Uterine fibroids are firm, compact benign tumors which are made of smooth muscle cells and fibrous connective tissue that originate in the uterus (womb). Sometimes, these tumors become quite large and cause severe abdominal pain and heavy periods. Although it is not clearly known what causes fibroids, it is believed that each tumor develops from an aberrant muscle cell in the uterus, which multiplies rapidly because of the influence of the hormone estrogen.
Most women with uterine fibroids have no symptoms. But these fibroids can also cause a number of symptoms depending on their size, location within the uterus, and how close they are to adjacent pelvic organs. Symptoms of uterine fibroids may include heavy or prolonged menstrual periods, abnormal bleeding between menstrual periods, pelvic pain due to the pressure caused as the tumor presses on pelvic organs, frequent urination, low back pain, pain during intercourse etc. In most cases, these heavy or prolonged menstrual periods, or the abnormal bleeding between periods, can lead to iron-deficiency or anaemia in women.
After uterine fibroids has been diagnosed properly relating its size, location etc. the patient may receive a combination of treatments. The doctor may prescribe medicines to destroy the fibroids. In case the fibroids are large and multiple, surgeries (myomectomy) may be performed. The doctor may also perform a hysterectomy (removal of the uterus) if the condition worsens, or if no other treatments work. Also, a new and completely non-invasive surgical procedure can be performed. This is called forced ultrasound surgery (FUS) where high-energy, high-frequency sound waves are directed at the fibroids to destroy (ablate) them.
Fibroids are not cancerous nor do they interfere with pregnancy. In such instances, women can get along with it without any treatment. They tend to shrink after menopause, when levels of reproductive hormones drop. But, otherwise, in order to treat uterine fibroids, medications are prescribed to regulate the menstrual cycle, treating symptoms such as heavy menstrual bleeding and pelvic pressure. These medicines like Gonadotropin-releasing hormone (Gn-RH) agonists, Progestin-releasing intrauterine device (IUD) target the hormones and thus help to shrink the fibroids. Non -steroidal anti-inflammatory drugs (NSAIDs), which may be taken side by along with the other medicines, may be effective in relieving pain related to fibroids.
MRI-guided focused ultrasound surgery (FUS) is a noninvasive treatment option for uterine fibroids that preserves the uterus. A high-energy ultrasound transducer detects the precise location of the uterine fibroids and sound waves (sonications) are used to heat and destroy small areas of fibroid tissue. Also, small particles (embolic agents) can be injected into the arteries supplying the uterus. This helps to cut off blood flow to fibroids, causing them to shrink and die. Laparoscopic procedures like myolysis and robotic myomectomy can also be used.
In case of multiple fibroids, very large fibroids or very deep fibroids, the doctor decides to perform surgical operations to remove the uterine fibroids. An open abdominal surgical procedure can help relieve the pain but affect future fertility. Also, hysterectomy can be performed as a permanent procedure. This involves removal of the uterus and ends one’s ability to bear children.
Usually, uterine fibroids do not cause much trouble unless large. A patient should, nonetheless, consult a doctor if she has symptoms of fibroids which include irregular and heavy menstrual bleeding, bleeding between periods, pelvic or abdominal pain, frequent painful urination, or an inability to control the flow of urine, increasing abdominal girth etc. These symptoms of vaginal bleeding is also associated with dizziness, lightheadedness, shortness of breath, or chest pain
Unless women have bothersome or severe symptoms, they do not need to treat uterine fibroids. Doctors examine the changes and size of fibroids when one is pregnant to avoid any complication.
Myomectomy poses a unique set of side effects. Risks may include infection of the pelvic region including uterus, fallopian tubes, or ovaries, scar tissue, injuries to the bladder or bowel. As a result of fibroids, the person might already have lost blood. Surgical operations may cause further complications like blood loss, infertility etc. Also, such operations if carried out callously, can increase the risk factors of having cancer.
After treatment, all patients should follow their health care practitioner's instructions. A health care practitioner or doctor may choose to perform more frequent pelvic exams, such as every six months, to determine whether there has been additional growth of fibroid tissues or other complications.
Time to recover depends on the size of the fibroids and the procedure of treatment. Medications may take a longer time to gradually cut down on the tissues and fiber growths. Surgical operations also provide variable recovery time. Hysteroscopy is an outpatient procedure and requires from a few days to 2 weeks to recover. Laparoscopy requires 1 to 2 weeks. Laparotomy is a longer procedure and may require 4 to 6 weeks to recover.
Operations for removing uterine fibroids requires a huge amount. On an average, surgical operations cost Rs. 70,000- Rs. 90,000/-.
