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 increased risk of miscarriage or premature delivery and pressure or discomfort on the bladder and bowel.
Types of Fibroids
There are 4 types of fibroids and it is possible to have multiple types of fibroids. Types of fibroids include;
- Intramural fibroids which grow in the wall of the uterus and are the most common type.
- Subserosal fibroids which grow on the outside of the uterus. These fibroids can grow to be large and cause pain as a result of their size or due to pressure exerted on other organs.
- Submucosal fibroids which occur underneath the uterine lining and can push into the uterus cavity. These types of fibroids often the cause of heavy bleeding.
- Pedunculated fibroids which are fibroids growing inside or outside the uterus on stalk-like growths.
Symptoms of fibroids
Many people with fibroids do not experience symptoms but 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
Some symptoms such as menstrual pain or pain during intercourse may also be a sign of endometriosis so it's important to establish the root cause of symptoms.
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.