What Are Uterine Fibroids?
These muscular tumors, also called leiomyomas, grow on the walls of the uterus, and are almost always benign. They are the most common form of tumor found in the female genital tract. Some women won’t even know that they have them, because the growths will be completely asymptomatic. In other women, these fibroids can cause a number of unpleasant symptoms, which can include:
● Abdominal pain or severe menstrual cramps
● Heavy menstrual bleeding
● Frequent urination, as a result of pressure that large fibroids may put on the bladder
● Rectal pressure, as a result of fibroids pushing onto the rectum
● In rare cases, these fibroids can become quite large, causing an enlarged abdomen and a pregnant-like appearance
What Are The Risk Factors?
Obviously, gender is the main risk factor for developing this condition, but there are a number of other factors that contribute to a woman’s risk for developing fibroid tumors, including:
● Age: Our chances of having developed a uterine fibroid increases with age. The risk for developing these tumors usually peaks in a woman’s 30s, with fibroids shrinking after menopause.
● Ethnicity: African American women are at a higher risk for developing fibroids than Caucasian women
● Weight: Women who are overweight or obese are at an increased risk, with women who are clinically obese having a risk that is two to three times that of a woman who has a healthy weight.
● Diet: Along with weight, an unhealthy diet that is rich in red meat has been linked to an increased risk for fibroid tumors, where a diet rich in green vegetables may help prevent the formation of these tumors
● Family History: A family history of uterine fibroids increases your risk of developing them, too. If your mother has uterine fibroids, you are three times more likely to develop them than someone who doesn’t have a relative with them.
While we know what risk factors increase our chances of developing fibroids, scientists still aren’t sure whether the cause is genetic or environmental, caused by hormone levels in the body. They do know that fibroids are controlled by hormones; they grow quickly when hormone levels are high, and stop growing or shrink after a woman reaches menopause or when she is given anti-hormone medications.
Are They Dangerous?
While fibroids are tumors, they are almost always benign, with only about one in 1,000 being diagnosed as a cancerous fibroid, called a leiomyosarcoma. These tumors are different than the benign fibroids discussed in this article, and doctors tend to agree that they aren’t caused by existing fibroids.
Fibroids can cause complications when a woman with fibroids becomes pregnant. In most cases, women are able to carry a pregnancy to term and have a normal delivery even with these tumors. However, some women who have fibroids may need to have a Cesarean section (C-section). In fact, they are six times more likely to need one than a woman who doesn’t have fibroids.
They may also face other problems with labor, such as breech birth, where a fetus isn’t properly positioned for a vaginal delivery, or a failure of labor to progress. Both instances will lead to the necessity of a C-section. Women with fibroids are also at a higher risk for a condition called a placental abruption, where the placenta breaks away from the uterine wall prior to labor. This can deprive the fetus of oxygen, and they are at a higher risk of preterm delivery.
How Are They Treated?
Even if they aren’t dangerous, living with fibroids can be painful and inconvenient, especially when they come with heavy menstrual periods or abnormally strong cramps. These uncomfortable symptoms can interfere with your day-to-day activities. How doctors treat fibroids depends largely on the severity of symptoms, the size and location of the tumors, the patient’s age and desire to become pregnant in the future. Among the options to discuss with your doctor:
● OTC Medications: Most doctors will advise women with fibroids to take over the counter (OTC) painkillers, like ibuprofen, to manage the pain that comes from heavy cramps. You may also be advised to take an iron supplement if you have heavy periods with your fibroids. This is to help prevent anemia.
● Prescription Treatments: Birth control pills, injections, and IUDs can be effective in controlling the symptoms of fibroids. You may also be prescribed anti-hormone medications. These have a number of side effects that you should discuss, including hot flashes, depression, insomnia, decreased libido, and joint pain.
● Surgery: For cases where fibroid symptoms are severe, or when women are older or not interested in a future pregnancy, doctors may recommend a surgical approach. Some procedures, like a myomectomy, will involve removing the fibroid tissue without removing the entire uterus. This allows a woman to have a pregnancy after the procedure. A hysterectomy is a more invasive procedure that involves removing the entire uterus; it is a serious procedure that carries a risk for complications and has a lengthy recovery time.
● Myolysis: This procedure involves inserting a needle into the fibroids laparoscopically, then using an electrical current to destroy the tumors.
● Endometrial Ablation: When there is very heavy bleeding, a doctor may recommend this procedure, which involves removing the lining of the uterus through a number of methods. While this procedure is safe, about half of patients will not have any future periods, and a woman will not be able to become pregnant after undergoing the procedure.
While your treatment options may vary depending on age, desire to have children, and the size and number of fibroid tumors you have, your doctor will be able to discuss with you an option that will both provide you relief for your pain and preserve your fertility. A long-term treatment plan may also include home remedies, such as heating pads. Alternative therapies, such as acupuncture, will ease your symptoms, get you back on your feet and not require invasive medical treatment.
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Fibroid tumors can be very unpleasant, but are rarely dangerous. Learn more about this condition that affects as many as 80 percent of women by age 50.