20/04/2022
Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas (lie-o-my-O-muhs) or myomas, uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer.
Uterine fibroids develop from the smooth muscular tissue of the uterus (myometrium). A single cell divides repeatedly, eventually creating a firm, rubbery mass distinct from nearby tissue. The growth patterns of uterine fibroids vary — they may grow slowly or rapidly, or they may remain the same size. Some fibroids go through growth spurts, and some may shrink on their own. Many fibroids that have been present during pregnancy shrink or disappear after pregnancy, as the uterus goes back to a normal size.
Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. They can be single or multiple, in extreme cases expanding the uterus so much that it reaches the rib cage.
As many as 3 out of 4 women have uterine fibroids sometime during their lives, but most are unaware of them because they often cause no symptoms. Your doctor may discover fibroids incidentally during a pelvic exam or prenatal ultrasound.SYMPTOMS
In women who have symptoms, the most common symptoms of uterine fibroids include:
Heavy menstrual bleeding
Prolonged menstrual periods — seven days or more of menstrual bleeding
Pelvic pressure or pain
Frequent urination
Difficulty emptying your bladder
Constipation
Backache or leg pains
Rarely, a fibroid can cause acute pain when it outgrows its blood supply. Deprived of nutrients, the fibroid begins to die. Byproducts from a degenerating fibroid can seep into surrounding tissue, causing pain and, rarely, fever. A fibroid that hangs by a stalk inside or outside the uterus (pedunculated fibroid) can trigger pain by twisting on its stalk and cutting off its blood supply.
Fibroid location, size and number influence signs and symptoms:
Submucosal fibroids. Fibroids that grow into the inner cavity of the uterus (submucosal fibroids) are more likely to cause prolonged, heavy menstrual bleeding and are sometimes a problem for women attempting pregnancy.
Subserosal fibroids. Fibroids that project to the outside of the uterus (subserosal fibroids) can sometimes press on your bladder, causing you to experience urinary symptoms. If fibroids bulge from the back of your uterus, they occasionally can press either on your re**um, causing a pressure sensation, or on your spinal nerves, causing backache.
Intramural fibroids. Some fibroids grow within the muscular uterine wall (intramural fibroids). If large enough, they can distort the shape of the uterus and cause prolonged, heavy periods, as well as pain and pressure.
When to see a doctor
See your doctor if you have:
Pelvic pain that doesn't go away
Overly heavy or painful periods
Spotting or bleeding between periods
Pain consistently with in*******se
Enlarged uterus and abdomen
Difficulty emptying your bladder
Seek prompt medical care if you have severe vaginal bleeding or sharp pelvic pain that comes on suddenly.CAUSES
Doctors don't know the cause of uterine fibroids, but research and clinical experience point to these factors:
Genetic changes. Many fibroids contain changes in genes that differ from those in normal uterine muscle cells. There's also some evidence that fibroids run in families and that identical twins are more likely to both have fibroids than nonidentical twins.
Hormones. Estrogen and progesterone, two hormones that stimulate development of the uterine lining during each menstrual cycle in preparation for pregnancy, appear to promote the growth of fibroids. Fibroids contain more estrogen and progesterone receptors than normal uterine muscle cells do. Fibroids tend to shrink after menopause due to a decrease in hormone production.
Other growth factors. Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth.PREPARING FOR YOUR APPOINTMENT
Your first appointment will likely be with either your primary care provider or a gynecologist. Because appointments can be brief, it's a good idea to prepare in advance for your appointment.
What you can do
Make a list of any symptoms you're experiencing. Include all of your symptoms, even if you don't think they're related.
List any medications, herbs and vitamin supplements you take. Include doses and how often you take them.
Have a family member or close friend accompany you, if possible. You may be given a lot of information at your visit, and it can be difficult to remember everything.
Take a notebook or electronic device with you. Use it to note important information during your visit.
Prepare a list of questions to ask your doctor. List your most important questions first, in case time runs out.
For uterine fibroids, some basic questions to ask include:
How many fibroids do I have? How big are they?
Are the fibroids located on the inside or outside of my uterus?
What kinds of tests might I need?
What medications are available to treat uterine fibroids or my symptoms?
What side effects can I expect from medication use?
Under what circumstances do you recommend surgery?
Will I need a medication before or after surgery?
Will my uterine fibroids affect my ability to become pregnant?
Can treatment of uterine fibroids improve my fertility?
What other alternative treatments might I try?
Make sure that you understand everything your doctor tells you. Don't hesitate to ask your doctor to repeat information or to ask follow-up questions
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