Treatment Options for Fibroids of Uterus

By: Blossomivf India


Fibroids are non-cancerous tumors of the uterus (womb). Fibroids grow out of the cells that make up your uterus. Uterine fibroids (also called myomas or leiomyomas) are benign (noncancerous) tumors of muscle tissue that can change the shape or size of the uterus and sometimes the cervix. They start in the smooth muscle cells inside the wall of the uterus (myometrium). Fibroids usually occur in the form of multiple tumors, although single fibroids are sometimes possible. Fibroids can be as small as a pea or as large as a football. Having uterine fibroids does not increase your risk of cancer. They are almost always benign, no matter how large they get.

The fact that approximately 20% to 50% of women suffer from the symptoms generated by fibroid tumors at some stage of their lives suggests that they are quite common growths in the reproductive system of a woman. Age is a factor. Fibroids are more common in women who are 35 years of age or older. Women under the age of 20 rarely have fibroids. These tumors of the uterus tend to shrink after menopause. Studies indicate that black women are nine times more susceptible to fibroids than white women. Furthermore, women who are overweight are more likely to have fibroids because of higher levels of estrogen. No one knows exactly what causes uterine fibroids. But the hormones that regulate your periods, particularly estrogen, are known to play a part. Fibroids increase in size slowly over the years. But when estrogen level in the body rises the rate of growth increases. The exact cause of uterine fibroids is unclear, but there is evidence that it may be a combination of genetic, hormonal, and environmental factors.

Not all fibroids are the same, and they're categorised based on where they are located. Fibroids are usually found in or around the body of the uterus, but they sometimes occur in the cervix. Fibroids within the uterus can be divided into three categories: subserous (located in the outer wall of the uterus); intramural (found in the muscular layers of the uterine wall); and submucous (protruding into the uterine cavity). In addition, fibroids can be connected to the uterus through a stalk (pedunculated), or fibroids can be attached to nearby organs, like the bladder and bowel, or the ligaments surrounding the uterus. About 55% of fibroids are subserosal; 40% are intramural; and 5% are submucosal. Fibroids are rarely found outside the pelvic cavity.

Large intramural fibroids may alter the blood flow to the uterine lining and may also alter the shape of the uterine cavity. Subserosal fibroids usually don't alter the shape of the uterine cavity, but when large can cause discomfort. The only type that is supposed to have a large impact on reproductive function (unless they are large or numerous) is the submucous type that pushes in to the uterine cavity. These are much less common than the other 2 types of fibroids. Because of their location inside the uterine cavity, submucous fibroids can cause fertility problems and miscarriages. Submucous fibroids can often be surgically resected to improve fertility.

Diagnosis of the Fibroids: Fibroids are very common. About 25 percent of women in their childbearing years will have signs of fibroids that can be detected by a pelvic examination, although not all will experience symptoms. Your medical history and a pelvic exam are necessary in diagnosing fibroids. Listed below are tests that may also be used to confirm the diagnosis:

1) Ultrasound - a scan that uses high frequency sound waves to detect fibroids in and around the uterus and cervix
2) Hysterosalpingogram - a procedure that uses x-rays and a special dye to detect fibroids on the inside of your uterus and to see if your fallopian tubes are open
3) Hysteroscopy - a procedure in which your doctor uses a narrow fiber optic telescope inserted into the uterine cavity to look for and sometimes remove fibroids
4) Laparoscopy - a procedure in which your doctor uses a narrow fiber optic telescope inserted through an incision near your navel to look for and sometimes remove fibroids

What symptoms are experienced if fibroids exist?

The severity of symptoms will depend on the number, size, and location of the fibroids. You may experience severe, painful cramps and abnormal or excessive bleeding, especially during your periods. Also, you may have difficulty with moving your bowels or urinating if you have fibroids that are putting pressure on your rectum or bladder. Hemorrhoids may also develop if you become constipated. However, if your fibroids are small, you may not have any symptoms at all. In fact, you may not know that you have fibroids until you go through infertility testing.

What treatments are available to cure fibroids?

