What Are Uterine Fibroids: Symptoms, Diagnosis, and Treatment

Fibroids are non-cancerous (benign) tumours that develop in the uterus. What causes fibroids is relatively unknown. However, these abnormal growths can cause severe abdominal pain and heavy periods. The different types of fibroids include; Intramural fibroids – these develop within the muscular wall of the uterus; Subserosal fibroids – these develop outside the uterine lining; Submucosal fibroids – these develop inside the uterine lining.

Uterine fibroids are most prevalent among women under reproductive-age. However, most women don’t experience any uterine fibroids symptoms, and some may not even know if they have fibroids. As such, now that you know what fibroids on uterus mean, let’s look at some of the most common symptoms of fibroids, their diagnostic methods, and fibroids treatment that are recommended based on their severity.

A] What Are The Symptoms of Fibroids?

Menorrhagia (Heavy and Painful Periods)

This is one of the most common uterine fibroid symptoms. Menorrhagia refers to heavy or prolonged menstrual bleeding wherein you have to frequently change your sanitary pad/tampon every couple of hours (or in less than an hour). It can be quite painful, and the passing of blood clots is also quite common.

Lower Back and Pelvic Pain

Most women with large fibroids can experience throbbing to sharp pelvic pain due to the enlarged uterus. Feeling a heaviness or pressure in the lower abdomen or pelvis is common. Also, the pain can be localized to a specific area. Likewise, compared to a small fibroid within the uterine wall, a large fibroid on the back surface of the uterus can cause a ripping sensation in the lower back.

Pain During Sexual Intercourse

Discomfort during sexual intercourse is another sign of fibroids. The severity of the pain may be distinct and localized. In some cases, only certain positions could elicit a painful/uncomfortable response. Thus, whatever might be the case, if you are experiencing pain during sexual intercourse, then it is important to mention it to your healthcare provider.

Frequent Urination and Constipation

Fibroids can also cause frequent urination. In few instances, wherein the fibroids are pressing against the bladder, some women may not be able to urinate despite a full bladder. Similarly, if the fibroids are pressed against the rectum, women may experience painful bowel movements and difficulty in passing stool. In rare instances, fibroids can also lead to hemorrhoids.

Repeated Miscarriage or Fertility Issues

While most women don’t experience any effects of uterus fibroids during pregnancy, research suggests that 10% to 30% of women with uterine fibroids can develop complications during pregnancy. Women with fibroids are also at a higher risk of recurrent miscarriage compared to women without fibroids. Also, fibroids (especially submucosal fibroids) can cause infertility.

B] How Are Uterine Fibroids Diagnosed?

Uterine fibroids are generally found during a routine pelvic examination. A pelvic exam allows your healthcare provider to feel the size and shape of the uterus. If there are any irregularities in the shape or if the uterus is enlarged, fibroids may be present. Other tests for identifying Fibroids include;

Transvaginal Ultrasound Scan

To detect fibroids, your healthcare provider may recommend an ultrasound scan. This diagnostic method helps get a picture of where the fibroids are located in the uterus and how big they are. The ultrasound scan is done either by moving a device over your abdomen or by inserting it into your vagina.

Magnetic Resonance Imaging (MRI)

If your healthcare provider requires more information about the type of uterine fibroids, its size and location, then he might recommend this detailed imaging test. The MRI test also helps the healthcare provider to determine appropriate treatment options.

Hysteroscopy

This procedure can be either diagnostic or operative. For diagnostic purposes, the Hysteroscopy procedure allows your healthcare provider to diagnose problems related to the uterus. For operative purposes, Hysteroscopy is used to remove polyps and fibroids, and it is a minimally invasive surgery.

Hysterosalpingography

This test uses a dye to highlight the uterine cavity and fallopian tubes and takes X-ray images. If infertility is a concern, then your healthcare provider may recommend Hysterosalpingography. This helps the doctor determine if the fallopian tubes are open or blocked. It can also show the growth of submucosal fibroids.

C] What Are The Treatments For Fibroids?

While uterus fibroids pain can be acute, treatment for fibroids is not necessary, as they usually stop growing or shrink during menopause. However, for severe symptoms, some of the recommended treatments are;

Medications

While medications won’t eliminate fibroids, it may shrink them. They help treat the symptoms of fibroids and largely target hormones that regulate the menstrual cycle. Some of the medication recommended are; Gonadotropin-releasing hormone (GnRH) agonists and Tranexamic acid.

Progestin-releasing Intrauterine Device (IUD)

Another uterine fibroids treatment, this helps alleviate the symptoms of fibroid tumours such as heavy bleeding and painful periods. This, however, doesn’t shrink fibroids. Also, an IUD device can prevent pregnancy.

MRI-guided Focused Ultrasound Surgery (FUS)

This is a non-invasive procedure, wherein the surgery is performed while you are inside the MRI scanner and makes use of high-energy ultrasound transducer for the treatment. Once the doctor locates the exact location of the uterine fibroids, he focuses the ultrasound transducer sound waves (sonications) into the fibroid to heat. This helps break down small areas of the fibroid tissue. MRI-guided FUS is a safe and effective method for uterine fibroid treatment.

Uterine Artery Embolization

This is a minimally invasive procedure that can help shrink fibroids and alleviate the symptoms. In this procedure, the radiologist uses a catheter to deliver small particles (embolic agents) into the uterine arteries, which blocks the blood flow, causing the fibroids to shrink and die.

Radiofrequency Ablation

The radiofrequency energy that is used in this procedure helps shrink the blood vessels that feed the fibroids, thereby destroying them. This procedure can be done through laparoscopy or transcervical.

Endometrial Ablation

This is a surgical procedure that is used to destroy (ablate) the endometrial lining of the uterus. This, however, doesn’t shrink the fibroids but can help reduce heavy menstrual bleeding.

Laparoscopic or Robotic Myomectomy

This is a surgical procedure that helps remove small/large fibroids while leaving the uterus in place. Laparoscopic or robotic procedure is completely safe and effective. Also, robotic myomectomy provides the surgeon with a 3D view of the uterus, thereby offering more precision at the time of surgery.

Hysteroscopic Myomectomy

This fibroids treatment is ideal for removing Submucosal fibroids and is a minimally invasive procedure. Read more about Hysteroscopic Myomectomy here.

#Conclusion

Since the causes of uterine fibroids are not determined, there is no way to prevent it. In most cases, uterine fibroids are relatively harmless, and many signs and symptoms of uterine fibroids can be treated by your healthcare provider based on its severity. A healthy diet and lifestyle changes can help lower the risk of uterine fibroids as well as relieve symptoms. And, if you do have fibroids, then consult with an expert who will recommend effective fibroid treatment based on the type of uterine fibroid you may have.

Neha Goel

Neha Goel, a Psychology alumna and MBA graduate from CASS Business School, London, brings together her expertise as a Reiki Practitioner and Practice Manager. She integrates psychology and business strategies to foster holistic well-being and personal development.