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It is very common for women to have heavy and painful periods or have a feeling of fullness in the lower abdomen. Although, it may not sound very alarming these could be the symptoms of uterine fibroids. These are the most common types of benign tumours found in women. The fibroids are basically some tissues and muscle cells that grow within the uterus, outside the uterus, or along the wall of the uterus. The fibroids are usually benign and asymptomatic and do not require any treatment unless they cause problems.
Know the causes
Though the exact cause of fibroid formation is not known, it is believed that the female hormones estrogen and progesterone have a role to play in their formation. Fibroids are formed only when a woman is producing these hormones and they are not seen in women in non-reproductive age i.e. before starting of menses or after stoppage of menses (menopause). If fibroids are persisting even after menopause or especially if increasing in size then it is an alarming sign. Such a fibroid needs to be taken care of immediately.
What are the symptoms?
Fibroids often remain quiet for long periods of time. They cause nonspecific symptoms in the pelvis and abdomen including:
- Fullness in the abdomen
- Low back pain
- Irregular menstruation
- Cramping with menstruation
- Painful sex
- Increased urgency to urinate
- Anemia, leading to tiredness and weakness
- Infertility Diagnosing the fibroids
When these symptoms are recurrent, it is good to confirm the diagnosis. This can happen with a pelvic exam followed by ultrasound scanning to confirm the size and location of the fibroids. A blood test also may be done to confirm anemia, which is common due to heavy periods.
Management of fibroids can range from doing nothing to periodic monitoring to surgical removal.
- If pain and heavy bleeding are the only symptoms, then pain killers like ibuprofen should suffice for symptomatic relief. Anemia, if severe, may require iron supplementation.
- Embolization is an option which shrinks the fibroid, at the same time preserving the uterus. The blood flow to the fibroid is cut off, thereby preventing its further growth. It takes about 1 to 3 hours and requires some bed rest after the procedure. There could be some pelvic pain and vaginal bleeding, which will gradually subside. The fibroids may grow back, but the benefits of keeping the uterus are definitely there. This is suitable in case of single fibroid with specific blood supply.
- The next surgical option is myomectomy, where the portion of the uterus which contains the fibroid alone is removed. This is done in women who still wish to get pregnant and in women who would like to retain the uterus. This can also be achieved laparoscopically( key hole surgery). In such cases, fibroids are cut into small pieces and then removed from the body. This procedure should be done by a doctor specialised in advanced gynecological endoscopy as all this cutting should be done in a bag to avoid any spillage of cells inside the abdominal cavity. This procedure is known as Laparoscopic Myomectomy with In-bag Moecellation.
- In women who have crossed their pregnancy phase, hysterectomy or complete removal of the uterus is advised. In these women, the bleeding and pain may not have subsided even after years of treatment with hormones. The growing fibroids could be pressing on the adjacent organs, causing pressure. This is the only definitive treatment and should be done in women have completed their family and don’t desire to be pregnant.
- Myomectomy and hysterectomy may be done laparoscopically or with an open method depending on the overall health, the size and location of the fibroids in the uterus.
In case you have a concern or query you can always consult an expert & get answers to your questions!
I am suffering from severe backache problem. From last three days. Like slip disk. What should I do? suggest please.
I was having Slip Disc problem in year 2005 and was confined on bed for 35 days. MRI reports revealed problem in L5 S 1 area. Doctors advised me not to sit on ground and sleep sideways by bending both the knees and keeping pillow in between them. Although I do not have that pain again but Now my body has become very stiff, I can not bend my knees and having very poor flexibility what should I do.
I am a student and suffering from lumbar disc herniation since last two years or more treatments are being done but there have been no proper result but severe development in sciatic pain, numbness and feeling some effect on other leg also. And please suggest me some solution for this herniation.
We have more than 200 bones in our body and each of them is susceptible to bone cancer. However, long bones in the arms and legs are most susceptible to this condition. Bone cancer can be primary or secondary. Primary bone cancer involves uncontrolled and abnormal cell division within the bones while secondary bone cancer refers to cancer that originated somewhere else in the body and later spread to the bones. While children and adults are equally at risk for primary bone cancer, adults and elderly people are more susceptible to secondary bone cancer. If diagnosed early enough, bone cancer can be treated and even cured with surgery, chemotherapy or radiation.
Hence it is essential to recognize the signs and symptoms of bone cancer. Here’s what you should look out for.
