Fibroids

Fibroids

A fibroid is a swelling that grows in the wall of the womb, or uterus. The swelling is, in fact a benign tumour, ie NOT cancerous or malignant.

The tumour is mainly composed of muscle fibres, and may vary in size from as small as a pea to as large as an orange.

Some fibroids may grow into the cavity of the womb and remain attached to the uterine wall by a stalk. Often, there is more than one fibroid in an affected womb.

Fibroids are quite a common condition, affecting about 25 - 30% of women. They rarely affect teenage girls, and are most common in women aged 35-45 years of age.

The exact cause of fibroids is unknown, but the female hormone oestrogen seems to stimulate their growth. Fibroids enlarge during pregnancy, and whilst taking the oral contraceptive pill, both instances of raised oestrogen levels. During the menopause, decreasing oestrogen levels cause fibroids to shrink.

Small fibroids cause no symptoms, but larger fibroids expand through the inner lining of the womb, causing heavy blood loss at period time and lengthy periods. Regular heavy periods often cause an iron deficiency anaemia. Large fibroids often lead to backache, and may press upon the bladder causing the patient to pass urine frequently, or, even have difficulty in passing urine. Pressure on the bowel can cause constipation.

Fibroids can be a cause of recurring miscarriages or even infertility. Patients with these problems will usually have an ultrasound scan to detect their presence.

A fibroid may produce sudden severe lower abdominal pain, by becoming twisted on its stalk. Only fibroids that cause problems are removed surgically from the womb. If there are several fibroids, or if a single fibroid is very large, the womb may be totally removed. This is an 'hysterectomy'.

Treatments for fibroids
Myomectomy
This is an operation to 'shell' the fibroids out of the wall of the womb (like shelling pees). As the womb itself is preserved, this is an option for women still wanting children. It's often recommended to women with infertility that may be due to fibroids, although there may be scarring that can aggravate infertility problems.

Hormone treatments
Drugs, such as progesterone, can decrease bleeding or shrink the fibroids but the effects may be temporary. Another group of drugs known as LHRH analogues, which suppress oestrogen production and induces an artificial menopause, may be more effective.

Uterine artery embolisation
This involves blocking the blood supply to the fibroids by injecting tiny particles through a small tube guided by x-ray scans. This can shrink tumours by up to 60%.

Hysterectomy
For many women, hysterectomy is the best option because it removes all chance of the fibroids recurring but it is a final step that carries significant risks and may cause an early menopause. Some women find it liberating, while others have problems with depression or lost libido.
Information about Hysterectomy from Dr Chris Steele


This content was created on Mon 31 July 2006

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