All About Fibroids

Updated: Apr 30, 2019

Fibroids are overgrowths of the muscle and fibrous soft tissue of the female pelvis. These non cancerous benign growths virtually never become cancerous. It affects women of the reproductive age group and linked to the main hormone secreted in this phase which is Estrogen. Females before puberty and after menopause (after cessation of menstruation) do not develop fibroids.


There are many types of Fibroids; Subserosal/Extramural, Intramural, Submucosal and Pedunculated, which refers to growths protruding outside of the uterus, present within the uterine musculature, growths into the uterine cavity and growths connected by a stalk.

Presentation of Fibroids

Women affected with fibroids can but not necessarily experience the following features:

  • Abdominal pain either cramp or vague pain

  • Back pain affecting commonly the lower back

  • Prolonged and excessive Menstruation (Periods)

  • Excessive Pain during Menstruation

  • Increased frequency of Urination

  • Constipation

  • Discomfort or Pain during contact with partner

  • Issues related to Pregnancy

  • Infertility

Treatment of Fibroid

The management of fibroid depends on the age, presentation and number of fibroids.

Usually fibroids are left under observation as they tend to shrink when oestrogen levels decrease.

However in the instances when troublesome or multiple resulting in inability to conceive, fibroids can be removed.

The most common procedure undertaken for removal of fibroids is referred to as Laproscopic Fibroidectomy. This is described as the insertion of fibre optic instrument that has a video camera at one end in order to visualise the abnormal growths and remove the same in total either by direct removal or larger growths can be crushed prior to removal to avoid large surgical openings.  

Another fairly similar procedure is Hysteroscopic Myomectomy deals with intramural fibroids (those growths within the uterine musculature) by using an instrument to visualise the interior of the uterus and removing the growths.


More recent therapeutic options include:

  • MRI-guided focused ultrasound surgery (FUS)

  • Endometrial ablation

  • Myolysis

  • Uterine artery embolization


General surgical methods done previously that resulted in longer recovery period and larger scars are Abdominal Myomectomy and Hysterectomy that are nowadays only carried out in selected cases i.e. when fibroid is too large or post menopausal women or when associated with uterine conditions.


Medical options include:

  • Gonadotropin releasing hormone (GnRH) agonists

  • Progestin releasing intrauterine device

  • Tranexamic acid

  • Oral contraceptives

  • NSAIDs

However, these agents have no to minimal efficacy in reducing the size of fibroids and are not commonly employed. Furthermore, their use as a preventive strategy has been studied over and found to have no such effect.


 

This information is brought to you by Specialized doctors in Al Arif Heart and Children Medical Center, Al Mujarrah, Sharjah, UAE. Keep yourselves fit as a fiddle.


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