Uterine fibroids, also called myomas or leiomyomas, are benign (noncancerous) growths that develop from the muscle tissue in the uterus. They may be left untreated if they are small, if they do not cause any symptoms (asymptomatic) or if the affected woman is nearing menopause (after which the fibroid may go away on its own).
Nonetheless, untreated fibroids can cause certain complications. For example, a pedunculated fibroid (fibroid attached to the uterus by stem-like tissue) may twist, resulting in symptoms such as abdominal pain, fever, or nausea. A rapidly growing or large fibroid can cause swollen abdomen, pain, and pressure on the nearby structures, such as pressure on the bladder causing problems with passing urine or pressure on the bowel leading to constipation. Fibroids can cause bleeding that may cause anemia when left untreated.
Although most fibroids are noncancerous, rarely they may lead to cancer. An untreated uterine fibroid may also cause infertility in some women, although removal of the fibroid in such women can restore fertility. Other, more common, causes of infertility must be ruled out as well.
When should you consult a doctor about a uterine fibroid?
Asymptomatic fibroid must be brought to medical attention. Consulting a doctor will help you be sure that the fibroid does not coexist with another cancerous condition (fibroids themselves never become cancerous).
Contact your doctor if you have fibroids and the following symptoms:
- Heavy menstrual periods.
- Excessive pain during periods.
- Bleeding between periods.
- Abdominal swelling.
- Pain in the back or abdomen.
- Pelvic pain or pressure.
- Pain during sexual intercourse.
- Increased urine frequency.
- Difficulty passing stools.
- Difficulty passing urine.
- Unexplained weight loss.
To diagnose a uterine fibroid, the doctor may perform a transvaginal ultrasound in which an ultrasound wand is inserted into the vagina. The doctor may also perform a pelvic MRI in addition to a pelvic exam to get a better picture of the fibroid.
What happens when you have uterine fibroids in pregnancy?
Fibroids are a hormone-dependent common condition affecting about 20 percent of women of reproductive age and about 2 to 12 percent of pregnant women. The likelihood of pregnancy-related complications due to fibroids depends mainly on the size, location, and the number of fibroids.
A few small fibroids may not cause any problem as is seen in most pregnant women. While a fibroid may not necessarily increase in size during pregnancy, when it does increase in size, it is generally seen during the first trimester (first 12 weeks) of pregnancy. Some fibroids may even shrink during pregnancy.
Large or multiple fibroids or fibroids present at certain locations in the uterus, however, may cause certain risks, such as in the table below.
|Risks to the mother||Risks to the unborn baby|
Can medications treat uterine fibroid?
Medications may help treat uterine fibroids, especially in people who do not have any serious symptoms or large fibroids. They help relieve symptoms such as pain, pressure, cramps, or excessive menstrual bleeding. Nonsteroidal anti-inflammatory drugs (such as acetaminophen, ibuprofen, and naproxen) may help manage pain and cramps. Hormonal birth control (contraceptive) pills, injections, or intrauterine devices may help manage cramps, excessive menstrual bleeding, and bleeding between periods.
Medications may help shrink fibroids, but they may start growing once the medications are stopped. At times, medications are given to shrink the fibroids before a surgical procedure. Iron supplements may be prescribed to treat anemia due to heavy bleeding.
Medications may not help in all cases. In women with a large fibroid or presence of severe symptoms, surgery may be advised. Surgery options include:
- Myomectomy (surgical removal of the fibroid)
- Endometrial ablation (destruction of the lining of the uterus using laser, freezing, electric currents, or other options)
- Uterine artery embolization also called uterine fibroid embolization (blockage of blood supply to the fibroid to shrink it)
In women who do not wish to have children, surgical removal of the uterus (hysterectomy) may be done, which is a major surgical procedure and is mainly preferred in postmenopausal women or those whose symptoms are not managed by other treatment options.
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