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Effective Management of Uterine Fibroids

Uterine fibroids are usually non-cancerous (benign) growths that are made up of the muscle and connective tissue growing from the wall of the uterus. These growths are also called leiomyomas or myomas. Uterine fibroids seldom develop into cancer and do not increase the risk of being affected by uterine cancer. However, the dangers of fibroids are many even though not fatal. This is why the management of uterine fibroids is required. In this blog by Dr. Banker, Gujarat, let us discuss signs and symptoms of uterine fibroids, reasons for fibroids, diagnosis, and treatment for the same.
 

Fibroids in the uterus: A basic understanding
 
Before we get into the management of fibroids, let us first understand what exactly they are. The normal size of a uterus is similar to that of a mango. Fibroids can grow as a singular nodule or in clusters. These clusters can vary in size from 1mm to larger than 20cm or 8 inches in diameter or larger. To draw a parallel, they are capable of becoming the size of a muskmelon. Fibroid cyst in the uterus grows within the walls, inside the cavity, and on the lining of the wall. They can vary in size, number, and area of growth within and on the uterus. Some fibroids are very small and may not be noticeable; others can affect the size and shape of your uterus.
 

Can there be different types of fibroid cyst in the uterus?
 
Management of uterine fibroids begins with understanding that there are various types. The types of fibroids are classified depending on their location in/on the uterus.
 

  • Intramural fibroids: This is the most common type of fibroids in the uterus. They grow within the wall of the uterus. They can grow in size and expand one’s uterus.
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  • Subserosal fibroids: These are present on the outside of the uterus also known as the serosa. They are capable of growing very large and make your womb appear larger on the side of growth.
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  • Pedunculated fibroids: Subserosal fibroids are capable of developing a stem that supports the fibroid. When this is the case, it is known as pedunculated fibroids.
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  • Submucosal fibroids: These fibroids develop in the myometrium (middle layer) of the uterus and project into the uterine cavity. These are not as common as the others mentioned above.

 
Reasons for fibroids
 
Reasons for fibroids can be many, one must consider several factors before treatment. Some of the reasons can be:
 

  • Hormones – Estrogen and progesterone help in thickening the line of the uterus. Both of these hormones affect the growth of these fibroids. When the production of these hormones decreases, cases have shown that these fibroids do shrink in size.
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  • Genetics – Genetic mutations can also be the reason for fibroids. As they are different from normal cells, they can cause abnormalities.
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  • Family history – A person who has a mother or sister with uterine fibroids is also likely to get affected.
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  • Diet – Alcohol consumption, meat-eating has been shown to put women at the risk of getting uterine fibroids.
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  • Getting your period at a very young age can also be a risk factor

 

Signs and symptoms of uterine fibroids
 
The most important part of the management of uterine fibroids is to pay attention to all indicators. Signs may vary depending on the size or number of uterine fibroids you have. The location of the growth also matters.
 

Symptoms of fibroids are as follows:
 

  • Heavy flow during menstruation. Clotting or clumps of the blood being expelled during your periods
  • Pain in the pelvic area or lower back
  • Severe menstrual cramps
  • Increased urination
  • Pain during intercourse
  • Longer cycles of menstruation
  • Swelling of the abdomen area
  • Fullness felt in the lower abdomen
  • Infertility

It must be noted that signs and symptoms of uterine fibroids may vary from person to person. If you or your loved one is noticing any of these indicators, then it is recommended to visit a doctor as soon as possible. You can do a simple google search of “Fertility specialists near me” and find expert doctors such as Dr. Manish Banker, Ahmedabad. Ensure that the clinic you visit follows all health and safety regulations ordered by the state for the Covid-19 pandemic.

 
How are uterine fibroids diagnosed?
 
The first step to the management of uterine fibroids is diagnosis. Very often, when you visit the doctor and talk about your symptoms, they may be alerted and consider the diagnosis of your uterus. There are several tests to detect if you have uterine fibroids, they are as follows:
 

  • Ultrasonography: This imaging test produces a picture of your organs through sound waves. Depending on the size of the patient’s uterus, the ultrasound will be performed transvaginally or through a transabdominal method. A transvaginal ultrasound is more accurate for its diagnosis.
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  • MRI: This imaging test uses radio waves and magnets to produce a clear picture of your uterus. Doctors may suggest this if you have a large uterus or in some specific conditions.
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  • Hysteroscopy: During this test, a scope (which is a thin, flexible tube) will be passed through your vagina and cervix which will be transferred gently inside your uterus. This helps in capturing the fibroids directly.
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  • Hysterosonography: In this procedure, saline is inserted into your uterine cavity to make it larger and then sonography is performed. This helps professionals see fibroids cyst in the uterus.

