Uterine fibroids, also known as leiomyomas or myomas, are noncancerous growths of the uterus that often appear during childbearing years. They are composed of muscle and fibrous tissue and can range in size from small and undetectable to large masses that can distort the shape of the uterus.
Common Signs and Symptoms of Uterine Fibroids:
- Menstrual Changes: Heavy menstrual bleeding, periods lasting longer than a week, and irregular periods.
- Pelvic Pain and Pressure: Discomfort or pain in the pelvis or lower back, often accompanied by a feeling of fullness or pressure.
- Frequent Urination: Fibroids can press against the bladder, causing a frequent need to urinate.
- Difficulty Emptying the Bladder: Large fibroids may obstruct the bladder, leading to difficulty emptying it completely.
- Pelvic Pain During Intercourse: Fibroids can cause pain or discomfort during sexual intercourse.
- Backache or Leg Pains: Rarely, fibroids pressing on nerves may cause backache or leg pains.
Causes and Risk Factors of Uterine Fibroids:
The exact cause of uterine fibroids is unclear, but several factors may contribute:
- Hormones: Estrogen and progesterone, hormones that stimulate the development of the uterine lining during each menstrual cycle, may promote the growth of fibroids.
- Genetics: Having a family history of fibroids increases the risk.
- Race: African-American individuals are at a higher risk of developing fibroids.
- Age: Fibroids are more common in women of reproductive age and tend to shrink after menopause.
- Obesity: Being overweight or obese increases the risk of fibroids.
Treatment Options for Uterine Fibroids:
- Watchful Waiting: In some cases, especially if the fibroids are small and asymptomatic, a “watch and wait” approach may be recommended.
- Medications: Hormonal medications, such as birth control pills, can help regulate menstrual cycles and manage symptoms. Gonadotropin-releasing hormone agonists may be used to temporarily shrink fibroids.
- Non-Invasive Procedures: Procedures like uterine artery embolization (UAE) and focused ultrasound surgery (FUS) can be used to shrink or destroy fibroids without surgery.
- Surgical Options: If symptoms are severe or fertility is a concern, surgical options such as myomectomy (removal of fibroids) or hysterectomy (removal of the uterus) may be considered.
Fertility and Pregnancy Considerations:
- Impact on Fertility: Fibroids can sometimes interfere with fertility by blocking the fallopian tubes or affecting the implantation of the embryo. However, many women with fibroids can conceive and have healthy pregnancies.
- Pregnancy Complications: Fibroids can increase the risk of certain complications during pregnancy, such as a higher chance of needing a cesarean section (C-section) and breech birth.
- Treatment Before Pregnancy: If fibroids are causing fertility issues, addressing them before attempting pregnancy may be considered. However, the decision depends on the size, number, and location of the fibroids.