If your doctor says you have a fibroid, it's not the end of the world. Often these common uterine growths are problem tree. When you do need treatment, however, there are now a number of uterus-preserving options instead of a traditional hysterectomy.
Fibroids are rubbery masses of muscle and fibrous tissue that develop within or along the wall of a woman's uterus (womb). They come in multiples, vary greatly in size (from microscopic to up to 40 cm or so) and generate a range of symptoms. You may be completely unaware of their existence, or you may have the most common symptom-- a heavy or prolonged menstrual period--which is potentially serious, because it can lead to anaemia.
The pressure of large fibroids on nearby organs can also cause lower back pain, abdominal cramping, pain during intercourse, difficult or increased urination and constipation. By distorting your uterus, fibroids may also hamper your ability to become pregnant and increase the risk of miscarriage or heavy bleeding after giving birth. Rarely, a stalklike (peduncualted) fibroid develops and gets twisted, causing its tissues to die. This painful condition, known as necrosis, usually calls for imediate surgery.
Between 20 and 40 percent of women over age 35 have uterine fibroids of a significant size. It's not known why fibroids form (although new research suggests genetics may be responsible), but once they do, the female hormone oestrogen certainly spurs their further growth. So fibroids tend to enlarge during pregnancy, when oestrogen levels increase, and shrink or disappear with menopause, when oestrogen falls. On the bright side: if you've carried at least two pregnancies to term, or if you're an athletic person, you may be less prone to developing fibroids.
LIKELY FIRST STEPS
fibroid in the uterus. Without blood, the fibroid withers away.
Treatments
Fibroids are virtually never life threatening: they don't develop into cancer, nor do they increase your risk of uterine cancer. For this reason, if you have no symptoms, you may initially want to opt for a wait-and-see approach. This doesn't mean doing nothing, however. You'll need regular pelvic examinations and ultrasounds to monitor any growth, and you'll want to relieve mild symptoms with medications and self-help remedies. On the other hand, more troublesome fibroids--those that cause particularly painful menstrual periods or related pain, or that could potentially interfere with fertility or pregnancy--should be removed. At one time, the traditional treatment for fibroids was the removal of the uterus, a surgical procedure known as a hysterectomy (see on shortly). Today there are a number of less radical procedures to consider first.
What is happening
Fibroids are rubbery masses of muscle and fibrous tissue that develop within or along the wall of a woman's uterus (womb). They come in multiples, vary greatly in size (from microscopic to up to 40 cm or so) and generate a range of symptoms. You may be completely unaware of their existence, or you may have the most common symptom-- a heavy or prolonged menstrual period--which is potentially serious, because it can lead to anaemia.
The pressure of large fibroids on nearby organs can also cause lower back pain, abdominal cramping, pain during intercourse, difficult or increased urination and constipation. By distorting your uterus, fibroids may also hamper your ability to become pregnant and increase the risk of miscarriage or heavy bleeding after giving birth. Rarely, a stalklike (peduncualted) fibroid develops and gets twisted, causing its tissues to die. This painful condition, known as necrosis, usually calls for imediate surgery.
Between 20 and 40 percent of women over age 35 have uterine fibroids of a significant size. It's not known why fibroids form (although new research suggests genetics may be responsible), but once they do, the female hormone oestrogen certainly spurs their further growth. So fibroids tend to enlarge during pregnancy, when oestrogen levels increase, and shrink or disappear with menopause, when oestrogen falls. On the bright side: if you've carried at least two pregnancies to term, or if you're an athletic person, you may be less prone to developing fibroids.
- Anti-inflammatory drugs (NSAIDs) to control pain.
- Cut dietary fat, which may stimulate fibroid growth.
- Consider procedures to treat problematic fibroids.
QUESTIONS TO ASK
- How many fibroids do I have, and where are they located?
- How will I know if they're getting bigger?
- Will fibroids affect my sex life?
- After surgery, what are the odds my fibroids will regrow?
fibroid in the uterus. Without blood, the fibroid withers away.
Treatments
Fibroids are virtually never life threatening: they don't develop into cancer, nor do they increase your risk of uterine cancer. For this reason, if you have no symptoms, you may initially want to opt for a wait-and-see approach. This doesn't mean doing nothing, however. You'll need regular pelvic examinations and ultrasounds to monitor any growth, and you'll want to relieve mild symptoms with medications and self-help remedies. On the other hand, more troublesome fibroids--those that cause particularly painful menstrual periods or related pain, or that could potentially interfere with fertility or pregnancy--should be removed. At one time, the traditional treatment for fibroids was the removal of the uterus, a surgical procedure known as a hysterectomy (see on shortly). Today there are a number of less radical procedures to consider first.
Treatment Options
MEDICATIONS
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Anti-inflammatories NSAIDs (Nurofen) for pain and cramps.
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Oral contraceptives Reduce bleeding and spotting.
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GnRH agonists Often used presurgically to shrink fibroids.
PROCEDURES
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Hysterectomy Eliminates fibroids by removing uterus.
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Myomectomy Removes only fibroids; variety of methods.
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UFE Shrinks fibroids by cutting off blood supply.
LIFESTYLE CHANGES
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Increase diet Low-fat, high-fibre reduces fibroid growth.
----------------------------------------------------------------------------------------------------------------------------------------------
Increase Iron Prevents anaemia due to heavy menstrual flow.
TAKING CONTROL
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Anti-inflammatories NSAIDs (Nurofen) for pain and cramps.
------------------------------------------------------------------------------------------------------------------------------------------
Oral contraceptives Reduce bleeding and spotting.
-------------------------------------------------------------------------------------------------------------------------------------------
GnRH agonists Often used presurgically to shrink fibroids.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Hysterectomy Eliminates fibroids by removing uterus.
---------------------------------------------------------------------------------------------------------------------------------------------
Myomectomy Removes only fibroids; variety of methods.
---------------------------------------------------------------------------------------------------------------------------------------------
UFE Shrinks fibroids by cutting off blood supply.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Increase diet Low-fat, high-fibre reduces fibroid growth.
----------------------------------------------------------------------------------------------------------------------------------------------
Increase Iron Prevents anaemia due to heavy menstrual flow.
TAKING CONTROL
- Schedule regular checkups. An annual pelvic examination ensures early detection of fibroids.
- Seek relief with heat. If fibroids cause abdominal pain, supply a heating pad or hot-water bottle.
- Soothe with moves. Yoga exercises can help relieve feelings of heaviness and pressure from fibroids. Look for classes at your local gym or through a health club.
- Put it in writing. Track symptoms, noting periods and heaviness of flow, pain and so on. Then discuss the data with your doctor.
- Ask about endometrial ablation, or removal of the uterine lining, if your chief complaint is very heavy periods. Be aware: this procedure may destroy fertility, and it won't help fibroids.
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