Uterine Fibroids
Uterine fibroids are a particularly common gynaecological condition, with around one in four women being affected at some point in their lives. Most will not experience any symptoms or require treatment, but are instead able to leave the benign growth to reduce in size over time. Some women, however, will suffer more serious complications, and in such cases more extensive treatment will be necessary.
What Are Fibroids?
Fibroids are non-cancerous growths that develop in the womb. These growths consist of muscle and tissue, and can vary in both size and position. The most common type is an 'intramural fibroid' (which occurs in the muscle wall of the womb), while others include 'cervical fibroids' (which grow in the cervix) and 'subserosal fibroids' (which develop outside the wall of the womb and extend into the pelvis).
The cause of fibroids remains uncertain. Medical professionals are, however, aware that fibroids are linked to high levels of oestrogen – the female reproductive hormone produced by the ovaries. Those most at risk therefore include women who continue to have a regular menstrual cycle (ie. pre-menopause), women who are pregnant, as well as women who are overweight or have an Afro-Caribbean heritage.
Symptoms of Fibroids
Fibroids often do not cause any symptoms, and in many cases a woman will not even be aware she had a fibroid. However, there are occasions in which symptoms are evident, and these may include:-
- Heavy or painful periods (known medically as menorrhagia);
- Abdominal pain;
- Pain in the lower back and legs;
- Bloating of the stomach;
- Frequent urination (if a fibroid is pressing on the bladder);
- Constipation (if a fibroid is pressing on the rectum);
- Pain during sex (known medically as dyspareunia).
Diagnosis and Treatment of Fibroids
Because fibroids often do not lead to any symptoms, they are often only discovered during routine gynaecological examinations, or may even go undetected altogether. However, should a woman be suspected of suffering from a fibroid, there are a number of diagnostic tests which can be carried out. These include:-
- Ultrasound scan;
- Trans-vaginal scan;
- Hysteroscope;
- Laparoscope;
- Biopsy.
Should it be confirmed there is a fibroid present, there are three different options available. Firstly, if there are no symptoms and a woman feels her day-to-day life is not being adversely affected by the condition, then she may decide not to take any action at all. If it is only a minor problem then this is a perfectly safe route to take, particularly as the fibroid will shrink after the menopause when oestrogen levels significantly reduce.
Secondly, it may be recommended that you take medication. There are a number of different types of drug that may be prescribed which can alleviate any symptoms, as well to shrink the fibroid.
Lastly, if the fibroid is extensive in size and is causing severe symptoms, or if the other forms of treatment have proved ineffective, then surgery may be necessary. Whether or not a woman wishes to remain fertile will often determine what type of operation is performed, but may include a myomectomy or a hysterectomy.
Complications
If a large fibroid is left untreated, or if it is located in a particular position, then a woman may experience serious complications, such as:-
- Heavy periods, which often causes anaemia;
- Problems during pregnancy, potentially even leading to a miscarriage;
- Infertility.
Furthermore, if surgery is needed to remove a fibroid from the womb, then there are certain risks involved. These include:-
- Perforation of the uterus;
- Haemorrhage;
- The need for an emergency laparotomy (incision through the abdominal wall);
- Infection.
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