Uterine Fibroids

What are fibroids?

Fibroids (often referred to as uterine fibromyomas, leiomyomas or myomas) are growths of muscular tissue that form within the walls of the uterus. They are very common, affecting an estimated 40 - 80% of people with a uterus by the age of 50.

The growths are almost always non-cancerous, but can cause anaemia due to heavy periods, fertility issues, an increase risk of miscarriage or premature delivery and pressure or discomfort on the bladder and bowel.

Symptoms of fibroids

Many people with fibroids do not experience symptoms. For those who do, common symptoms can include:

  • Heavy or long periods
  • Painful periods
  • Spotting in between periods
  • Pressure in the back or on the bowel or bladder
  • Pain during sex
  • More frequent urination
  • Feeling a lump in the lower abdomen

What causes fibroids?

There are certain factors that can increase the risk of developing fibroids, such as:

  • Age - as you age and enter menopause, fibroids become more common. After menopause, fibroids will usually start to shrink
  • Early onset of menstruation
  • Family history - you are three times more likely to develop fibroids if your mother also had them
  • Ethnicity - those of Afro-Caribbean descent are at higher risk of developing fibroids
  • Being overweight - if you are very overweight, you are two or three times more likely to develop fibroids
  • Red meat or processed meat consumption - a diet high in red meat or processed meats such as ham or salami are linked with a higher risk of fibroids, while diets high in dark leafy greens appear to reduce risks
  • Having never given birth
  • Other health conditions such as Polycystic Ovary Syndrome (PCOS) or high blood pressure.

Diagnosing and treating fibroids

You may have fibroids but never be diagnosed or require treatment if there are no symptoms present, as the growths can shrink and resolve on their own over time. If fibroids are detected during a routine pelvic exam or other procedure but you are not experiencing any symptoms, the doctor will usually recommend to simply monitor the growths without treatment.

For those who are experiencing symptoms, fibroids can be detected using ultrasound or hysteroscopy (a thin telescope camera that enters the uterus through the cervix).

After diagnosis, there are a range of treatment options depending on the size and location of the growths. These can include:

  • Medication to shrink the fibroids (can be followed by surgical removal)
  • MRI-guided focused ultrasound surgery (FUS), a non-invasive technique used to destroy the growth with ultrasound waves
  • Uterine artery embolisation, where a hysteroscope is used to inject the fibroid’s blood supply with a fine substance that causes it to shrink and break down
  • Myomectomy to completely remove the fibroid using keyhole surgery or through an incision in the abdomen
  • Hysterectomy, where the entire uterus is removed.

If you are experiencing any of the symptoms of fibroids, see your doctor for further testing or to be referred to a gynaecologist.

Sources:

https://www.womenshealth.gov/a-z-topics/uterine-fibroids

https://www.racgp.org.au/afp/2016/october/uterine-fibroids-investigation-and-current-management-trends/

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/fibroids

http://womhealth.org.au/conditions-and-treatments/fibroids-fast-facts

https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288

https://jeanhailes.org.au/health-a-z/vulva-vagina-ovaries-uterus/fibroids