What are fibroids?
Fibroids are the most frequently seen tumors of the female reproductive system. Fibroids, also known as uterine myomas, leiomyomas, or fibromas, are firm, compact tumors that are made of smooth muscle cells and fibrous connective tissue that develop in the uterus. It is estimated that between 20 to 50 percent of women of reproductive age have fibroids, although not all are diagnosed. Some estimates state that up to 30 to 77 percent of women will develop fibroids sometime during their childbearing years, although only about one-third of these fibroids are large enough to be detected by a health care provider during a physical examination.
What causes fibroid tumors?
While it is not clearly known what causes fibroids, it is believed that each tumor develops from an aberrant muscle cell in the uterus, which multiplies rapidly because of the influence of estrogen.
Who is at risk for fibroid tumors?
Women who are approaching menopause are at the greatest risk for fibroids because of their long exposure to high levels of estrogen. Women who are obese and of African-American heritage also seem to be at an increased risk, although the reasons for this are not clearly understood.
What are the symptoms of fibroids?
Some women who have fibroids have no symptoms, or have only mild symptoms, while other women have more severe, disruptive symptoms. The following are the most common symptoms for uterine fibroids, however, each individual may experience symptoms differently. Symptoms of uterine fibroids may include:
*Heavy or prolonged menstrual periods
*Abnormal bleeding between menstrual periods
*Pelvic pain (caused as the tumor presses on pelvic organs)
*Low back pain
*Pain during intercourse
*A firm mass, often located near the middle of the pelvis, which can be felt by the physician
In some cases, the heavy or prolonged menstrual periods, or the abnormal bleeding between periods, can lead to iron-deficiency anemia, which also requires treatment.
How are fibroids diagnosed?
Fibroids are most often found during a routine pelvic examination. This, along with an abdominal examination, may indicate a firm, irregular pelvic mass to the physician. In addition to a complete medical history and physical and pelvic and/or abdominal examination, diagnostic procedures for uterine fibroids may include:
*X-ray: Electromagnetic energy used to produce images of bones and internal organs onto film.
*Transvaginal ultrasound (also called ultrasonography): An ultrasound test using a small instrument, called a transducer, that is placed in the
*Magnetic resonance imaging (MRI): A non-invasive procedure that produces a two-dimensional view of an internal organ or structure.
*Hysterosalpingography: X-ray examination of the uterus and fallopian tubes that uses dye and is often performed to rule out tubal
*Hysteroscopy: Visual examination of the canal of the cervix and the interior of the uterus using a viewing instrument (hysteroscope)
inserted through the vagina.
*Endometrial biopsy: A procedure in which a sample of tissue is obtained through a tube which is inserted into the uterus.
*Blood test (to check for iron-deficiency anemia if heavy bleeding is caused by the tumor).
Treatment for fibroids
Treatment for fibroids may include:
Hysterectomy: Hysterectomies involve the surgical removal of the entire uterus(womb).
Conservative surgical therapy: Conservative surgical therapy uses a procedure called a myomectomy. With this approach, physicians will remove the fibroids, but leave the uterus intact to enable a future pregnancy. This has a minimal chances of complications.
Uterine artery embolization: Also called uterine fibroid embolization, uterine artery embolization (UAE) is a newer minimally-invasive (without a large abdominal incision) technique. The arteries supplying blood to the fibroids are identified, then embolized (blocked off). The embolization cuts off the blood supply to the fibroids, thus shrinking them. Health care providers continue to evaluate the long-term implications of this procedure on fertility and regrowth of the fibroid tissue.
Anti-inflammatory painkillers: This type of drug is often effective for women who experience occasional pelvic pain or discomfort. This has a significant side effect.
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