What are fibroids?
Fibroids are non-cancerous growths that develop in or around your womb (uterus). The growths are made up of muscle and fibrous tissue.
What causes fibroids?
The exact cause of fibroids is still unknown.
However, fibroids have been linked to the female reproductive hormone oestrogen, which is produced by the ovaries.
This is why fibroids are more common in females in their childbearing years and may regress after the menopause.
Being hormone sensitive, fibroids may also grow during pregnancy, and shrink after childbirth.
Who is at risk of having fibroids?
Fibroids occur most commonly in women during their reproductive years.
Other risk factors for fibroids include a positive family history of fibroids, increased body weight (overweight or obese females), early onset of menstruation, and exposure to hormone treatments.
Types of fibroids
Fibroids can grow both inside and outside the walls of the womb/uterus and can vary significantly in size and location.
Fibroids are commonly classified according to their location.
Intramural: located within the wall of the uterus.
Subserous: located in the outer layer of the uterine wall
Submucous: located in the inner layer of the uterine wall, and can protrude into the uterine cavity
Pedunculated: growing on a stalk, either into the uterine cavity or outside the womb
What are the symptoms?
Many women do not have any symptoms and are unaware that they have fibroids. For some women symptom includes :
- Heavy periods
- Bleeding in between periods
- Bleeding after sexual intercourse
- Discomfort, bloating and “heaviness” in the lower abdomen
- Pain or pressure: severe cramps, colicky pain, painful periods, lower backache
- Urinary frequency or constipation due to the fibroid pressing on the bladder or bowel
- Anaemia due to heavy menstrual bleeding. Anaemia is caused by a lack of red blood cells, and symptoms include tiredness, dizziness, weakness and headaches.
How do I get a check for fibroids?
An ultrasound scan can confirm the diagnosis of fibroids. The scan helps the doctor assess the number of fibroids, their exact size, and location within the womb.
How are fibroids treated?
Non-steroidal anti-inflammatory drugs (NSAIDs) help to decrease menstrual or pelvic pain, while tranexamic acid can reduce the amount of menstrual bleeding.
Both tranexamic acid and NSAIDs are not contraceptives, meaning they can be used while you are trying to get pregnant.
Hormonal therapy is used to reduce heavy menstrual bleeding associated with fibroids.
These include the oral contraceptive pill, intrauterine devices (IUD), progesterone tablets, and progesterone injections.
Surgical treatment involves removal of the fibroids, which can be performed by a gynaecologist via keyhole (laparoscopy or hysteroscopy) or open surgery (laparotomy).
Will this affect my fertility?
Fibroids can impact your fertility and pregnancy, depending on their size and location.
Large submucosal fibroids can distort the uterine cavity, interfering with normal implantation of a fertilised egg.
In pregnancy, fibroids can sometimes increase the risk of miscarriage or premature birth.
During labour, large fibroids can obstruct the opening of the uterus, making delivery difficult.
However, the majority of women with fibroids do not experience issues and are able to fall pregnant and deliver successfully.
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