Fibroids are the non cancerous growth of the uterus that occurs during the child bearing age of a woman. They never develop into cancer. Fibroids do not increase the chance of developing any other cancer of the uterus. They are the most common type of benign tumors in females.
The actual cause for a fibroid to occur is still not fully understood, however, research and clinical experience points to the following factors:-
Genetic changes – mutations in gene cells of the uterine muscle cells
Hormonal causes – hormones like estrogens and progesterone appear to promote the growth of fibroids
Chemical causes – includes substances that helps in tissue maintenance such as insulin-like growth factor
Fibroids in the uterus develop from the muscular tissue of the uterus which is smooth. The cells of this layer multiply several times and eventually create a mass which is pale, firm, rubbery mass and different than the adjoining tissue. The fibroids can be as small as microscopic seedlings to something that can enlarge the uterus or deform it.
Women at reproductive age, heredity, high blood pressure and being of black race some of the risk factors cited for development of uterine fibroids.
Uterine fibroids can be diagnosed on the basis of menstrual history of the patient, pelvic examination, histerosonography, hysteroscopy, histerosalpingography, ultrasonography, biopsy of the endometrium or magnetic resonance imaging.
The ultrasonography may be transabdominal or transvaginal. Transvaginal ultrasound gives better details of the uterus.
If ultrasound does not give sufficient information then Hysteroscopy, Histerosonography, or Histerosalpingography are done.
Blood tests may also be done to rule out other causes.
Most of the times, uterine fibroids do not require any treatment. If there is any discomfort or trouble due to this then they may be treated medically or removed surgically.
There are several treatment options: wait and watch, medications or surgery (hysterectomy, mayomectomy, uterine artery embolization or focused ultrasound surgery).
If the symptoms are not there then it is better to wait and watch.
Medications are given to help shrink the fibroids. Medications are gonadotrophin releasing hormone, androgen, anti-progestin, non-steroidal anti-inflammatory drugs or oral contraceptives.
In hysterectomy uterus is removed and in mayomectomy only fibroids are removed keeping the uterus intact.
Normally uterine fibroids are not dangerous; rarely may they outgrow the uterus on stalk like projections. If they twist around this stalk then there may be severe abdominal pain and surgery may be required. There may be anemia due to excessive bleeding.
Fibroids may break away from uterus and grow at some other places, for example, lungs. Sometimes uterine fibroids may block the Fallopian tubes and affect fertility. Pregnancy with fibroids has higher risk of abortion, bleeding, premature labor or it may hinder with the location of the baby in the uterus. Most of the times, fibroids do not affect pregnancy.
