If you are a woman in your reproductive years or even older,
there is an up to 80 per cent chance that you may get fibroids at some stage
in your life, though not everyone will have symptoms.
Dr Joan Okemo, a consultant obstetrician gynaecologist at Aga
Khan University Hospital gives a comprehensive overview of uterine fibroids,
including risk factors, symptoms, diagnosis and treatment options available.
She explains uterine fibroids as a very common non-cancerous
growths that develop in the muscle of the uterus. Though they are common and
typically do not become cancerous, they can cause a range of symptoms depending
on their size, number and location.
Many women may have fibroids without even knowing it,
especially if the fibroids are small. However, for others, fibroids can cause
significant discomfort and complications.
According to Dr Joan, “there are several factors that can
increase the likelihood of developing uterine fibroids. These include age. Fibroids are most common in women between the ages of 30 and 40. Their risk
tends to increase as women approach menopause.”
“Genetic Factors like a family history of fibroids raises
the likelihood of developing them. Women with a mother or sister who has had
fibroids are at a higher risk."
She says that ethnicity is also a factor. Black African women are more likely to develop fibroids, often at a younger age, and may experience more severe symptoms and larger fibroids;.
Hormones are also a factor. High levels of oestrogen and progesterone, which regulate the menstrual cycle, can stimulate the growth of fibroids, she says.
Other risk factors include obesity. She says that women who are overweight or obese are at greater risk of developing fibroids, likely due to higher oestrogen levels produced by fat cells. A diet high in red meat and low in fruits and vegetables may also increase the risk of fibroids.
Women who have had no children or delayed childbirth may be
at higher risk of getting fibroids. This is because pregnancy may reduce the
risk of fibroids, likely due to hormonal changes during pregnancy.
She finally says that some studies suggest that a lack of
vitamin D may contribute to an increased risk of fibroids; Hypertension (High
Blood Pressure), High blood pressure has been linked to an increased risk of
fibroid development.”
Dr Joan opines that fibroids can vary greatly
in size, from tiny growths to very large masses. While some women may have
fibroids without experiencing any symptoms, larger fibroids or a higher number
of fibroids can cause significant discomfort.
She says: “Excessive menstrual bleeding is a common symptom. If you're soaking through a pad or tampon in less than an hour or bleeding for more than eight days, this may be a sign of fibroids. This can lead to iron deficiency anaemia and fatigue. Large fibroids can cause a feeling of fullness or pressure in the pelvic region, sometimes making the abdomen appear swollen or 'pregnant.'"
She explains: “Fibroids can press on the bladder, leading to
frequent urination. When fibroids press on the rectum, they may cause
constipation or alternating constipation and diarrhoea and lastly while many
women with fibroids can get pregnant without problems, fibroids that affect the
shape of the uterus can make conception more difficult.”
She further says that fibroids can also increase the risk of
miscarriage, though age is often a more significant factor. Larger fibroids or
multiple fibroids may increase the risk of pregnancy complications, including
pain, improper baby positioning, the need for a cesarean section (C-section),
and excessive bleeding after birth (postpartum hemorrhage).
Treatment for uterine fibroids Dr Joan says depends on several factors, including the severity of your symptoms, the size and location of the fibroids, your age and whether you want to have children in the future.
Some treatment options focus on symptom management, while others aim to remove
or shrink fibroids which you may ignore if they do not affect your quality of
life.
However, for women experiencing symptoms, several treatment
options are available, including medications, observation, and surgery. While
medications can help manage symptoms, they do not shrink or eliminate fibroids
thus surgical treatment is recommended.
Dr Joan Sys that If medications are not effective, or if
your fibroids are large, surgical treatments may be necessary. She explains the
following processes for complete elimination of the fibroids:
Myomectomy: This is surgery to remove fibroids while leaving
the uterus intact, allowing women to maintain fertility. The approach will
depend on the location and size of the fibroids. While fibroids can return
after surgery, most women do not need additional surgeries.
Uterine Fibroid Embolization (UFE): In this procedure, blood
vessels supplying the fibroids are blocked, causing them to shrink and stop
bleeding. UFE is mainly for women who do not plan to get pregnant in the
future, as it may affect fertility.
Endometrial Ablation: This procedure destroys the lining of
the uterus to stop heavy bleeding. While it can help with bleeding, it does not
shrink fibroids. Pregnancy is not recommended afterward.
Hysterectomy: A hysterectomy is the removal of the uterus and is considered a permanent solution for fibroids. However, this procedure eliminates the possibility of future pregnancies.
