Fibroid Uterus

Overview

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A fibroid uterus, or uterine leiomyoma, is a benign tumor composed of smooth muscle and fibrous tissue that develops in the uterus. Fibroids can vary in size and number, and while they are often asymptomatic, they can cause various health issues in some women.

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Symptoms
  • Heavy Menstrual Bleeding: Prolonged or excessive menstrual bleeding (menorrhagia).
  • Pelvic Pain: Discomfort or pain in the pelvic region, which may vary in intensity.
  • Pressure Symptoms: Increased frequency of urination or difficulty emptying the bladder, pressure on the rectum leading to constipation.
  • Menstrual Irregularities: Changes in the menstrual cycle, including irregular periods.
  • Infertility: In some cases, fibroids may contribute to difficulties in conceiving.
Complications
  • Anemia: Due to heavy menstrual bleeding, leading to fatigue and weakness.
  • Pregnancy Issues: Potential complications during pregnancy, including increased risk of cesarean delivery, preterm birth, and placental abruption.
  • Degeneration: In some cases, fibroids can outgrow their blood supply, leading to degeneration and severe pain.
  • Torsion: If a fibroid is pedunculated (attached by a stalk), it may twist, causing acute pain.
Causes

The Exact Cause of Fibroids is not known, But they are Thought to be Influenced by

  • Hormones: Estrogen and progesterone appear to promote fibroid growth.
  • Genetic Factors: A family history of fibroids may increase the likelihood of developing them.
  • Other Growth Factors: Substances that help the body maintain tissues may also play a role.
Prevention

There is no Guaranteed way to Prevent Fibroids, But Maintaining a Healthy Lifestyle may Help Reduce Risk Factors

  • Weight Management: Maintaining a healthy weight can lower the risk.
  • Diet: A balanced diet rich in fruits, vegetables, and whole grains may be beneficial.
  • Regular Exercise: Physical activity can help regulate hormones and overall health.
Risk Factors
  • Age: Most common in women of reproductive age, especially in their 30s and 40s.
  • Family History: Increased risk if a close relative has had fibroids.
  • Ethnicity: Higher prevalence in African American women.
  • Obesity: Being overweight increases the risk of fibroids.
  • Hormonal Factors: Early onset of menstruation or late menopause may increase risk.
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How is it treated?

Observation

  • If fibroids are asymptomatic, a watch-and-wait approach may be taken.

Medications

  • Hormonal treatments (like birth control pills) can help manage symptoms.
  • GnRH agonists can shrink fibroids temporarily.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) may alleviate pain and reduce bleeding.

Surgical Option

  • Myomectomy Surgical removal of fibroids while preserving the uterus, ideal for women wishing to maintain fertility.
  • Hysterectomy: Complete removal of the uterus, usually recommended for women with significant symptoms or who do not wish to preserve fertility.
  • Uterine Artery Embolization (UAE): A minimally invasive procedure that reduces blood flow to fibroids, causing them to shrink.
  • Treatment decisions depend on the size and location of fibroids, symptoms, and a woman's reproductive plans. Regular follow-ups with a healthcare provider are important for monitoring and managing fibroids.
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How is it Diagnosed?

Fibroid uterus, or uterine fibroids, are non-cancerous growths in the muscular wall of the uterus. Diagnosis typically begins with a detailed medical history and physical examination. Women often report symptoms like heavy menstrual bleeding, pelvic pressure, frequent urination, or infertility. During a pelvic exam, a gynecologist may detect an irregular or enlarged uterus suggestive of fibroids.

The primary diagnostic tool is ultrasound, particularly transvaginal ultrasound, which provides clear imaging of the uterus and can confirm the presence, number, size, and location of fibroids. In cases requiring further detail, Magnetic Resonance Imaging (MRI) is used to assess fibroid characteristics and guide treatment plans, especially if surgical intervention is being considered.

Other useful diagnostic methods include hysterosonography (saline infusion sonography), which enhances ultrasound imaging by filling the uterine cavity with saline, and hysteroscopy, which allows direct visual examination of the uterine cavity using a thin, lighted scope.

Blood tests may also be performed to rule out other causes of abnormal bleeding, such as anemia or hormonal imbalances. In some cases, especially where malignancy is suspected or when the diagnosis is unclear, an endometrial biopsy may be conducted.

Overall, accurate diagnosis of fibroid uterus combines clinical evaluation with imaging studies, ensuring that the treatment approach ranging from watchful waiting to surgery or hormonal therapy is well-informed and personalized.

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