What are fibroids?
Fibroids – also known as leiomyomas and uterine myomas – are growths which develop in and around the uterus (womb). They are non-cancerous, can vary in size, and consist of fibrous tissue and muscle.
There are several different types of fibroids – intramural fibroids, which are the most common, and develop in the womb’s muscle wall; submucosal fibroids, which grow into the womb cavity from the muscle layer beneath the inner lining; and subserosal fibroids, which can become large, and develop outside the womb’s wall into the pelvis.
In some cases fibroids are asymptomatic, which means women are not aware that they have them.
What are the causes of fibroids?
Although the direct cause of fibroids is not yet known, they have been linked to levels of oestrogen, which is the female reproductive hormone. Fibroids typically develop in women in the age range of 16 to 50, which are the reproductive years in which oestrogen levels are higher. When oestrogen levels drop, such as in the post-menopause period, fibroids can shrink.
While in many cases, fibroids are asymptomatic, around one in three women are understood to experience symptoms. These can include; abdominal pain, periods which are painful or heavy, needing to urinate frequently, back pain, pain during sex, and constipation.
Who is at risk of developing fibroids?
It has been found that fibroids are most common for women aged in the 30 to 50 age range. Approximately one in three women will develop fibroids at some point. Women of African-Caribbean descent are understood to be more likely to develop fibroids. The same applies to women who are obese or overweight, due to their increased oestrogen levels. Conversely, women who have given birth are less likely to develop fibroids, with risk decreasing continually according to the number of children a woman has had.
Diagnosis of fibroids
When a doctor suspects fibroids, they will typically make a physical examination of the pelvis as a first step. Further tests which can help to confirm a diagnosis of fibroids include an ultrasound scan, a laparoscopy, a hysteroscopy and in some cases, a biopsy.
Treatments for fibroids
In many cases, treatment may not be needed for fibroids with little or no symptoms. Medications prescribed to treat fibroids can include levonorgestrel intrauterine system, injected progestogen, tranexamic acid, anti-inflammatory medicines and the contraceptive pill.Non-surgical procedures to treat fibroids can include endometrial ablation, uterine artery embolisation (UAE) and endometrial ablation, as well as new MRI guided procedures. Surgical procedures can include a hysterectomy, hysteroscopic resection of fibroids, myomectomy, and hysteroscopic morcellation of fibroids.