Fibroids are muscular tumours that develop in the uterine (womb) wall. They are non-cancerous growth that often appears during childbearing years. They can develop as a single tumour or as several tumours that can range in size from an apple seed to a grapefruit in the uterus. Some women with fibroids experience no symptoms, while others may struggle to cope with their symptoms. According to the Journal of Women’s Health, 25 to 50 per cent of women with fibroids have symptoms like heavy menses, reproductive issues, increased urinary frequency, anemia, and abdominal pain.
Dr Nirmala M, Consultant Obstetrician, Gynecologist, and Fertility Specialist Motherhood Hospitals, Whitefield, Bengaluru, shares how to manage if you experience abdominal pain due to fibroids.
Before we get into the pain solutions, let us understand the causes of fibroids. These are benign tumors that develop on the uterine linings or walls. Though there is no particular cause that has been fully understood, there might be multiple factors that can contribute to the development of fibroids. Some of these factors are:
1. Obesity: Excess body fat tends to increase the estrogen levels in the body. This makes obese women more likely at risk of developing fibroids.
2. Hormonal imbalance: It has been determined that fibroids have more estrogen and progesterone receptors than typical uterine muscle cells, which raises the possibility that these hormones may be involved in the growth and development of fibroids. Age, pregnancy, and specific drugs can all affect these hormones’ levels, which in turn can affect how quickly fibroids grow.
3. Family History: Women with a family history of fibroids tend to be more at risk of developing fibroids themselves. This suggests that there might be genetic influence and a hereditary factor causing fibroids.
4. Age: Age also plays a crucial role as a factor. Fibroids are more likely seen in people approaching menopause which says that women who are of the age group of 45-55 are more susceptible to fibroids.
Fibroids might cause women to have abdominal pain for several reasons. It mostly depends on its location, size, and the number of fibroids present. Dr Nirmala says, “Fibroids tend to grow big, putting pressure on nearby organs, and causing severe abdominal pain. They can outgrow their blood supply chain degenerating or breaking down the tissue. The pain maximises during the menstruation period, causing heavy bleeding and severe abdomen pain.”
However, you should keep in mind that fibroids are not the only reason for abdominal pain. It can be because of indigestion, or constipation. So, check out if that’s the case with you.
Here are 5 tips to manage the abdominal pain caused due to fibroids:
Fibroids cause inflammation that can immobilize the area and using a heating pad on the lower abdomen can help reduce pain to some extent by increasing mobility. It helps to relax tense muscles and relieve cramping.
Also read: Did you know fibroids can lead to infertility? Here’s what you need to know
A balanced diet is essential because it helps to minimise inflammation, which in turn helps to lessen pain. According to Dr Nirmala, eating a lot of cruciferous vegetables like broccoli and cabbage, as well as fruits like apples and tomatoes, may help reduce the risk of getting fibroids. Increase your protein, whole-grain, and vitamin D intake as well. In addition to this, avoid processed foods, red meat, and goods with a lot of dairy and sugar to stop the fibroids from getting worse.
One of the elements that can exacerbate the pain of fibroids is stress. Practicing certain relaxation techniques like yoga, meditation, massage, acupuncture, etc. has been proven effective in fighting pain. For additional pain relief, try lying on your side with your legs close to your chest.
Alcohol consumption can increase the severity and duration of common fibroid symptoms. Therefore, reducing your alcohol intake may help you cope with some of the worst fibroid symptoms.
Your doctor may advise taking an over-the-counter nonsteroidal anti-inflammatory medicine (NSAID), such as ibuprofen or naproxen to help decrease the shooting pain. NSAIDs can also lessen fibroids-related excessive menstrual flow.
Treatment of fibroids depends upon several factors such as the size, intensity of pain, location, age, and their wish to conceive in the future. Some proven treatment methods, according to Dr Nirmala, are:
1. Medication: Hormonal medications such as birth control pills can reduce fibroids but can alleviate symptoms like heavy bleeding and pelvic pain. The purpose of the medications is to shrink the fibroids by targeting hormones that regulate the menstrual cycle.
2. Gonadotropin-releasing hormone (GnRH) medications: Usually used for three to six months, this medication treats fibroids by preventing the production of hormones like estrogen and progesterone, resulting in a temporary menopause-like state where the fibroids shrink and anaemia improves.
3. Progestin-releasing intrauterine device (IUD): This form of medication helps relieve heavy bleeding caused by fibroids. Even though this progestin-releasing IUD may not make fibroids shrink or disappear, it helps provide relief.
4. Other medications: In cases of anaemia due to heavy bleeding, doctors suggest iron supplements and vitamins, which help alleviate the symptoms of anaemia. Before undertaking any form of medication, it is important to consult the doctor to discuss any possible side effects or complications.
When medications do not improve the condition of the fibroids, there are surgical methods to consider which also depend upon factors like fibroids size, location, and future pregnancy plans of a patient. Creating a treatment plan under these conditions is essential because some surgical options preserve the uterus and allow pregnancy in the future, while other options can either damage or remove the uterus.
These are a few surgical treatments for a patient who is planning for future pregnancies:
1. Myomectomy is a surgical operation in which the fibroids are removed while the uterus is still in place. There are a few surgical methods to treat fibroids depending on the size, number, and location.
2. In Laparoscopy, small incisions are made in the abdomen through which a scope is inserted to remove the fibroids.
3. In hysteroscopy, a scope cuts away the fibroids which are inserted through the vagina and cervix into the uterus.
4. Open incisions like laparotomy where the incision is made in the abdomen can all be used to remove the fibroids.
In cases where the individual does not consider future pregnancies, a few surgical measures that can help treat fibroids effectively are:
1. Uterine fibroid embolization: UFE is a minimally invasive therapy that includes obstructing the blood vessels that the fibroids use to receive minuscule particles, which causes the fibroids to contract and eventually die.
2. Hysterectomy: Hysterectomy is a surgical process in which the entire uterus is removed. This is the most effective method of treating uterine fibroids, and it is frequently suggested to women who no longer want to become pregnant.
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