The exact cause of fibroids is not known although certain factors may contribute to their formation, such as:
- Genetics (including gene mutations in the MED12, HMGA2, COL4A5/COL4A6, or FH genes)
- Progesterone and estrogen
- Growth factors
- Extracellular matrix (ECM)
- The substance that binds cells together, just like mortar holds bricks together
- Increased ECM contributes to the growth of fibroids
- ECM stores growth substances and modifies the biology of the cells
Fibroids are probably caused by the interaction among several variables. Once we are aware of the source or causes of fibroids, we may be able to work more quickly toward prevention or even a cure.
What are fibroids?
Fibroids are noncancerous (benign) growths that form in the uterine muscle (uterus). They are also called myomas and leiomyomas.
According to estimates, more than 40 percent of women are at risk of fibroids. Although they can occur at any age, women in their 30s and 40s seem to experience them more frequently. Fibroids are sensitive to hormones, progesterone, and estrogen. They are more prevalent among Afro-Caribbean women, who are at a higher risk of multiple fibroids than Caucasian women.
The size and location of the fibroid determine the method of treatment.
Fibroids can be categorized according to where they manifest:
- Submucosal fibroids (grow inside the uterine cavity)
- Intramural fibroids (embedded into the uterine wall)
- Subserosa fibroids (attached to the uterus' outer wall)
- Pedunculated fibroids (attached to the uterus by a slender stalk)
What are the signs and symptoms of fibroids?
Some women with fibroids exhibit minor or no symptoms; however, others may exhibit severe symptoms.
The most typical signs of uterine fibroids include the following:
- Bleeding between periods
- Low back pain
- Heavy or lengthy periods
- Pain during intercourse
- Pelvic pain (occurs as the tumor presses on pelvic organs)
- Lower abdomen fullness or bloating
- Vaginal discharge
- Abdominal distention (enlargement)
- Frequent urination or inability to empty your bladder (as a fibroid may exert pressure on the bladder)
- A firm mass often near the middle of the pelvis. This can be felt by your healthcare provider.
What are the risk factors for fibroids?
Most fibroids affect women of childbearing age. Most of the time, fibroids do not manifest in young women, who have not yet begun their first period.
Although there is no proven reason for them, there are various risk factors that could heighten the risk of fibroids:
Can fibroids be cancerous?
Most fibroids are benign (noncancerous). Less than 1 in 1,000 fibroid tumors are known to be cancerous, and these are known as leiomyosarcomas. Doctors claim that these cancers do not arise from preexisting fibroid lesions.
Having fibroids does not increase your risk of malignant fibroids. Additionally, a woman's risk of other uterine malignancies is unaffected by having fibroids.
What are the treatment options for fibroids?
Uterine fibroids don't usually need to be treated unless they cause troublesome symptoms or effects. The type of treatment will depend on the symptoms, location, and size of the fibroid.
The following are some of the treatment options:
- Painkillers: In addition to relieving pain, anti-inflammatory medicines, such as ibuprofen or naproxen, may decrease menstrual bleeding caused by fibroids. Women who experience sporadic pelvic pain or discomfort owing to fibroids are advised to use this most conservative treatment option.
- Tranexamic acid: Works by slowing the breakdown of blood clots in the uterus and can be taken for the duration of the menstrual cycle to reduce bleeding.
- Mefenamic acid: It is a nonsteroidal anti-inflammatory drug. It can be used to reduce the amount of bleeding and pain that come with periods during the menstrual cycle. It functions by lowering the levels of the prostaglandin chemical in the lining of the uterus, which in turn lowers the amount of blood loss and discomfort related to periods.
- Gonadotropin-releasing hormone agonists (GnRH agonists): This treatment lowers your estrogen levels and brings on a brief "medical menopause." GnRH agonists help decrease fibroids. They can also be used before surgery to boost your blood count or stop your period. Often, doctors recommend the medication only for a year because its effects are reversed once it exits your body.
- Oral contraceptive pills, a vaginal ring, or a patch: May decrease bleeding caused by fibroids. Bleeding may also be controlled with progesterone-containing medications, including tablets, implants, injections, and intrauterine devices.
- Myomectomy: In a myomectomy, the uterus is left intact, but the fibroids are removed. Women who desire to maintain their fertility are advised to use this method.
- Uterine artery embolization (UAE): Also known as uterine fibroid embolization, it is a more recent procedure. This minimally invasive procedure decreases fibroids by cutting off their blood supply. An interventional radiologist performs UAE under the watchful eye of an X-ray machine. Medical researchers are examining the long-term consequences of this operation on fibroid tissue renewal and fertility.
- Magnetic resonance-guided focused ultrasound: A newer technique, it concentrates sound waves on uterine fibroids that are in the front of the uterus. We don't yet fully comprehend its potential impacts on fertility.
- Radiofrequency ablation: Another more recent procedure for treating fibroids. It involves heating the fibroids to reduce their size and soften them under laparoscopic and ultrasound monitoring. There is currently a lack of knowledge regarding its potential effect on fertility.
- Hysterectomy: Involves the removal of the entire uterus. In the United States, fibroids are the main cause of hysterectomies. Depending on the size of your uterus, where the fibroids are located, and your medical history, the treatment may be carried out vaginally, abdominally through a major incision, laparoscopically, or robotically. Hysterectomy is a big procedure; thus, it's only advised for fibroid situations in women who don't care about preserving their fertility. It is the most efficient way to treat fibroids because it prevents the risk of recurrence.
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