Signs, Symptoms and Treatment of Uterine Fibroids
Uterine fibroids are benign tumors of the uterus. They can occur in various locations on or inside the uterus. Most women who are diagnosed with uterine fibroids do not experience symptoms. The uterine fibroids are usually diagnosed during a gynecological pelvic exam. When symptoms of uterine fibroids do occur, they usually depend on the size and location of the uterine fibroid. If the uterine fibroid is located in the wall of the uterus under the surface, which would be referred to as subserosal, the uterine fibroid may not be symptomatic. Uterine fibroids that grow into the actual uterine lining are referred to as submucosal and these uterine fibroids can cause very heavy or irregular bleeding. Uterine fibroids that attach themselves to the uterus by a thin stalk are referred to as pedunculated uterine fibroids, according to Christiane Northrup, MD.
Uterine fibroids can cause heavy bleeding simply because the uterus is very vascular and has a rich blood supply. Heavy bleed from uterine fibroids can result in extreme fatigue and anemia. In severe cases, a women can be at risk for hemorrhaging from uterine fibroids. The are many causes of uterine bleeding, but to make sure that the uterine bleeding is indeed from uterine fibroids, an endometrial biopsy should be taken which involves taking a small sample of endometrial tissue and examining the cells. A D&C can also be done to rule out uterine cancer when abnormal uterine bleeding is present. A D&C can both diagnose and stop abnormal uterine bleeding.
Urinary frequency and feelings of pressure in the pelvic area can be symptomatic of uterine fibroids. Sometimes the location of the fibroid can cause it to impinge on the bladder or rectum causing pressure in those areas. Pressure or pain in the lower back can also result from uterine fibroids. When a uterine fibroid causes pressure to the bladder, it can lessen the bladder’s ability to maintain urine which can result in urinary frequency and sometimes urinary incontinence.
Uterine fibroids are usually fueled by hormones. Estrogen in particular. They can increase in size during pregnancy and they tend to shrink around the time of menopause when estrogen levels fall off. Sometimes uterine fibroids will completely go away on their own without treatment.
There are many treatments for uterine fibroids. Some more drastic that others. The most conservative treatment for uterine fibroids would be the watch and wait approach. If uterine fibroids aren’t causing too much of a disruption in a woman’s life, she should get regular pelvic exams or perhaps an ultrasound exam periodically to gauge the growth of the uterine fibroid. Another non-surgical approach in the treatment of uterine fibroids is hormonal therapy. In women whose main symptoms of uterine fibroids is bleeding, progestin or progesterone can be given as a treatment to control bleeding.
Gonadotropin releasing hormones such as Synarel and Lupron can also be used in the treatment of uterine fibroids. These hormones cause the pituitary gland to react in such a way as to decrease the function of the ovaries, thereby decreasing the estrogen production that fuels uterine fibroids to begin with. There are drawbacks to this treatment such as triggering menopause. Also, after treatment is discontinued, the uterine fibroids tend to grow back.
A surgical procedure call a myomectomy in which the uterine fibroids are removed can be used in the treatment of uterine fibroid. This procedure leaves the uterus intact, which might be a good choice for women who want to preserve their fertility. Another treatment for uterine fibroids is uterine artery embolization which involves injecting the uterine artery with a substance that cuts the uterine fibroid’s blood supply and therefore actually causing the uterine fibroid to shrink in size.
Finally, the most drastic, in the treatment of uterine fibroids is the hysterectomy. Hysterectomy is a surgical procedure that removes the uterus. A women may choose the hysterectomy if she is bleeding for a long time or because the uterine fibroid is actually pressing on her bladder which is causing urinary frequency or even urinary incontinence.
Uterine fibroids naturally shrink when a women reaches menopause because her estrogen levels are decreasing. Remember, uterine fibroids are fueled by estrogen. If, after menopause a women begins a regimen of hormone replacement therapy, the uterine fibroids can, in theory return.
Uterine fibroids are very common and many women will develop them at some point in their lives. Fortunately, uterine fibroids rarely develop into cancer and very treatable and can eventually subside on their own with or without treatment, depending on their extent.