What is Uterine Fibroids?

Causes of Uterine Fibroids

The exact cause of uterine fibroids is not clear, but hormones like estrogen and progesterone are believed to play a key role. These non-cancerous growths typically develop during reproductive years when hormone levels are high. Fibroids often grow larger during pregnancy due to increased hormone production and tend to shrink as estrogen levels drop, such as during menopause. They can range from a single growth to multiple ones, and while some are too small, others can grow to the size of a grapefruit or even larger. In severe cases, fibroids can become large enough to fill the pelvic or stomach area, causing a noticeable abdominal bulge like a pregnancy stomach.

Risk factors of uterine fibroids

From obesity to family history, there are several factors that may increase the risk of developing uterine fibroids. Here’s how:

• Obesity: Excess body fat can elevate estrogen levels, which may encourage the development and growth of fibroids.
• Family history: Having a close relative with a history of fibroids can increase your likelihood of developing them.
• Not having children: Women who have not had children may face a higher risk, as during and after pregnancy, the uterus undergoes significant changes, which may help eliminate small fibroids.
• Early menstruation: If your period starts before the age of 11, it can expose you to a higher level of estrogen and progesterone hormones, which can increase the risk of fibroids.
• Late age of menopause: Fibroids are more common in women between the ages of 30 and 50, and they tend to shrink after menopause. However, late menopause may cause high estrogen production in your body that may put you at higher risk of fibroids uterine growth.

Key Facts of Uterine Fibroids

Major Symptoms	Heavy bleeding between or during periods Presence of menstrual clots Menstruation lasting longer than usual Severe menstrual cramps Bleeding between periods Pelvic pain or lower back pain Feeling of pressure or fullness in the lower abdomen Swelling or enlargement of the abdomen Frequent urination, due to pressure on the bladder Pain during intercourse Increased abdominal distention, making the abdomen look pregnant
Necessary Health Tests	Test Pelvic exam Ultrasound Transvaginal ultrasound Hysteroscopy Pelvic MRI CT scan
Treatment	Medication for hormonal imbalance Focused ultrasound surgery Surgery

Symptoms of Uterine Fibroids

Most women with fibroids experience a few or no symptoms at all. Here are some common symptoms of it:

• Heavy bleeding between or during periods
• Presence of menstrual clots
• Menstruation lasting longer than usual
• Severe menstrual cramps
• Bleeding between periods
• Pelvic pain or lower back pain
• Feeling of pressure or fullness in the lower abdomen
• Swelling or enlargement of the abdomen
• Frequent urination, due to pressure on the bladder
• Pain during intercourse
• Increased abdominal distention, making the abdomen look pregnant

Complications of uterine fibroids

While most uterine fibroids do not cause any serious complications, in some cases, women may face:

1. Unmanageable pain

As fibroids grow, the pain can increase, becoming severe and difficult to manage without medical treatment or pain relief medications. You may notice pain in the lower abdomen or pelvis, pain in the lower back, and pain during sex and periods.

2. Swelling

Fibroids may cause the abdomen or pelvic area to swell, leading to visible enlargement that can make the stomach appear larger than normal, like pregnancy in some cases.

3. Excessive bleeding

Heavy menstrual bleeding is a common complication. Sometimes, you may even experience bleeding between periods, which can be difficult to control and affect daily life.

4. Anemia

Excessive blood loss from fibroids can result in anemia, where the body does not have enough healthy red blood cells. Due to this, you may experience extreme fatigue, weakness, and lightheadedness and may require iron supplements to overcome anemia.

5. Infertility (rare)

Though uncommon, fibroids can interfere with fertility by blocking the fallopian tubes, distorting the shape of the uterus, or disrupting implantation, making conception difficult.

Types of uterine fibroids

Uterine fibroids can be defined into 5 types based on where they grow in or around the uterus. Here they are:

1. Intramural fibroids: This is the most common type of fibroid. They grow within the muscular wall of the uterus. As they expand, they can cause the uterus to stretch and may lead to symptoms like heavy periods, pain, and pressure in the pelvis.

2. Subserosal fibroids: These develop on the outer surface of the uterus. Since they grow outward, they can increase pressure on nearby organs, causing symptoms like back pain, pressure on the bladder, or a feeling of fullness in the abdomen.

3. Pedunculated fibroids: This type of fibroid grows on a stalk-like structure. They hang off the uterus, and if they twist on their stalk, they can cause sudden, sharp pain.

4. Submucosal fibroids: These fibroids grow just underneath the lining of the uterus. They can push into the uterine cavity and are known to cause heavy, prolonged periods and may lead to fertility issues.

