Uterine fibroids are noncancerous uterine growths that commonly occur during reproductive years. Fibroids differ in size from tiny seedlings that are imperceptible to the naked eye to bulky masses that can deform and expand the uterus. Multiple fibroids can cause the uterus to grow so much that it approaches the rib cage and adds weight in severe situations. Many women get uterine fibroids at some point in their lives. However, because uterine fibroids seldom cause symptoms, you may be unaware that you have them.

Symptoms

Many women with fibroids exhibit no symptoms. Symptoms can be impacted by the location, size, and quantity of fibroids in people who have them. The following are the most prevalent indications and symptoms of uterine fibroids

• Heavy bleeding during menstruation
• Menstrual cycles that last more than a week
• Pelvic discomfort or pressure
• Urination occurs often.
• Having trouble emptying the bladder
• Constipation
• Back pain or leg pain

When should you see a doctor?

• Pelvic discomfort that does not go away
• Periods that are excessively heavy, lengthy, or uncomfortable
• Bleeding or spotting between periods
• Having trouble emptying your bladder
• Unknown cause of a low red blood cell count (anemia)

Causes

Genetic alterations: Many fibroids have gene alterations that vary from those found in normal uterine muscle cells.

Hormones: Estrogen and progesterone, two hormones that drive the formation of the uterine lining in preparation for pregnancy throughout each menstrual cycle, appear to encourage the growth of fibroids.

Extracellular matrix: ECM is the substance that holds cells together, similar to mortar between bricks. Fibroids have an increase in ECM, which causes them to become fibrous. ECM also stores growth factors and induces biological changes in cells.

Many fibroids that were present throughout pregnancy diminish or vanish after delivery when the uterus returns to its normal size.

How are uterine fibroids treated?

Treatment for uterine fibroids varies based on their size, quantity, and location, as well as the symptoms they cause. If you don't have any symptoms from your fibroids, you might not require treatment. Your treatment strategy will be determined by a number of criteria, including

• The number of fibroids you have.
• The dimensions of your fibroids.
• The location of your fibroids.
• The symptoms you are experiencing are caused by fibroids.
• Your wish to become pregnant.
• Your wish to keep your uterus.

The optimal treatment choice for you will also be determined by your future reproductive objectives. Some treatment choices may not be available to you if you wish to have children in the future. When considering treatment choices, tell your healthcare practitioner about your opinions on fertility and your future aspirations.

Uterine fibroids can be treated with the following methods

Medications

OTC pain relievers These medicines can be used to relieve the discomfort and pain caused by fibroids.

Iron supplements If you develop anemia as a result of excessive bleeding, your physician may advise you to take an iron supplement.

Birth control pills can also be used to aid with fibroids symptoms, such as excessive bleeding during and between periods and menstrual cramps. Heavy menstrual bleeding can be controlled using birth control pills.

Agonists of gonadotropin-releasing hormone (GnRH): These medicines operate by reducing your fibroids and can be given as a nasal spray or an injection. They're occasionally used to reduce a fibroid before surgery so that it may be removed more easily. These drugs, however, are only temporary, and if you stop using them, the fibroids may return.

It is critical to discuss any medications you are taking with your healthcare practitioner. Before beginning a new medicine, always visit your provider to discuss any potential side effects.

Fibroid surgery

When discussing the various forms of fibroid removal surgery, there are numerous variables to consider. Not only may the size, location, and the number of fibroids impact the kind of surgery, but your preferences for future pregnancies can also play a role in establishing a treatment plan. Some surgical methods maintain the uterus and allow you to get pregnant again in the future, whilst others damage or remove the uterus.

Myomectomy is a treatment that allows your physician to remove fibroids without causing any damage to the uterus. Myomectomy may be classified into various kinds. The method that is best for you will be determined by where your fibroids are situated, their size, and the number of fibroids. Myomectomy procedures for fibroids can include the following

• Hysteroscopy involves passing a scope (a thin, flexible tube-like instrument) through the vagina and cervix and into the uterus. During this operation, no incisions are performed. The scope will be used by your physician to cut away the fibroids during the operation. The fibroids will subsequently be removed by your healthcare provider.
• Laparoscopy: Your specialist will use a scope to remove the fibroids during this procedure. This technique, unlike hysteroscopy, requires making a few tiny incisions in your abdomen. The scope will enter and exist in your body in this manner. This operation can also be carried out with the help of a robot.
• Laparotomy: An incision is created in your belly during this operation, and the fibroids are removed through this one bigger cut.

If you have no plans for future pregnancies, your healthcare practitioner may offer other surgical alternatives that remove the uterus. These procedures can be highly beneficial, but they almost always result in the prevention of future births. Fibroid removal surgery may involve the following procedures

• Hysterectomy Uterus is removed during a hysterectomy procedure. Fibroids can be treated permanently by a hysterectomy. The fibroids won't return when your uterus is removed entirely, and your symptoms should go away. After a hysterectomy, if your uterus is removed but your ovaries are left in situ, you will not experience menopause. If you have big fibroids or are having excessive bleeding from your fibroids, this surgery may be advised. When hysteroscopy is recommended, it is best to choose the least intrusive method possible. Vaginal, laparoscopic, and robotic operations are examples of minimally invasive procedures.
• Uterine fibroid embolization An interventional radiologist collaborates with your gynecologist to conduct uterine fibroid embolization. Tiny particles are utilized to restrict the flow of blood from the uterine artery to the fibroids using a small catheter inserted in the uterine artery or radial artery. The loss of blood flow causes the fibroids to shrink, which improves your symptoms.
• Radiofrequency ablation (RFA) is a safe and effective therapy for symptomatic uterine fibroids that can be done laparoscopically, transvaginally, or transcervically.