FIBROIDS

Fibroids are non- cancerous tumors that grow from the muscle layer of the uterus. They are also known as uterine fibroids, Myomas or Fibromyomas
Roughly 20 to 50 percent of women of reproductive age have fibroids but most go undetected. 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.
Causes
The exact cause of Fibroids is not known it is believed that the growth develops from an aberrant muscle in the uterus whose growth is enhanced by the influence of estrogen.

Who are at risk to get fibroids :
• pregnancy
• a family history of fibroids
• age of 30 or older
• African-American
• Obesity
• Women approaching menopause
Types of Fibroids:
Intramural Fibroids: Fibroids in the wall of the uterus
Subserosal Fibroids: Fibroids on the outside of the uterus, they are usually visible and make the womb bigger on one side

Pedunculated fibroids: Subserosal tumours that develop a stem, a slender base that supports the tumor are known as pedunculated fibroids.

Submucosal fibroids: These types of tumors develop in the middle muscle layer, or myometrium, of your uterus. Submucosal tumors aren’t as common as the other types.

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:
• Heavy or prolonged menstrual periods
• Abnormal bleeding between menstrual periods
• Pelvic pain (caused as the tumor presses on pelvic organs)
• Frequent urination
• Low back pain
• Pain during intercourse
• 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.
Diagnosis of Fibroids
• X-ray. Electromagnetic energy used to produce images of bones and internal organs onto film.
• Transvaginal ultrasound (also called ultrasonography). An ultrasound test using a small instrument, called a transducer, that is placed in the vagina.
• Magnetic resonance imaging of the Pelvis (MRI). A non-invasive procedure that produces a two-dimensional view of an internal organ or structure.
• Hysterosalpingography. X-ray examination of the uterus and fallopian tubes that uses dye and is often performed to rule out tubal obstruction.
• Hysteroscopy. Visual examination of the canal of the cervix and the interior of the uterus using a viewing instrument (hysteroscope) inserted through the vagina.
• Endometrial biopsy. A procedure in which a sample of tissue is obtained through a tube which is inserted into the uterus.
• 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.” 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.
• Your overall health and medical history
• Extent of the disease
• Your tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease
• Your opinion or preference
• Your desire for pregnancy
In general, treatment for fibroids may include:
• Hysterectomy. Hysterectomies involve the surgical removal of the entire uterus. Fibroids remain the number one reason for hysterectomies in the United States.
• 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.
• 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.
• 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.
• 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.
• Anti-inflammatory painkillers. This type of drug is often effective for women who experience occasional pelvic pain or discomfort.

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