Uterine fibroids are growths that develop in the walls of the uterus, or womb. Approximately 75 percent of women develop fibroids at some point during their childbearing years. While fibroids can be extremely painful, many fibroids cause no symptoms and women are often unaware of their existence. Fibroids are also called leiomyomas, fibromyomas or myomas.
Types
There are several types of uterine fibroids. Submucosal fibroids are partially located on the wall of the uterus and partially located in the uterine cavity and can cause heavy bleeding. Subserosal fibroids are found on the outside uterine wall and can cause urinary symptoms if they press on your bladder. Intracavity fibroids are located in the cavity of the uterus and can cause cramping and bleeding between periods. Intramural fibroids are found in the wall of the uterus and usually do not cause problems unless they become very large.
Risk Factors
Age is the biggest factor for developing uterine fibroids. Although you can develop fibroids at any time during your fertile years, it is most common for fibroids to become a problem for women in their forties and fifties. After menopause, you may find that your fibroids will actually shrink, due to decreased levels of estrogen and progesterone. Being overweight increases your risk for developing fibroids, as does eating meat, particularly ham and beef. African-American women have a higher chance of developing fibroids and women of all races have a higher risk if their mothers had fibroids.
Symptoms
The size of uterine fibroids can determine if you will experience symptoms or not. Fibroids can range from microscopic to the size of a grapefruit and it is usually the larger fibroids that cause problems. Symptoms of troublesome fibroids include painful menstrual periods and heavy bleeding. If the bleeding is severe, it can result in anemia. You may also experience a feeling of fullness in the lower part of your abdomen and may notice that this area of your body has gotten larger, although you haven't gained weight. Uterine fibroids can also cause lower back pain, pain during sexual intercourse and can interfere with fertility in rare cases.
Diagnosis
Fibroids can often be felt by your doctor during a routine examination. If you and your doctor think that you have fibroids and they are causing you problems, she may order an ultrasound to determine exactly where the fibroids are and how large they are. Other tests that might be used to view the fibroids are X-rays, computerized tomography (CAT) scan or a magnetic resonance imaging (MRI) scan. You may also undergo a sonohysterogram, a procedure in which the uterus is X-rayed after being injected with water; or hysterosalpingogram, which uses dye instead of water.
In some cases, your doctor will want to view the fibroids with a tiny camera and will use either a laprascopic or hysteroscopic procedure. During laproscopy, you doctor will make a small cut near your navel and pass a thin, flexible scope with a camera through the cut in order to view your uterus. If hysteroscopy is used, the scope with passed through the vagina and cervix into the uterus.
Treatment
If your fibroids are small and not causing any trouble, your doctor may recommend keeping an eye on them to see if they grow. There are a number of medications used to shrink fibroids or control heavy bleeding. In cases in which bleeding is a problem, drugs can be used to stop menstruation temporarily.
A myomectomy is used to remove uterine fibroids surgically. This procedure is recommended for women who want to have children, as the uterus is usually not damaged during this procedure. It is possible for fibroids to reoccur after a myomectomy. A myomectomy can performed as an open surgical procedure through an incision in your abdomen or can be done laprascopically. In some cases, the fibroids can be removed via your vagina using a hysteroscope.
Myolsis uses an electric current to destroy uterine fibroids. The current also shrinks the vessels that supply blood to the fibroids. Crymyolysis freezes fibroids using liquid nitrogen. Uterine artery embolization causes fibroids to shrink by cutting off blood flow to the arteries supplying the fibroids.
During endometrial ablation, the lining of your uterus is destroyed using heat. This procedure stops or reduces menstrual bleeding. Focused ultrasound surgery is a non-invasive procedure that allows doctors to view your uterus with an MRI scanner. Ultrasound waves are then used to destroy the fibroids.
A hysterectomy, a surgical procedure used to remove the uterus, may be used in severe cases. A hysterectomy is a major operation and is only considered if you no longer wish to have children.
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