Uterine fibroids are benign tumors located in the uterus. Whilst very common, they can be very disabling. What are their symptoms and what is their treatment?
Definition: What Is A Uterine Fibroid?
Uterine fibroids are benign (non-cancerous) tumours that develop in the uterus. It is a common condition that affects between 20 and 50% of women. The size, number and location of fibroids vary from one woman to another. Round in shape, they can be microscopic or up to the size of a melon.
There are three different types of uterine fibroids depending on their location. Intramural (or interstitial) fibroids form in the thickness of the muscle of the uterine wall. This represents the vast majority of cases (70%). Subs serous fibroids grow out of the uterus and can be attached via a pedicle (an elongate structure connecting an organ to a tumour). Submucosal fibroids are present in the uterine cavity and form under the endometrium. Generally asymptomatic, uterine fibroids can however be disabling and cause some complications such as heavy bleeding.
Symptoms Of Uterine Fibroma
Only about a third of uterine fibroids cause symptoms. The most common are longer and more abundant periods (menorrhagia), bleeding outside menstruation (metrorrhagia), pain and heaviness in the lower abdomen and pain during intercourse. Fibroids can also put pressure on the bladder, causing a frequent urge to urinate and loss of urine, or bowel, involving bloating and constipation. In some cases, uterine fibroids cause complications, including haemorrhage or anaemia. In addition, whilst they generally do not affect fertility, they can block the fallopian tubes and hinder the passage of sperm.
Causes Of Uterine Fibroma
The causes of the appearance of uterine fibroids are still poorly understood and are linked to a set of factors. The fibroid appears to originate in a cell that has mutated and multiplies uncontrollably. Research has shown a link, direct or indirect, between certain female hormones (estrogen) and cell growth. Similarly, family predisposition and childlessness seem to play a role.
Treatment Of Uterine Fibroma
Uterine fibroids are benign and do not require treatment when asymptomatic. Otherwise, the treatment depends on the age of the person affected, their desire to have children, the seriousness of symptoms and the size and location of the fibroids. Medication may be prescribed to fight the symptoms. It helps reduce bleeding and regain a normal menstrual cycle but does not affect the volume of fibroids. Only surgery can provide a definitive solution. There are several possible operations. Myomectomy involves removing the fibroids while retaining the uterus. A future pregnancy is thus still possible. However, there are risks of recurrence (15 to 20% of cases). Hysterectomy is a removal of the uterus. It is reserved for the most serious cases and for women who no longer wish to have children.