Fibroids are common, non-cancerous growths of the uterus. Many women are unaware they have fibroids, while others experience significant symptoms requiring treatment.
Treatment of Fibroids
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Fibroids are known as growths or benign tumours that form inside the uterus (womb). Around four in 10 women over the age of 40 years will be likely to have fibroids.
The reason why fibroids develop is not known, but it is thought that the sex hormones, oestrogen and progesterone, could play key roles in this process. This is because fibroids will rarely grow in girls before puberty and women after menopause. Pre-existing fibroids generally stop growing and can even shrink in women after menopause.
Treatment depends on the size, number and location of the fibroids, but can involve medication, procedures done under local anaesthetic, ultrasound procedures and surgery. Fibroids rarely become cancerous.
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Fibroids, non-cancerous growths in the uterus, can cause a variety of symptoms, including heavy or prolonged periods, painful periods, bleeding between periods, and pelvic or lower back pain. Other potential symptoms include pain during sex, frequent urination, constipation, bloating, and anaemia. Many women with fibroids, however, experience no symptoms or only mild ones.
Menstrual Symptoms:
Heavy or prolonged periods - Bleeding may be heavier than usual and last longer than expected.
Painful periods - Cramps may be more severe or frequent.
Bleeding between periods - This can be spotting or more significant bleeding.
Iron deficiency anaemia - Heavy bleeding can lead to low iron levels, causing fatigue and weakness.
Pain and Discomfort:
Pelvic pain - A feeling of pressure or pain in the lower abdomen or pelvis.
Lower back pain - Fibroids can press on nerves in the lower back, causing pain.
Pain during intercourse - Fibroids can make sexual intercourse uncomfortable or painful.
Pain in the legs - In some cases, pain can radiate down the legs, especially if a fibroid is pressing on nerves.
Bowel and Bladder Symptoms:
Frequent urination - Fibroids can put pressure on the bladder, leading to needing to urinate more often.
Difficulty emptying the bladder - The pressure on the bladder can also make it harder to empty it completely.
Constipation - Fibroids can press on the bowels, causing constipation and bloating.
Other Symptoms:
Bloating - A feeling of fullness or distension in the lower abdomen.
Fullness in the lower abdomen: A general feeling of fullness or heaviness in the lower abdomen.
An enlarged abdomen - In some cases, fibroids can cause the abdomen to appear larger than usual.
Important Considerations:
Not everyone experiences symptoms: Many women with fibroids don't have any noticeable symptoms at all.
Symptoms vary: The severity and type of symptoms can vary depending on the size, location, and number of fibroids.
Seek medical advice: If you experience any of these symptoms, it's important to consult with a healthcare professional to determine the cause and receive appropriate treatment.
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Fibroids are categorised by their location, which includes:
Intramural – the most common type, growing in the wall of the uterus
Submucosal – growing in the lining of the uterus (endometrium), sometimes causing heavy, long and painful periods
Sub serosal – growing on the outside of the wall of the uterus, sometimes appearing like long stalks.
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Some of the complications Fibroids can cause include:
Anaemia – Excessive menstrual blood loss can cause anaemia, where the body is not able to carry enough oxygen in the blood. Symptoms of anaemia include breathlessness, fatigue and paleness.
Problems while urinating – Large fibroids can make the uterus bulge, pressing against the bladder. This can cause a feeling of fullness or discomfort and the need to urinate often.
Infertility – Fibroids can interfere with implantation of the fertilised egg in several ways. For example, the egg may try to implant into a fibroid, or fibroids may change the shape of the uterus and make it difficult for an egg to implant.
Miscarriage and premature delivery – Fibroids can reduce blood flow to the placenta or compete for space with the developing baby.
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Fibroids can be detected using an ultrasound, where sound waves create a two-dimensional picture. The inside of the uterus can be seen with a hysteroscope, which is a thin tube that is passed through the cervix (entrance to the womb). A small camera may be placed at the tip of the hysteroscope to see the inside of the uterus on a monitor.
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Non- Surgical Management
Dr Joshi will discuss with you different treatment options like hormonal treatment, or intrauterine device.
Monitoring – If the fibroids are not causing any symptoms and are not large, the condition can be watched over time for any changes.
Medication – A combination of hormones or other medication can be used to shrink the fibroids before surgery.
Surgical Management
Dr Joshi also offers Surgical Treatment where necessary.
Hysteroscopy – The fibroids are removed through the cervix using a hysteroscope (a thin tube with a light on the end, which is inserted into the vagina to examine the cervix and inside the uterus).
Myomectomy – Removal of fibroids while preserving the uterus. It can be done as a hysteroscopic myomectomy, or abdominal or laparoscopic myomectomy
Laparoscopy or Keyhole Surgery - A thin tube is inserted through the abdomen to remove the fibroids.
Open surgery – Larger fibroids need to be removed through a cut in the abdomen. Please note that this procedure weakens the wall of the uterus and makes Caesarean sections for future pregnancies more likely.
Hysterectomy – The surgical removal of some, or all, of the uterus. Pregnancy is not possible after a hysterectomy.
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Most of the surgical procedures are performed under anaesthesia. Recovery time varies with the type of procedure chosen and it is important to have a talk with Dr Joshi regarding the care and precautions to be observed after the surgery.
All surgical procedures come with their own risks, some of them could be life-threatening. Your doctor will explain to you all the risks associated with a particular procedure, to assist you in your decision making.
After surgery, following symptoms require contacting the doctor – increasing nausea or vomiting, persistent abdominal pain or bleeding, Fever more than 38 degrees or chills, dizziness, to name a few.
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