Ask the expert: Here are some frequently asked questions about uterine fibroids

It really isn’t easy being a woman. After all, the play of hormones can cause several bodily changes through their lifetime. One such issue that crops up commonly among women of child-bearing age are uterine fibroids. There are several questions floating in the minds of women, which is why we are here to answer them all! Let’s go!

1.What are uterine fibroids?

Fibroids are most common noncancerous growth or benign tumors along the wall or within the smooth muscle of the uterus. They consist of smooth muscle and fibrous connective tissue. It doesn’t just arise from the myometrial layer, but it can also emanate from the outer layer (subserous) or inner layer (submucous). Fibroids are common and can be seen in women of reproductive or childbearing age. Fibroids can be many and may vary in size and placement. The placement of the uterine fibroids may impact one’s ability to conceive etc. Intramural fibroids are in the myometrium, submucosal fibroids jut into the endometrium (to the uterine cavity), while subserosal fibroids protrude outside.

2.What are the causes that indicate the presence of uterine fibroids?

The cause of fibroids has not been found out yet, but the growth of uterine fibroids can be dependent on the levels of estrogen and progesterone that are being produced and circulated in the blood. Hence, these uterine fibroids may enlarge during pregnancy as a response to the high estrogen levels and the hormones that are generated in the female body. It has been suggested that these uterine fibroids start from a single smooth muscle cell, which is then deviated from normal signals and finally develop into uterine fibroids. 

3.What are the signs and symptoms of uterine fibroids that women should look out for?

Fibroids can cause several gynecological problems and can indicate aggressive forms of surgery like a hysterectomy. Most fibroids are asymptomatic, and one might not be able to figure it out by themselves. One of the most common symptoms of uterine fibroids is abnormal bleeding.. This could either be heavy bleeding during menstrual cycles or inter-menstrual bleeding (bleeding between menstrual cycles). 

Other symptoms of uterine fibroids are less common which are-

• Dyspareunia (pain during sexual intercourse)
• Subfertility (this happens due to distortion in the fallopian tubes or because of submucosal fibroids that interfere with the endometrial cavity which in turn prevents a fertilized egg to be implanted in the uterus)
• Urinary frequency increased.
• Bladder and bowel dysfunction
• Signs of anemia
• Pain in the pelvic region
• Recurrent miscarriages 
• Lower backache
• Painful sexual intercourse
• Painful periods

4. What are the treatment options for uterine fibroids?

Uterine fibroids can be asymptomatic. These asymptomatic fibroids generally do not need any kind of surgery or treatment. They can be in control with moderate therapy. Symptomatic fibroids that can be seen through its signs and symptoms can be treated with medical therapy, radiological therapy, or surgical therapy. The treatment of the uterine fibroids totally depends upon the size and location of the uterine fibroid. Surgical removal of the fibroids is the best mode of treatment. A hysterectomy is not always needed and not always wanted by the patient as well. One should also know that medication and pills are not really a long-term solution for uterine fibroids. 

Surgical methods of treatment include: 

• Hysteroscopic myomectomy: It is a minimally invasive surgery to remove the uterine fibroids, using a hysteroscope. (This includes no surgical incisions and can even enhance the fertility of a woman)
• Myomectomy: This is an invasive surgery to remove the fertility-sparing fibroid. This surgery can be done with a laparotomy or with a laparoscopic technique. Though the laparoscopic technique is viable only for the smaller fibroids. 
• Hysterectomy: This is a very aggressive surgery and a huge step in a woman’s life. Hysterectomy basically means removal of the uterus, which will immediately induce menopause. This surgery means that the woman will no longer be able to bear children, and this is only reserved for women who have completed their family and are no longer willing to have children. 

One should keep a lookout for anything, which is different from the ordinary and get checked as soon as possible. Maintaining a healthy and balanced diet is very important to be healthy.