Dr Sarthak Sidapara

Uterine Fibroids

What is Uterine Fibroids?

In women’s uterus, sometimes an abnormal growth occurs known as fibroids which are also referred to as tumors that develop with fibrous connective tissue and muscle cells. The tumors’ size sometimes grows large, thereby causing severe abdominal pain and heavy bleeding during the menstrual cycle. It is quite tough to identify fibroids as it is asymptomatic. However, it is non-cancerous. As per the research, almost 80% of women tend to have fibroid growth, which is different in rate. Treatments are available which can help you to get relief. Fibroids are also named Uterine myomas, Leiomyomas, Fibromas, Myomas.

Essential facts about Fibroids:

By now, we all are aware of fibroid. But, still, there are specific vital facts that you need to know. Such as,

  • Fibroids are non-cancerous tissue masses, developed generally inside the uterus wall or surface.
  • The size of fibroids differ. Sometimes they are like seeds and sometimes like the size of a watermelon.
  • At times, fibroid gives several symptoms and sometimes none. Some of the common symptoms include painful intercourse, pain in the pelvic area, etc.

There is a specific risk factor present while developing fibroids in the uterus and pelvic. The risk factor includes,

  • The risk of getting obese or overweight becomes much higher.
  • Any woman can have fibroids at any age.
  • Generally, it occurs at the age of 30 to 50 years and undergoes menopause.

These are the essential facts that you should know about the problem.

Who gets fibroids?

Fibroids are a tumor, also known as myomas or leiomyomas. They are non-cancerous and have very little chance to develop into cancer. It is common in women during the childbearing years, and it may grow along the wall of the cavity as well as into the uterus.

Many women might have uterine fibroids sometime during their lives. More than 30% of women in the country develop fibroids at some point in their life. Mostly, the problem appears to those who have ages between 30 to 50 years. Obese women or women who have overweight have a high tendency to develop fibroids in the uterus. Because of overweight, the estrogen level (a female sex hormone) increases, and as a result, the chance of developing fibroids also increases.

There is a lower chance of developing fibroids who have a baby. It will decrease the likelihood of developing fibroids when you have more than one baby.

Types of Fibroids

There is a variety of Fibroids which are classified based on the location of the uterus. Hence, it is essential to know the type of fibroids. So, let us have a look below:

  • Intramural fibroids

These are the most commonly occurring fibroids in women’s uterus. You can generally notice them appearing at the uterus’s muscular cell. This fibroid tends to grow larger and more shape, thereby stretching your womb.

  • Subserosal Fibroids

It is also known as a serosa. This fibroid generally occurs at the outer part of the uterus. This also tends to grow larger, and hence the womb appears significant on one scale.

  • Pedunculated Fibroids

At times, a stem is noticed by the growth of the subserosal tumor to provide support, known as pedunculated fibroid. It generally appears like a slender base.

  • Submucosal Fibroids

This is rarely formed that you can notice. It generally appears at the middle layer of the uterus.

These are some of the essential types of fibroids that you should be aware of. Various factors lead to fibroid growth, such as hormones if there is any family history, or during pregnancy. Hence, it would be best if you took proper measures if you do not have a fibroid. And in case you have a fibroid, you must undergo appropriate treatment so that it does not lead to something severe.

Nowadays, there are various diagnostic measures with the help of which you can quickly identify fibroid and undergo the necessary treatment that is needed.

Causes for Uterine Fibroids to Grow

It isn’t easy to find out the actual cause of forming fibroids in the uterus. Gynecologists have failed to explain why fibroids increase and shrink in size. Let’s check out some of the major factors for which the problem appears.

  • Hormone Factor

The two hormones, estrogen, and progesterone stimulate the uterine lining development during each menstrual cycle in preparation for pregnancy and promote the fibroids’ growth.

  • Genetic Changes

Some researchers say that fibroids could be hereditary as many fibroids contain changes in genes that differ from those in normal uterine muscle cells. However, there is no conclusive evidence of this.

  • Growth Factors

Some substances help the body maintain tissues, such as insulin-like growth factors that might affect fibroids’ growth.

  • Pregnancy

You might have a question in your mind about the relationship between pregnancy and fibroids. Fibroids usually do not interface with getting pregnant; however, it is possible that fibroids, especially submucosal fibroids, can be a reason for infertility or pregnancy loss. and some sizeable intramural fibroid that is more than 4 cm can affect fertility.

Risks of uterine fibroids during pregnancy

It may also raise the risk of certain pregnancy complications such as abruption, fetal growth restriction of the baby, preterm delivery, etc. Let’s check out the dangers of uterine fibroids during pregnancy.

  • Restrict Fetal Growth:

When the fibroids’ size increases, the length of the womb decreases, and as a result, it prevents the embryo from growing.

