fibroid is a non-cancerous tumour that develops from
the layer of the uterus. These growths are smooth muscles and fibrous tissues
that vary in size ranging from small pea up to the size of a watermelon. Many
women live with fibroids without their
knowledge because there is no visible symptom. It is advised that women
without symptoms should opt for observation rather than treatment
Types of fibroid
There are four types of fibroid classified
based on its location in the womb, and they include:
fibroid: this fibroid
is the most common type embedded in the muscular wall of the womb.
type of fibroid is found in the muscle under the inner lining of the wall which
can protrude into the cavity of the womb.
Cervical fibroids grow in the cervix.
subserosal fibroid extends beyond the wall of the womb. It grows within the
surrounding outer uterine tissue layer. It might have the potential of growing
into pedunculated fibroids when it develops a stock and becomes very large.
Fibroid doesn’t often cause symptoms in some cases.
One out of every three women having fibroid is likely to experience the
following symptomswhich include:
- Heavy or painful periods,
also known as menorrhagia
- lower backache
- frequent urination
- abdominal pain, especially
in the case of large fibroids
- pain during sex, known as
possible symptoms that may be experienced include:
- fertility problems
- repeated miscarriages
When to see your
Fibroids are sometimes diagnosed since they don’t often cause symptoms; they
can be diagnosed by chance on one of your routine gynaecological examination,
test or scan. Seeing your GP is important if you have persistent symptoms of
fibroids so they can investigate the possible cause. You may be referred for an
ultrasound scan to diagnose if he or she suspects a fibroid case.
It is only recommended that women who are
experiencing symptoms of fibroid go through fibroid treatment. Treatment may
not be necessary in cases where the fibroid does not affect the quality of
life. Medication and surgery are the two main treatments of fibroid and the choice
of treatment to be used can be affected by factors such as the location of
fibroids, the severity of symptoms, and plans of childbearing.
A drug called gonadotropin-releasing hormone
agonist (GnRHa) is used which causes the body to produce less estrogen and progesterone
making fibroid to shrink. GnRHa is only for short-term fibroid treatment. When
used, it stops the menstrual cycle without affecting fertility. It also causes
menopause-like symptoms such as a tendency to sweat more, vaginal dryness, hot
flashes, and, in some cases, increase the risk of osteoporosis. GnRHa can be
given before surgery to shrink the fibroids.
Other drugs can be used in the treatment of
fibroid but may be less effective when treating larger fibroids; they include:
- Non-steroidal anti-inflammatory
drugs (NSAIDs): these drugs include ibuprofen and
mefenamic. They reduce the
production of prostaglandins which is a hormone-like lipid compound that
causes crampy periods with heavy menstrual flow. NSAID is effective at
reducing fibroid pain, but does not
reduce bleeding from fibroids or neither does it affect fertility.
- Birth control pills: You can regulate
the ovulation cycle using Oral contraceptives, and they may help reduce
the amount of pain or bleeding during periods.
intrauterine system (LNG-IUS): This is a plastic device placed
inside the womb to releases a hormone called levonorgestrel over an
extended timeframe. Levonorgestrel hormone stops the inside lining of the
womb from rapid growth and hence reducing menstrual bleeding. Adverse
effects of LNG-IUS may cause irregular bleeding for some time, headaches,
breast tenderness, and acne.
Surgery may be needed for severe fibroid cases. The
following are some of the procedures your GP might suggest in treating fibroids:
- Hysterectomy: this is the
procedure used for treating extremely large fibroid which may involve
partial or total removal of the womb. A total hysterectomy prevents the
reoccurrence of fibroids, and it may reduce libido or cause early
menopause if the ovaries and fallopian tubes were removed.
percutaneous laser ablation: an MRI scan can locate fibroid.
After locating fibroid with an MRI scan, then fine needles are inserted
through the skin and body tissues to the targeted fibroids. A laser fibre
device is inserted through the needles, and laser light is sent through the
device to shrink the fibroid.
- Myomectomy: this is the
best remedy for women who still want to have children. In this surgery
procedure, the fibroid is removed from the muscular wall of the womb.
- Endometrial ablation: this is an
alternative procedure for hysterectomy in some women which involves the
removal of the lining inside the womb if the fibroid is near the inner womb
- Uterine artery embolisation
(UAE), more specifically uterine fibroid embolisation (UFE): this
procedure cuts off the blood supply in the area of the fibroid which makes
it shrink. It is guided by fluoroscopic X-ray imaging. A chemical is injected through a
catheter into the arteries supplying blood to any fibroid. This procedure is
the best remedy for women who are pregnant or those who still want to have
children because it can help to reduce symptoms up to 90%.
- MRI-guided focused
ultrasound surgery: An MRI scan locates the fibroids,
and high energy ultrasound waves are delivered to shrink them.