 

Management of uterine fibroid: Treatment options
 
There are several ways to treat fibroids. It depends on various factors such as the patient’s age, symptoms, if they want to conceive a baby in the future, location of the fibroids etc.
 
Observation: Fibroids are quite common in all women and not all women with fibroids need treatment, irrespective of the size. If you show mild or light symptoms, your doctor may ask you to wait and observe. They may shrink and disappear after menopause.
 

Medication: Medications for fibroids treat the symptoms they cause. They do not go away but can be shrunk through drugs. Oral birth control can help with reducing heavy bleeding. Vitamins and iron supplements can help with anemia, which can be one of the dangers of fibroids if left untreated. Gonadotropin-releasing hormone (GnRH) puts a person in temporary menopause blocking estrogen and progesterone. GnRH helps in shrinking fibroids. IUD devices with progestin can be inserted into your uterus which helps with heavy bleeding.
 

Surgery: If you have severe symptoms or the fibroid is distorting the shape of the uterine cavity making it difficult to conceive, then you may undergo the following surgeries for the management of uterine fibroids.

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  • Myomectomy – The best option for people who wish to get pregnant in the future. It leaves the healthy tissues and removes only the fibroids. This is usually done with the help of laparoscopy and hence leaves only a few small scars on the abdomen.
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  • Hysteroscopic Resection – Fibroids which have a major component inside the uterine cavity can be removed with the help of hysteroscopy.
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  • Endometrial ablation – Using various technological medical equipment like microwaves, laser, etc, professionals may remove the lining of the uterus. This is a minor surgery. Ideally, you will stop having periods after the surgery.
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  • Hysterectomy – This completely removes the uterus and along with it the fibroids. This is usually advocated in women near their menopause who present with severe symptoms.

 

IVF in patients with Fibroids
 
Having a fibroid does not mean you cannot undergo an IVF treatment. If the fibroid is small and not impacting the uterine cavity, a successful pregnancy can be achieved in these women. In cases where the fibroid is large or is distorting the cavity, one might need corrective surgery first before undergoing IVF.
 

Are there any home remedies for uterine fibroids?
 
During the management of uterine fibroids, one may also consider if there are any home remedies. According to studies, the consumption of red meat increases one’s chances of uterine fibroids. So does consumption of alcohol. Eating excess carbohydrates, sugary foods all can trigger growth in fibroids, due to the production of insulin. Home remedies for uterine fibroids include inculcating habits that improve women’s reproductive health like including foods that boost fertility, exercising, weight loss, etc. Exercising and weight loss are important because they help regulate the production of insulin. Other home remedies for uterine fibroids include consumption of clean, organic milk and dairy which contain calcium, magnesium, and phosphorus. These nutrients can stop the growth of fibroids.
 

Conclusion
 
Only your doctor can determine the severity of your condition. Depending on this, they may suggest medication, surgery, or observational treatment. In women with infertility, IVF can give good results. If certain fibroids are left untreated, they may cause anemia and complications during pregnancies. They also disrupt menstrual cycles. Before taking any supplements or birth control for the management of uterine fibroids, do consult your doctor. Most importantly, if you notice any sign or indication of deteriorating reproductive health, please visit the doctor as soon as possible. To read more useful blogs, visit our blog page. If you would like to visit Dr. Manish Banker, the top IVF specialist in Gujarat, then you can book your slot in 2 mins on our website. We take all safety precautions for the patients for the COVID-19 pandemic.

 
 
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FAQs
 

    1. What are uterine fibroids?
    Uterine fibroids are benign (non-cancerous) growths that can grow in or on the wall of the uterus. They may vary in size and numbers. However, management of symptomatic uterine fibroids is required to avoid disruptions in menstrual cycles, complications during pregnancies, anemia, etc.
     

    2. What happens if fibroids are left untreated?
    Some of the dangers of uterine fibroids include heavy menstrual cramps, pelvic pain, complications during pregnancy, severe anemia, etc. Small and asymptomatic fibroids can be left untreated as they usually do not interfere with reproductive health. Larger or symptomatic fibroids need attention to get relief from these ill effects.
     

    3. What is the best treatment for uterine fibroids?
    There is no ‘best’ treatment in treating a fibroid. Asymptomatic fibroids can be left alone and symptomatic ones must be corrected. IVF with small fibroids, or with fibroids not distorting the cavity can give good results.
     

    4. Can you have successful pregnancy fibroids?
    Women with large fibroids or with fibroids impacting the endometrial cavity might need surgical correction. Small or asymptomatic fibroids can be left untreated and do not pose a problem. Women who are seeking IVF treatments need not worry about small fibroids.

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