  • Placental Abruption:

When the fibroid blocks the uterine wall, the placental abruption has occurred. It may reduce the nutrients and oxygen, which is a vital component of your body.

  • Preterm Delivery:

When the size of the fibroids increases, you feel pain. This pain leads to uterine contractions. It leads to early delivery.

  • Breach Position:

Sometimes, the baby may not be able to align for a standard delivery because of the cavity’s abnormal shape.

  • Cesarean Delivery:

According to the researchers, women who have fibroids are six to seven times more likely to need a cesarean delivery than those who do not have this type of issue in their bodies.

  • Miscarriage:

The chances of miscarriage are doubled in women who have suffering from this problem.

Symptoms of Fibroids

The symptoms of fibroids may vary. The symptoms of fibroids depend upon the size, location, and several tumors. Sometimes, women don’t know they have uterine fibroids as they cause no symptoms. A doctor might discover uterine fibroids incidentally during a pelvic examination or prenatal ultrasound. But in symptomatic women, the most common symptoms are as follows:

  • Very and heavy bleeding during the menstrual cycle.
  • Longer than the usual menstrual period that is more than seven days.
  • There might be a bloated feeling in the lower abdominal area.
  • There would be a feeling of pressure or even pain in the pelvic region.
  • A woman having fibroids may be due to constipation.
  • There might be an increased urge to urinate frequently.
  • You might feel pain during sex.
  • Difficulty in conceiving is infertility.
  • The reproductive issue includes miscarriage, preterm delivery, etc.

Here we would like to say that having any of these symptoms does not necessarily mean that you may have fibroids. These are the general symptoms and could be due to other reasons as well. Hence, it is recommended that whenever you find any of these symptoms, consult a gynecologist, and he may do the necessary tests to confirm the diagnosis.

How are fibroids diagnosed?

Most of the time, fibroids are initially diagnosed with ultrasound. They can then be interpreted from a fertility standpoint by either a saline infusion sonogram or Hysterosalpingogram (HSG).

To confirm whether you have fibroids or not, the doctor does some necessary tests such as Hysterosalpingography, Blood test, ultrasound test, etc.

Treatment for uterine fibroids

Treatment is recommended only if it causes any symptoms. If you have symptoms, then it is best to talk to your doctor, and he will suggest the best treatment plan according to your size and position of the fibroid.

  • If the fibroid is well away from the cavity and it is not changing the shape of the cavity at all, and it is not causing you any other symptoms, there is no reason you need to have it taken out. So, doctors typically recommend that you have the fibroid taken out if it is changing the shape of the cavity or causing some of the other symptoms.
  • Some doctors recommend the wait and watch technique to ascertain if treatment is required or not. Some suggest medications regulate your menstrual cycle or treating symptoms such as heavy menstrual bleeding and pelvic pressure. Medication will help to shrink the size of the fibroids. There are various medications available.
  • Among one of them is Gonadotropin-releasing hormone (Gn-RH), agonists. They treat fibroids by the production of estrogen and progesterone, putting you into a temporary postmenopausal state. As a result, the menstruation stops, fibroids shrink, and anemia often improves in patience.
  • Another essential medical treatment is progestin-releasing IUD can relieve heavy bleeding caused by fibroids.
  • One more treatment for fibroids is Hysterectomy. This is the removal of the uterus and a permanent solution to prevent fibroids, which are usually indicated if the patient’s family is completed.
  • A non-invasive procedure is performed using an ultrasound transducer to destroy the fibroids, which is the latest technology. It is also known as Magnetic Resonance-guided Focused Ultrasonographic. In this process, the fibroid tissues are routed using ultrasound rays.
  • Another minimally invasive procedure is uterine artery embolization to destroy the fibroids.

Hence, these are the different treatment options available depending on the number of fibroids, size of the fibroids, symptoms of the patient, and age group of the patient.

Medical treatment for fibroids
There are also other medications available which decrease the size of the fibroids as well as bleeding loss. A doctor may recommend Myomectomy – a procedure to remove the fibroids. This procedure can be performed either laparoscopically or through open surgery, depending upon the fibroid’s size and the location of the fibroid.

Surgery for Fibroids
Fibroids are typically removed in one of two ways. You can either have them removed by having surgery, either laparoscopically or an open surgery where they make an incision in the belly and have the fibroids removed. In the surgery, the doctor put a little camera inside the uterus and looked around. One can see the whole fibroid. The recovery time is even faster in this situation.

Cost of uterine fibroid surgery

The cost of uterine fibroid surgery is dependent on the type of surgery required. For example, if you want to do a Hysterectomy, it will cost around 1,85,000 in Indian rupees. This is the latest technology to remove a fibroid. Another surgery such as Myomectomy, Endometrial Ablation will cost up to 1,65,000 to 1,70,000.