- Pain in Bones: Pain is one the primary symptoms of bone cancer. As the tumour grows larger, this pain can become more intense. In its early stages, the pain may be experienced as a dull ache inside the bone or the affected part of the body. It may also increase or decrease according to your activity level or may be experienced only at night. However, not all bone pains signify ‘cancer’ as this is also a symptom associated with osteoporosis.
- Swelling: In some cases, the abnormal growth of bone cells can result in the formation of a lump of mass that may be felt through the skin. In other cases, the affected area may also show signs of swelling.
- Breaking of the Bone: Cancer can weaken the bones and make them more brittle. This may make the bones more susceptible to fractures. A bone breaking in an area that has been painful or sore for a long period of time may be a sign of cancer. This is known as a pathologic fracture.
- Reduced Flexibility: If the tumour is located near a joint, it may affect the range of movements possible and make simple actions uncomfortable. For example, a tumour around the knee may make walking and climbing stairs a painful exercise.
Other symptoms to look out for are sudden and drastic weight loss, tiredness, excessive sweating at night, fever and difficulty breathing in case cancer has spread to other organs. Since many of these symptoms are common to other medical disorders, you should conduct a doctor immediately if you notice any of them. A physical examination and a couple of tests along with a biopsy will be required to confirm a diagnosis of bone cancer.
In case you have a concern or query you can always consult an expert & get answers to your questions!
The womb or the uterus is a muscular structure that is fixed in its place by the ligaments and the pelvic muscles. If these ligaments or muscles become weak or stretch, they no longer will be capable of holding the uterus, resulting in a prolapse. Uterine prolapse happens when the uterine slips or sags from its usual position into the birth canal or vagina. The main indications of uterine prolapse are recurrent bladder infections, constipation, a tug at the pelvic area, the cervix or uterus protruding out of the vagina, problems during sexual intercourse, increased discharge and vaginal bleeding.
What causes it?
1. Age is the most important reason for this condition to manifest itself.
2. A dip in the estrogen level as this hormone keeps the pelvic muscles strong.
3. Damage to the pelvic tissues and muscles due to pregnancy or during childbirth can also contribute to this condition.
4. A woman who has undergone multiple vaginal births is at an increased risk of this condition.
5. Any physical activity that exerts pressure on the pelvic muscles can also result in this disorder.
6. Chronic constipation and obesity, over time, can lead to this disorder.
How it can be treated?
1. Nonsurgical methods:
- Shedding the extra kilos helps reduce stress from the pelvic structures. This helps to avert this disorder.
- Avoid lifting heavy objects throughout the course of the treatment.
- Pelvic floor exercises or Kegel exercises help build up the vaginal muscles.
- Estrogen replacement therapy or Hormone Replacement Therapy can help relieve the symptoms of this disease.
- Wearing a pessary (an instrument that is placed into the vagina and fits under the cervix) helps to push up and stabilize the cervix and the uterus.
2. Surgical treatments:
- Uterine suspension- In this case, the surgeon inserts the uterus back into its former position by reattaching the pelvic ligaments by the use of surgical techniques.
- Hysterectomy- Here, the surgeon removes either the whole or just a part of the womb.
Fibroids are non-cancerous growth that develop in the uterus in varying sizes. Fibroids do not usually show symptoms, but if they are large they may cause severe pain in the abdomen, heavy menstrual bleeding, bloating, infertility or complications during pregnancy. Several factors may lead to the formation of fibroids, including hormones, family history, and pregnancy.
What is myomectomy?
Myomectomy is the surgical procedure which is used for removing fibroids from the uterus. It is a safe method that allows women to become pregnant in future. Gonadotropin-releasing hormone analogue therapy, performed before myomectomy helps in lowering the estrogen level and also controls anemia by stopping uterine bleeding. The different surgical methods for myomectomy include:
- Hysteroscopy, involving the insertion of a lighted viewing instrument into the uterus
- Laparoscopy, involving the insertion of a lighted viewing instrument and one or more incisions in the abdomen
- Laparotomy, involving a larger incision made in the abdomen
Why is the surgery performed?
Myomectomy treats fibroids while preserving the uterus. It is a viable option for those who have:
- Anemia which cannot be controlled with medicines
- Pain which cannot be tackled with medicines
- A fibroid that can cause infertility or increases the risk of miscarriages
How well does it work?
- Pregnancy: myomectomy is the only treatment for treating fibroids that improve your chances of having a baby. The method is effective for treating submucosal fibroid. A cesarean section is required for delivery after performing a myomectomy.
- Recurrence: recurrence of fibroids after myomectomy is really low. It is possible in rare cases, depending on what the original fibroid problem was. Large and numerous fibroids have a greater risk of recurrence. Consult an expert & get answers to your questions!