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Uterine Fibroids are growths in the muscle wall of the womb (uterus). They are, in 99.9% of cases, non-cancerous (benign). Fibroids often decrease in size after the menopause, when levels of oestrogen, the female hormone that circulates in the blood, decrease dramatically, reducing blood flow to the fibroids, which then shrink. Fibroids can range in size from tiny (less than 1cm) to large (over 20cm). There is usually more than one fibroid in the womb.
Alternative Names of Uterine Fibroids are: Leiomyoma; Fibromyoma; Myoma; Fibroids
Complications of Uterine Fibroids
Fibroids may cause pregnancy complications, although the risk is thought to be small:
Other complications of fibroids include:
Causes of Uterine Fibroids
Signs & Symptoms of Uterine Fibroids
Depending on their size and position in the womb, fibroids may cause:
Diagnosis of Uterine Fibroids
Fibroids are often first diagnosed during an internal pelvic examination.
Abdominal or Transvaginal ultrasound
This is a painless procedure in which a small, handheld probe is moved across the abdomen. Sound waves are transmitted through the skin, allowing the technician to see the size, shape and texture of the uterus on a monitor. Uterine size, the position and number of fibroids and, with the use of Doppler techniques, the uterine and fibroid blood vessels can usually be evaluated. In Transvaginal ultrasound a sheathed ultrasound probe is put into the vagina so that the inside of the uterus can be seen more easily. This may be required if small fibroids are suspected or if images from an abdominal ultrasound are unclear. There is generally little, if any, discomfort associated with this.
MRI (Magnetic Resonance Imaging) scan
This is now the method of choice for imaging fibroids when alternatives to hysterectomy are being considered. It gives precise information of the number, size and location of fibroids. You will need to put on a hospital gown and lie flat on your back under the scanner. Usually an injection (contrast medium) is necessary to produce even more accurate images and to look at the relative blood supply of the uterus and the fibroids.
A long, thin endoscope is passed through the vagina and cervix into the uterus, allowing the doctor to check for growths and take samples of tissue. It is sometimes required to confirm and treat small submucosal and intracavity fibroids. It can cause some discomfort and is generally performed by a gynaecologist, either with a local or general anaesthetic.
A small incision is made in the abdomen, usually next to the navel, allowing insertion of an endoscopic camera.
Treatments of Uterine Fibroids
Treatment depends on various factors, including:
Some women may just need pelvic exams or ultrasounds every once in a while to monitor the fibroid's growth.
Treatment for the symptoms of fibroids may include:
Hormonal therapy (gonadotropin releasing hormone (GnRH) agonists or Depo Leuprolide injections) may be used to help shrink the fibroids. This therapy is used only for a short period of time, either before surgery to remove a fibroid or when a woman is expected to reach menopause soon. Side effects include hot flashes and vaginal dryness.
Surgery and procedures used to treat fibroids include:
Prevention of Uterine Fibroids
There is no known treatment that prevents uterine fibroids. But getting regular exercise may help. According to one study, the more exercise women have, the less likely they are to get uterine fibroids.
Preventing fibroids from coming back after treatment
It is common for fibroids to grow back after treatment. The only treatment that absolutely prevents regrowth of fibroids is removal of the entire uterus, called hysterectomy. After hysterectomy, you cannot get pregnant. While many women report an improved quality of life after hysterectomy, there are also possible long-term side effects to consider.
When to seek Medical Advice
Call your doctor if:
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