5. Cervical fibroids: These are less common and develop on the cervix, the lower part of the uterus. They can cause discomfort, bleeding, and difficulty during sexual intercourse or childbirth.

When to see a doctor?

You should see a doctor if you experience heavy or prolonged periods, severe pelvic pain, frequent urination, difficulty emptying your bladder, or pressure in your abdomen. Also, seek medical attention if fibroids cause fertility issues, sudden sharp pain, or excessive bleeding that leads to constant anemia symptoms such as fatigue, dizziness, or weakness. Diagnosing fibroids at an early stage can help manage the symptoms.

Diagnosis of Uterine Fibroids

You will have to visit either a gynecologist or reproductive endocrinologist to get a diagnosis of uterine fibroids. The doctor will review your medical history and family history and may suggest a few imaging tests, etc. Here’s an overview of the diagnosis of uterine fibroids:

• Pelvic exam: This test is done to check the size, shape, and condition of your uterus.
• Ultrasound: It uses sound waves to take pictures of your uterus and find fibroids.
• Transvaginal ultrasound: An ultrasound wand is inserted inside the vagina to get a closer look at the uterus.
• Hysteroscopy: A thin tube with a camera is inserted into the uterus to see the fibroids inside more clearly.
• Pelvic MRI: Provides detailed images of the uterus to show the size and location of fibroids.
• CT scan: Another imaging test that may be used to look at the uterus and fibroids.

These tests will help your doctor understand the fibroid’s presence, size, and location.

Treatment of Uterine Fibroids

Here are common methods of treating uterine fibroids:

1. Medication for hormonal imbalance

Medicines like gonadotropin-releasing hormone (GnRH) agonists, such as leuprolide acetate (Lupron Depot), help control hormone levels to shrink fibroids or reduce symptoms. Apart from these medications, to help control bleeding and pain without shrinking fibroids, your doctor may also suggest:

• Over-the-counter pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) and naproxen (Aleve, Anaprox DS) may help relieve pain and inflammation caused by fibroids, but they do not reduce bleeding caused by fibroids.
• Birth control pills: These pills can be effective in managing menstrual bleeding and regulating hormones.
• IUD with progestin: An intrauterine device that releases the hormone progestin can reduce heavy bleeding and pain.

2. Focused ultrasound surgery

This non-invasive technique uses high-energy sound waves to target and destroy fibroids. It is done with the help of an MRI and does not involve surgical cuts called incisions.

3. Surgery

For more severe cases in which fibroids become very large and multiple growths, surgical options such as myomectomy (removal of fibroids) or hysterectomy (removal of the uterus) may be considered, especially if other treatments do not show positive results.

The treatment option may vary from one person to another, depending on the number of fibroids, size, and location. If you have any doubts related to your treatment method, feel free to ask.

Home remedies to deal with uterine fibroids

While these 6 home remedies may not treat fibroids, they can help manage symptoms such as pain and discomfort:

1. Dietary changes: Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help manage fibroid symptoms. Also, avoid processed foods, excessive sugar, and red meat, instead, add foods high in fibre and antioxidants to support overall health and potentially reduce inflammation.

2. Acupuncture: This traditional Chinese medicine technique involves inserting thin needles into specific points on the body. It may help relieve pain, reduce inflammation, and balance hormones, potentially easing fibroid symptoms.

3. Exercises such as yoga: Regular exercise, especially yoga, can help improve circulation, reduce stress, and manage pain. Yoga poses that focus on stretching and relaxation can be particularly soothing and may help with symptoms like pelvic pain or cramps.

4. Massage: Gentle abdominal massage may help relieve tension and reduce discomfort associated with fibroids. It can improve blood flow and help relax the muscles in the pelvic area.

5. Gui Zhi Fu Ling Tang: This traditional Chinese medicine formula contains a blend of herbs believed to support uterine health and reduce fibroid symptoms. It is used in some cultures to help balance hormones and improve blood flow.

6. Applying heat: Using a heating pad or warm compress can help ease cramps and discomfort caused by fibroids. However, avoid applying heat if you experience heavy bleeding, as it could worsen the symptoms.

How to prevent uterine fibroids?

Following a healthy lifestyle may not directly help you reduce the risk of fibroids but it can ease the symptoms and promote overall well-being. A healthy lifestyle includes regular exercise and a balanced diet rich in fruits, vegetables, and whole grains to manage a healthy weight and hormone levels. Managing stress and avoiding excess alcohol and caffeine may also be beneficial. For women with a family history of fibroids, regular check-ups can help with early detection.