What are uterine fibroids and how are they treated? | Expert Opinion
Uterine fibroids are common and estimated to occur in up to 70% of women by the time they reach menopause. Some can become quite large and cause heavy menstrual bleeding or pelvic pressure.
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Uterine fibroids, known as leiomyomas, are benign solid tumors that develop in a woman’s uterus. They are common and estimated to occur in up to 70% of women by the time they reach menopause. Some tumors can become quite large and cause prolonged or heavy menstrual bleeding, pelvic pressure or painful periods.
There are three different types of uterine fibroids that can develop depending on where the tumor is located:
Intramural fibroids grow in the muscle layer of the uterus.
Subserosal fibroids and pedunculated fibroids grow on the outside surface of the uterus.
Submucosal fibroids grow on the inner lining of the uterus.
Although uterine fibroids have no definite cause, the factors associated with increased risk include premenopausal status, family history and obesity.
Determining a diagnosis of uterine fibroids includes complete medical history and an abdominal and pelvic examination. Imaging such as transvaginal ultrasound, sonohysterography, or magnetic resonance imaging (MRI) may be used to confirm a diagnosis.
Severity of uterine fibroid symptoms commonly depends on size, location and the number of tumors. Although there are some cases in which no symptoms occur, a woman with uterine fibroids may experience one or more of the following:
Heavy bleeding (which can be severe enough to cause anemia).
Painful periods.
Feeling of fullness in the pelvic area/pelvic pressure.
Enlargement of the lower abdomen.
Pain during sex.
Lower-back pain.
Complications during pregnancy and labor, including more significant risk of cesarean section.
Fibroids can be treated in several ways.
Medications can relieve fibroid-related bleeding symptoms.
For symptoms that are not relieved by medication, non-invasive, minimally invasive and traditional surgical options are available to shrink or destroy fibroids. Women who desire uterine preservation can consider uterine artery embolization, radiofrequency ablation, MRI-guided focused ultrasound surgery, endometrial ablation, and myomectomy.
Hysterectomy is recommended as a definitive surgical management of fibroids for women who do not wish to retain the uterus.
There is no one best choice of treatment. When diagnosed with uterine fibroids, you should talk to your doctor and determine a personalized treatment plan.
Jyothi Rangadhama is an obstetrics and gynecology specialist at Nazareth Hospital.