Fibroids can be treated surgically or with medications. Fibroids can be removed during a laparoscopy, hysteroscopy, or through an open incision (myomectomy). Medications that stop or interfere with your body's estrogen production are used to shrink fibroids and prevent them from growing larger. Once the medication is stopped, the fibroids will regrow. Medication is mainly used for treatment prior to surgery. However, you can only use these medications for a few months - long-term use may increase your risk of bone loss. Keep in mind that treatments do not provide a cure - new fibroids can grow after treatment. Most fibroids are usually small, asymptomatic, and don't require treatment. These benign tumors only need close gynecological observation to document changes in size or the early onset of symptoms.

Fibroid Symptoms

Common symptoms associated to fibroids are back pain, abdominal pressure or discomfort, urinary frequency, rectal pressure or discomfort, and periods that can be painful, heavy and prolonged, Difficulty emptying your bladder and constipation. Rarely, a fibroid can cause acute pain when it outgrows its blood supply.

Does fibroid decrease fertility?

Uterine fibroids are common, and they are found in 5-10% of infertile women. When all other causes of infertility are excluded fibroids may account for only 2 to 3% of infertility cases. Certain types of fibroids are known to decrease fertility. They include fibroids that are inside the uterine cavity and very large fibroids (>6 cm in diameter) that are located within the wall of the uterus. Because most women with fibroids will not be infertile, they and their partners should have a thorough evaluation to detect other problems that can decrease fertility. A fertility specialist can help determine if fibroids might be hampering their ability to conceive.

There are several explanations for why uterine fibroids may reduce fertility.

1) Changes in the position of the cervix due to fibroids located above it may affect the number of sperm that can travel through the cervix.
2) Changes in the shape of the uterus can interfere with sperm movement.
3) Blockage of the fallopian tubes by the fibroids.
4) Affecting the blood flow to the uterine cavity where the embryo would implant.
5) Changes in the uterine muscle that prevents movement of the sperm or the embryo.

If you have a fibroid problem, there are several treatments to consider. Fibroids can be surgically removed, the blood supply to fibroids can be cut off, the entire uterus can be removed, or medicine can temporarily shrink fibroids. Your choice will depend on whether you have severe symptoms and whether you want to preserve your fertility. If you have uterine fibroids but you have few or no symptoms, you don't need treatment. Instead, your doctor will recommend watchful waiting. This means that you will have regular pelvic exams to check on fibroid growth and symptoms. Talk with your doctor about how often you will need a checkup. If you are nearing menopause, watchful waiting may be an option for you, depending on how tolerable your symptoms are. After menopause, your estrogen and progesterone levels will drop, which causes most fibroids to shrink and symptoms to subside.

It is an impression that fibroids contribute to infertility and there are instances that shows that previously infertile women conceived after their fibroids had been removed. However there are no strong evidence of causation, so whether fibroids do cause infertility, and therefore whether they should be removed, is still uncertain.

You should call your doctor if you have heavy bleeding, increased cramping, or bleeding between periods or if you feel fullness or heaviness in your lower belly area. Blossom Fertility and IVF Centre in Surat is committed to offer to the patients clinical excellence, cost-effective treatment options, personalized compassionate care, and exceptional success rate. The clinic is equipped with all types of latest Art equipments including laparoscope, ultrasound and Art laboratory that help in diagnosing fibroids of any type present in the uterus. Our expertise in infertility treatment and cutting edge IVF technology has helped majority of our patients achieve pregnancy. At Blossom Fertility Centre treatment such as ivf, artificial insemination, ovulation induction, fibroid tumor removal, myomectomy, tubal reversal is explained in detail.

You can contact the fertility specialist of Blossom Fertility and Ivf centre in Surat at http://www.blossomivfindia.com/ or at http://www.blossomivfindia.com/fertility-treatments

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The Blossom Fertility and IVF Centre aims to reduce the stress and hassle associated with infertility treatment and investigations by offering a one-stop fertility diagnostic and treatment service for infertile couples. Excellent IVF success rates are achieved for most types of fertility treatment. www.blossomivfindia.com

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