Fibroids are abnormal growths that develop in or on a woman’s uterus. Sometimes these tumours become quite large and cause severe abdominal pain and heavy periods. In other cases, they cause no signs or symptoms at all. The growths are typically benign, or noncancerous. The cause of fibroids is unknown. Fibroids are also known by the following names:
• Leiomyomas
• Myomas
• Uterine myomas
• Fibromas
According to the National Institutes of Health (NIH), about up to 80 percent of women have them by the age of 50. However, most women don’t have any symptoms and may never know they have fibroids.
Types
The type of fibroid a woman develops depends on its location in or on the uterus.
1. Intramural fibroids
Intramural fibroids are the most common type of fibroid. These types appear within the muscular wall of the uterus. Intramural fibroids may grow larger and can stretch your womb.
2. Subserosal fibroids
Subserosal fibroids form on the outside of your uterus, which is called the serosa. They may grow large enough to make your womb appear bigger on one side.
3. Pedunculated fibroids
Subserosal tumours can develop a stem, a slender base that supports the tumour. When they do, they’re known as pedunculated fibroids.
4. Submucosal fibroids
These types of tumours develop in the middle muscle layer, or myometrium, of your uterus. Submucosal tumours aren’t as common as the other types.
Symptoms
Symptoms will depend on the number of tumours as well as their location and size. For instance,
• submucosal fibroids may cause heavy menstrual bleeding and trouble conceiving.
• If your tumour is very small or you’re going through menopause, you may not have any symptoms.
Additional symptoms include:
• Heavy bleeding between or during your periods that includes blood clots
• Pain in the pelvis or lower back
• Increased menstrual cramping
• Increased urination
• Pain during intercourse
• Menstruation that lasts longer than usual
• Pressure or fullness in your lower abdomen
• Swelling or enlargement of the abdomen
Fibroids may shrink during and after menopause. This is because women undergoing menopause are experiencing a drop in their levels of oestrogen and progesterone, hormones that stimulate fibroid growth.
Treatments
Your doctor will develop a treatment plan based on your age, the size of your fibroids, and your overall health. You may receive a combination of treatments.
1. Home remedies and natural treatments
Certain home remedies and natural treatments can have a positive effect on fibroids, including:
• Acupuncture
• Yoga
• Massage
• Gui zhi fu ling tang (gflt), a traditional chinese medicine formula
• Applying heat for cramps (avoid heat if you experience heavy bleeding)
Dietary changes can help as well. Avoid meats and high-calorie foods. Instead, opt for foods high in flavonoids, green vegetables, green tea, and cold-water fish such as tuna or salmon. Managing your stress levels and losing weight if you’re overweight can also benefit women with fibroids.
2. Medications
Medications to regulate your hormone levels may be prescribed to shrink fibroids. Gonadotropin-releasing hormone (GnRH) agonists, such as leuprolide (Lupron), will cause your estrogen and progesterone levels to drop. This will eventually stop menstruation and shrink fibroids. GnRH antagonists, such as ganirelix acetate and cetrorelix acetate (Cetrotide), also help to shrink fibroids. They work by stopping your body from producing follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Other options that can help control bleeding and pain, but won’t shrink or eliminate fibroids, include:
• An intrauterine device (IUD) that releases the hormone progestin
• Over-the-counter (OTC) anti-inflammatory pain relievers, such as ibuprofen (Advil)
• Birth control pills
3. Surgery
Surgery to remove very large or multiple growths may be performed. This is known as a myomectomy. An abdominal myomectomy involves making a large incision in the abdomen to access the uterus and remove the fibroids. The surgery can also be performed laparoscopically, using a few small incisions into which surgical tools and a camera are inserted. Fibroids might grow back after surgery. If your condition worsens, or if no other treatments work, your physician may perform a hysterectomy. However, this means that you won’t be able to bear children in the future.
4. Minimally invasive procedures
A newer and completely noninvasive surgical procedure is forced ultrasound surgery (FUS). You lie down inside a special MRI machine that allows doctors to visualize the inside of your uterus. High-energy, high-frequency sound waves are directed at the fibroids to ablate, or destroy, them.
Similarly, myolysis shrinks fibroids using an electric current or laser, while cryomyolysis freezes the fibroids. Endometrial ablation involves inserting a special instrument into your uterus to destroy the uterine lining using heat, electric current, or hot water. Another surgical option is uterine artery embolization. In this procedure, small particles are injected into the uterus to cut off the fibroids’ blood supply.
