Fibroids

Fibroids are growths (tumors) that develop from the smooth muscle layer of the uterus. Although fibroids are sometimes called tumors, they are almost always benign (not cancerous). The medical term for fibroids is uterine leiomyomata (you-ter-in lie-oh-my-oh-mah-tah). Fibroids can grow as a single growth or in clusters (or groups). As many as three out of four women have uterine fibroids, but most are unaware of them as they often cause no signs or symptoms. Your doctor may discover them incidentally during a pelvic exam or prenatal ultrasound. Fibroids cause problems for about one in four women, most frequently during their 30s or 40s. This is the reason why fibroids have the potential to enlarge during pregnancy (when increased levels of estrogen are present) as well as to regress after menopause (when there is decreased levels of estrogen). In the past, the contraceptive pill was thought to increase the risk of fibroids, but that was when the pill contained higher levels of oestrogen than it does today. Some studies suggest that the newer combined pill (oestrogen and progestogen) and the mini pill (progestogen only) may actually help prevent or slow the growth of fibroids.

Fibroids are classified by their location (see figure), which effects the symptoms they may cause and how they can be treated.  Uterine fibroids are among the most common tumors in women. Also called fibromyomas, leiomyomas or myomas, uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer. Although the exact cause of fibroids is unknown, they seem to be influenced by oestrogen. This would explain why they appear during a woman's middle years (when oestrogen levels are high) and stop growing after the menopause (when oestrogen levels drop). Women whose close female relatives have fibroids are more likely to develop symptoms, suggesting that the cause is partly genetic. Fibroids are also much more common among African-Canadian women. Most fibroids do not cause any symptoms and many women are unaware that they have them. When they do cause symptoms, it ranges from abnormal bleeding to pelvic pressure.

Causes of Fibroids

The common Causes of Fibroids :

• Many fibroids contain alterations in genes that code for uterine muscle cells.
• Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth.
• Never having given birth to a child (called nulliparity).
• If you are pregnant or taking birth control pills or menopausal estrogens, fibroids may grow more quickly because of the increased estrogen level in your body.
• Estrogen and progesterone, two reproductive hormones produced by the ovaries that stimulate development of the uterine lining in preparation for a possible pregnancy, appear to promote the growth of fibroids. Fibroids contain more estrogen and estrogen receptors than do normal uterine muscle cells.
• Fibroids can cause fertility problems and blood loss, but it has not been known why they develop.
• If a fibroid is large, it can cause a miscarriage, as the foetus gets bigger. Fibroids are the commonest reason for a woman to have a hysterectomy

Symptoms of Fibroids

Some common Symptoms of Fibroids :

• Pelvic cramping or pain with periods.
• pain during sex.
• Increase in urinary frequency.
• Prolonged menstrual periods or bleeding between periods.
• Lower back pain.
• Heavy bleeding or painful periods.
• Sudden, severe pain due to a pedunculated fibroid.
• Constipation.

Treatment of Fibroids

• Treatment for fibroids depends on your symptoms, the size and location of your fibroids, your age (how close you are to menopause), your desire to have children, and your general health.
• A surgical procedure in which the lining of the uterus is destroyed to prevent further bleeding.
• It is frequently the chosen treatment for premenopausal women who want to have children, because it usually can preserve fertility.
• Motrin or other anti-inflammatory medications may be prescribed for pain.
• A new way to treat women with fibroids is called uterine fibroid embolization.
• The choice of treatment depends on factors such as your own wishes and your doctor's medical advice about the size and location of the fibroids.
• A surgical procedure that removes the uterus, and thus, the fibroids.
• This approach uses liquid nitrogen to "freeze" the fibroids.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), which are not hormonal medications, are effective for heavy vaginal bleeding unrelated to fibroids, but they don't reduce bleeding caused by fibroids.
• This operation the removal of the uterus remains the only proven permanent solution for uterine fibroids. But hysterectomy is major surgery. It ends your ability to bear children, and if you elect to have your ovaries removed also, it brings on menopause and the question of whether you'll take hormone replacement therapy.

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