of the uterus. They are composed of smooth muscle and fibrous connective tissue, and can vary in size, from very small to large masses that can distort the shape of the uterus. Fibroids are quite common, affecting a significant number of women during their reproductive years, often between the ages of 30 and 50.

Fibroids can occur as a single tumour or in clusters. They are classified based on their location within or on the uterus:

1. Intramural fibroids: Found within the uterine wall, these are the most common type
2. Subserosal fibroids: Located on the outer surface of the uterus, they can extend outward and may cause the uterus to appear larger
3. Submucosal Fibroids: These grow just beneath the inner lining of the uterus and can protrude into the uterine cavity, often causing more severe symptoms

Despite their prevalence, the exact cause of fibroids remains unclear. Hormones, specifically oestrogen and progesterone, are believed to play a significant role in their growth, along with genetic factors.

Signs and symptoms

While many women with fibroids experience no symptoms, those who do may notice a range of issues. These can vary depending on the size and location of the fibroids. Common signs and symptoms include:

• Heavy menstrual bleeding: Excessive bleeding during periods (menorrhagia) is one of the most common symptoms
• Prolonged menstrual periods: Periods lasting longer than a week can be indicative of fibroids
• Pelvic pain or pressure: Larger fibroids can cause discomfort or a feeling of fullness in the abdomen
• Frequent urination: Depending on the fibroid’s location, it may press against the bladder, leading to increased frequency of urination
• Difficulty emptying the bladder: A bulging fibroid may obstruct urinary flow
• Constipation: Fibroids can exert pressure on the bowel, leading to digestive issues
• Pain during intercourse: Certain fibroids can cause discomfort during sexual activity
• Enlarged abdomen: In cases where fibroids are quite large, they can alter the shape of the abdomen

If any of these symptoms are experienced, it’s important to consult a healthcare provider for a proper diagnosis and evaluation.

Treatment options

The treatment for fibroids depends on several factors. These include the severity of symptoms, the size and location of the fibroids, and a patient’s overall health and reproductive plans.

Potential treatment options include:

1. Watchful waiting: If fibroids are asymptomatic, a healthcare provider may recommend monitoring the condition without immediate treatment.
2. Medications: Hormonal treatments such as birth control pills or gonadotropin-releasing hormone (GnRH) agonists may help regulate menstrual cycles and reduce symptoms. Pain relievers may also be prescribed to manage discomfort.
3. Non-invasive procedures: MRI-guided Focused Ultrasound Surgery (FUS): A non-invasive technique that uses ultrasound waves to destroy fibroid tissue.
4. Minimally invasive procedures:
   • Uterine Artery Embolisation (UAE): A procedure that cuts off blood supply to the fibroids, causing them to shrink
   • Laparoscopic myomectomy: Surgical removal of fibroids through small incisions, preserving the uterus
5. Traditional surgical options:
   • Abdominal myomectomy: The surgical removal of fibroids through an abdominal incision
   • Hysterectomy: The complete removal of the uterus, which is a definitive solution for women who have completed their families or have very large fibroids

Fibroids are common, non-cancerous growths that can affect a woman’s quality of life and reproductive health. Awareness of the symptoms and available treatment strategies are crucial for managing the condition effectively.
Women experiencing symptoms should seek medical advice for proper diagnosis and to explore the best treatment options tailored to their individual needs. With proper care, many can find relief from the discomfort and regain control over their health and well-being.

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