Uterine fibroids also known as leiomyomata, myomas or uterine polyps are the most common, non-cancerous uterine growths in women of childbearing age.
Uterine fibroids grow within the muscles of the uterus, on the outside of the uterus, hang in the uterine cavity or very rarely form within the cervix.
Uterine fibroids are rarely a cause for concern, but when they become too large, or there are many present, they may become a problem.
Fibroids may grow as a single tumour or in clusters with differing locations. A single fibroid can be from microscopic to several inches in diameter .A group of fibroids can also vary in size.
TYPES OF UTERINE FIBROIDS
According to the location of the growth, they can be categorised as
Submucosal: grow in the innermost layer of the uterus
Intramural: grow in the middle layer of the uterus
Subserosal: grow in the outer wall of the uterus
Pedunculated: attached to a stalk either outside of the uterus or within the uterine cavity
Cervical: in the cervical tissue
Interligamentous: between the uterine broad ligaments
Symptoms of Uterine Fibroids
While many women will never even know that they have uterine fibroids, because the condition often exhibits no symptoms, there are some women that will experience certain effects from the fibroid’s presence. Symptoms of uterine fibroids include:
- A sensation of fullness or pressure in the abdominal area
- Excessive bleeding during menstruation
- Excessive length of menstruation
- Extreme cramping during menstruation
- Lower back pain
- Painful intercourse
- A frequent urge to urinate
- Reproductive problems, such as infertility, multiple miscarriages, or early onset of labour during pregnancy
CAUSES OF FIBROID
The cause of uterine fibroids is unknown, however genetic, hormonal, immunological, and environmental factors may play a role in starting the growth of fibroids, or in continuing that growth.
FACTORS THAT MAY INCREASE FIBROID DEVELOPMENT
An increase in lifetime exposure to estrogen:
There are many factors that increase a woman’s lifetime exposure to estrogen. More than at any other time in history, women are exposed to more estrogen. This increased exposure can contribute to a wide variety of reproductive health problems including the development of uterine fibroids. The following factors increase a woman’s lifetime exposure to estrogen:
(1) Early menarche – the longer a woman has her menstrual cycle, the longer estrogen levels are elevated
(2) Fewer pregnancies – many women today are restricting how many children they are having or are not having children at all, which increases their total exposure to estrogen
(3) High body fat content – body fat produces and stores estrogen; the more body fat a woman has the more estrogen
(4) Exposure to xenoestrogens – plastics, pesticides, herbicides, synthetic hormones in both meat and dairy products, and hormone replacement therapy (HRT) including oral contraceptives (birth control) containing synthetic estrogen
(5) Poor estrogen metabolism – some women’s bodies have a harder time removing and metabolizing excess estrogen
In addition to exposure to estrogen the following factors may also play a role in the development of uterine fibroids:
(6) Hypertension
(7) Infection complications from IUD use
(8) Perineal talc use
(9) Anovulatory cycles
(10) Endometrial hyperplasia (common in women with PCOS)
MANAGEMENT
OF FIBROID
In many cases, the effects of uterine fibroids are so minor that often these women use a general over-the-counter pain medicine to treat any cramping or pain associated with the fibroid tumors. Since the tumors can also cause excessive menstrual bleeding, which can lead to anemia, an iron supplement is recommended if excessive bleeding is occurring.
In the medical world, the only “successful” treatment for uterine fibroids is removal the uterus. This is due to the fact that growth of fibroid can reoccur after surgery in the case of removal of the uterine fibroids alone, There are four ways in which doctors aim to remove uterine fibroids:
MYOMECTOMY
A myomectomy can help to remove the existing tumors t but it will not prevent the tumors from growing back (only lifestyle changes can help to balance the body and promote hormonal balance). However, this method of uterine fibroid removal is the best of the two surgery choices for those women that are still wanting to conceive a child.
HYSTERECTOMY
This surgical procedure removes the uterus completely. With a hysterectomy, you can guarantee that the tumors will not grow back. Unfortunately, there are many other side effects that can occur from a hysterectomy including early menopause, an increased risk of osteoporosis and of course, the inability to become pregnant..
UTERINE FIBROID EMBOLIZATION
Another procedure that is being used for treating uterine fibroids is uterine fibroid embolization. This method of treatment has proven effective at shrinking fibroids or destroying them completely, however, it is not without side effects. This treatment should not be used by those women that are wanting to become pregnant, since it is known to throw the body into early menopause and can cause infertility.
EXABLATE – FOCUSED ULTRASOUND THERAPY (MRGFUS)
A relatively new way to eliminate uterine fibroids is through a non-invasive technique using high doses of focused ultrasound waves (HIFU). This procedure destroys the uterine fibroids without damaging the surrounding uterine tissue. As an outpatient procedure, doctors perform ExAblate in a magnetic resonance imaging (MRI) scanner, which allows the doctor to “see” inside of the body and target the uterine fibroids with HIFU. Because ExAblate is a newer procedure, it is not available everywhere, it is only available in select countries .and states in the United State of America.
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