Use of medications like Gonadotropin releasing hormone agonists (GnRHa) and others do not guarantee a permanent cure. There may arise issues relating pregnancy or recurrent pregnancy loss related to submucosal fibroids. The only permanent solution for uterine fibroids is undergoing surgical operations. Complete removal of uterus provides permanent relief from extreme symptoms of fibroids but also take away the ability to become pregnant.
Homeopathy is a lot more effective treatment of uterine fibroids. Though slowly, but homeopathy provides the best non surgical treatment for fibroids. The medicines surely retard the growth of fibroids and over a period of time, the fibroids disappear completely. This is a far more effective and the most convenient treatment of fibroids.
There is no specific self-care is available for uterine fibroids. In case of immense pain, women may apply heat to the lower abdomen by using a heating pad or hot water bottle. Doing exercise, which improves blood flow, may also reduce pain. Anemia can be prevented by Increasing the amount of iron in the diet.
Rs 2000- Rs 90,000
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:
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.
In case you have a concern or query you can always consult an expert & get answers to your questions!
The uterine fibroids are one of the most common gynecologic problems, with over 40-50% of women having them at some point in their life. The number and size of the fibroids, the age of onset, associated symptoms like dysfunctional bleeding and pelvic pain will determine the management of fibroid. The following is a series of management measures, starting from the most conservative to the most invasive.
1. Wait and watch: In women who are asymptomatic, it is best to watch them for the development of symptoms without any intervention. Also, in women nearing menopause, it is best to just watch the fibroids as they just shrink once menstruation ceases.
2. Medical therapy: In some women, menstrual cycles could be heavy or irregular and require hormonal replacement. They could also have occasional pain, and so may require painkillers.
3. Noninvasive procedure: MRI-guided focused ultrasound surgery is when the women are inside the MRI scanner and an ultrasonic transducer is used for treatment. The exact location of the fibroids are identified and sound waves are used to destroy the fibroid. Done on an outpatient basis, it is safe and effective.
4. Minimally invasive procedures: Uterine artery embolization is where the arterial supply is cut off to reduce fibroid growth. Myolysis is where laparoscopically heat or cold waves are used to lyse off the fibroids. Endometrial ablation is where the uterine lining is destroyed through high-intensity heat or cold waves.
5. Invasive procedures: Abdominal or Laparoscopic myomectomy is where the fibroids are removed through an abdominal incision or keyhole surgery. If fibroids are extensive and completed family, hysterectomy is the choice of treatment. Given their high incidence, fibroids require management based on symptoms, age, and other considerations as discussed and decided between the patient and the doctor.
It is likely for you to experience abnormal vaginal bleeding between your periods during one point in life. Vaginal bleeding is termed abnormal when you are not expecting your periods, when your menstrual flow is heavier or lighter than normal, and at times when it is not expected such as during pregnancy, or after menopause. Abnormal vaginal bleeding may result from a wide range of causes. It does not always indicate a serious or severe condition.
The different possible causes are discussed below:
There are several other less common causes, which may result in abnormal vaginal bleeding. They include the following:
It is important for you to consult a doctor on experiencing abnormal vaginal bleeding. It is very important to diagnose the condition properly and start with management measures at the earliest. In case you have a concern or query you can always consult an expert & get answers to your questions!
Uterine cancer is often treated with a combination of treatments. The recommendation of treatment option depends on the factors such as stage and type of cancer, age, the overall health of the patient, side effects, personal preference etc. Another important consideration that goes before taking a call on the treatment option includes the research on the patient’s ability to bear a child in future. But, overall, the treatment plan includes surgery, chemotherapy, radiotherapy, hormone therapy etc.
Surgery is often the first step towards removing the tumor and a few healthy tissues around it. Some of the common surgical procedure include hysterectomy, lymph node dissection, and sentinel lymph node biopsy.
Uterine fibroids, also known as leiomyomata, are non-cancerous growths which develop in and around the uterus or the womb and form benign tumors in course of time. Though there are several types of uterine fibroids, they are all consistently similar in their genetic makeup. They are generally classified depending on their specific locations:
Signs and symptoms
In most cases, uterine fibroids display little or no symptoms at all. Therefore many women are caught unawares and do not realize whether they have leiomyomata or not. When symptoms do show, however, they may include any one of the following:
Since uterine fibroids do not cause any significant complications, they normally do not require much treatment. The condition, however, can be treated through either one of the following approaches:
1. Non-surgical approach
(1) Alert and careful inspection as well as watchful anticipation of the growth and development of uterine fibroids
(2) Birth control pills or oral contraceptives which help reduce heavy periods caused by uterine fibroids
(3) Pain relievers to help numb the pain
(4) Intrauterine device along with levonorgestrel to help reduce heavy periods
(5) Iron tablets are helpful in substituting the blood loss caused by heavy menstruation
These two procedures can be performed using several techniques like:
iii) Uterine artery embolization (UAE)
In case you have a concern or query you can always consult an expert & get answers to your questions!