There probably isn't a woman alive who doesn't feel a wave of terror when her doctor mentions the word tumor. But when it's a fibroid tumor, experts say there is little to fear.
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.
In more than 99 percent of fibroid cases, the tumors are
benign (non-cancerous). These tumors are not associated with cancer and do not
increase a woman's risk for uterine cancer. They may range in size, from the
size of a pea to the size of a softball or small grapefruit.
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.
Research has also shown that some factors may protect a
woman from developing fibroids. Some studies, of small numbers of women, have
indicated that women who have had two liveborn children have one-half the risk
of developing uterine fibroids compared to women who have had no child.
Scientists are not sure whether having children actually protected women from
fibroids or whether fibroids were a factor in infertility in women who had no
children. The National Institute of Child Health and Human Development are
conducting further research on this topic and other factors that may affect the
diagnosis and treatment of fibroids.
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:
Ø
Heavy or
prolonged menstrual periods
Ø
Abnormal
bleeding between menstrual periods
Ø
Pelvic
pain (caused as the tumor presses on pelvic organs)
Ø
Frequent
urination
Ø
Low back
pain
Ø
Pain
during intercourse
Ø
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:
Ø
X-ray.
Electromagnetic energy used to produce images of bones and internal organs onto
film.
Ø
Transvaginal
ultrasound (also called ultrasonography). An ultrasound test using a small
instrument, called a transducer that is placed in the vagina.
Ø
Magnetic
resonance imaging (MRI). A non-invasive procedure that produces a
two-dimensional view of an internal organ or structure.
Ø
Hysterosalpingography.
X-ray examination of the uterus and fallopian tubes that uses dye and is often
performed to rule out tubal obstruction.
Ø
Hysteroscopy.
Visual examination of the canal of the cervix and the interior of the uterus
using a viewing instrument (hysteroscope) inserted through the vagina.
Ø
Endometrial
biopsy. A procedure in which a sample of tissue is obtained through a tube
which is inserted into the uterus.
Ø
Blood
test (to check for iron-deficiency anemia if heavy bleeding is caused by
the tumor).
Treatment for
fibroids
Since most fibroids stop growing or may even shrink as a
woman approaches menopause, the health care provider may simply suggest
"watchful waiting." With this approach, the health care provider
monitors the woman's symptoms carefully to ensure that there are no significant
changes or developments and that the fibroids are not growing.
In women whose fibroids are large or are causing significant
symptoms, treatment may be necessary. Treatment will be determined by your
health care provider(s) based on:
Ø
Your overall health and medical history
Ø
Extent of the disease
Ø
Your tolerance for specific medications,
procedures, or therapies
Ø
Expectations for the course of the disease
Ø
Your opinion or preference
Ø
Your desire for pregnancy
In general, treatment for fibroids may include:
Ø
Hysterectomy.
Hysterectomies involve the surgical removal of the entire uterus. Fibroids
remain the number one reason for hysterectomies in the United States.
Ø
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.
Ø
Gonadotropin-releasing
hormone agonists (GnRH agonists). This approach lowers levels of estrogen
and triggers a "medical menopause." Sometimes GnRH agonists are used
to shrink the fibroid, making surgical treatment easier.
Ø
Anti-hormonal
agents. Certain drugs oppose estrogen (such as progestin and Danazol), and
appear effective in treating fibroids. Anti-progestins, which block the action
of progesterone, are also sometimes used.
Ø
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.
Ø
Anti-inflammatory
painkillers. This type of drug is often effective for women who experience
occasional pelvic pain or discomfort.
Disclaimer:
The contents on this site are for
informational purposes only. The Content is not meant to be an alternative for
professional medical advice, diagnosis, or treatment. Always ensure to seek the
advice of your physician or a qualified health professional before starting any
new program.
Sources:
http://obgyn.ucla.edu
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