Uterine Fibroids: Causes, Symptoms, Diagnosis, Treatment, and Prevention
Uterine fibroids are common growths that form in or on the wall of the uterus. They are also known as leiomyomas or myomas. Uterine fibroids rarely become cancerous. However, they can cause various symptoms and complications, such as heavy menstrual bleeding, pelvic pain, infertility, and pregnancy complications.
As we discuss the causes, symptoms, diagnosis, treatment, and prevention of uterine fibroids in this blog post, we hope that you will be able to make informed health decisions.
Causes of Uterine Fibroids
The exact cause of uterine fibroids is not clear, but several factors may contribute to their development. These factors include:
-
Gene changes. Many fibroids have changes in genes that differ from those in normal uterine muscle cells.
-
Hormones. Estrogen and progesterone, the hormones that regulate the menstrual cycle, stimulate the growth of the uterine lining and the fibroids.
-
Growth factors. Substances that help the body maintain and repair tissues, such as insulin-like growth factor, may affect fibroid growth.
-
Other factors. Some studies suggest that diet, obesity, stress, infection, inflammation, and environmental toxins may also play a role in fibroid formation.
Symptoms of Uterine Fibroids
Many people with uterine fibroids do not have any symptoms and may not even know that they have them. However, some people may experience one or more of the following symptoms:
-
Heavy menstrual bleeding or painful periods.
-
Longer or more frequent periods.
-
Pelvic pressure or pain.
-
Frequent urination or difficulty urinating.
-
Enlarged abdomen or bloating.
-
Constipation or difficulty passing stool.
-
Pain in the lower back or during sex.
-
Infertility or recurrent miscarriages.
Symptoms and severity may differ based on the number, size, and location of fibroids. The fibroids can grow inside or outside the uterus (submucosal), within or outside the uterine wall (intramural), or outside the uterus (subserosal or pedunculated). It is also possible for fibroids to outgrow their blood supply and die suddenly, causing severe pain.
Diagnosis of Uterine Fibroids
In most cases, uterine fibroids are discovered accidentally during a routine pelvic exam or ultrasound scan. To confirm the diagnosis and evaluate the condition of your uterus and pelvic organs, your doctor may order the following tests if you have symptoms of uterine fibroids:
-
Ultrasound. This test uses sound waves to create a picture of your uterus and the fibroids. It can also measure the size and number of the fibroids and check for any complications, such as ovarian cysts or endometriosis.
-
Hysteroscopy. This procedure involves inserting a thin, lighted instrument (hysteroscope) through the vagina and cervix into the uterine cavity. It allows the doctor to see the inside of your uterus and the fibroids. It can also be used to remove small fibroids or take a biopsy (tissue sample) for further analysis.
-
Laparoscopy. This procedure involves making small incisions in the abdomen and inserting a thin, lighted instrument (laparoscope) and other surgical tools. It allows the doctor to see the outside of your uterus and the fibroids. It can also be used to remove or destroy the fibroids or perform other surgeries, such as a hysterectomy (removal of the uterus).
-
This test uses a powerful magnetic field and radio waves to create detailed images of the uterus and fibroids. It can also detect blood flow and fibroids' structure. If you are considering a nonsurgical procedure, such as uterine artery embolization or focused ultrasound, it can help your doctor plan the best treatment option for you.
Treatment of Uterine Fibroids
Several factors affect how uterine fibroids are treated, including your age, symptoms, the size and location of the fibroids, your desire to have children, and your personal preferences. Choose the treatment option that best suits your needs by discussing the benefits and risks of each option with your doctor. There are several options for treating uterine fibroids, including:
-
A few fibroids may shrink or stop growing over time, especially after menopause, when hormone levels drop. If you have no symptoms or mild symptoms, you may not need any treatment and can just monitor your condition with regular check-ups and ultrasound scans.
-
Medications. If you have moderate symptoms, you may benefit from taking medications that reduce bleeding, pain, and swelling. These medications include:
-
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, which can relieve the pain and inflammation.
-
Hormonal contraceptives, such as birth control pills, patches, injections, or intrauterine devices (IUDs), which can regulate the menstrual cycle and reduce the bleeding and cramping.
-
A gonadotropin-releasing hormone (GnRH) agonist, such as leuprolide or goserelin, can temporarily block estrogen and progesterone production and shrink fibroids. It is important to note, however, that these drugs can cause hot flashes, vaginal dryness, and bone loss, and they should only be used for a limited time period (usually 3 to 6 months).
-
Ulipristal, a selective progesterone receptor modulator (SPRM), can also shrink fibroids by blocking the effects of progesterone. It is not recommended for long-term use or for people who want to conceive because these drugs can cause liver problems and abnormal bleeding.
-
Taking aromatase inhibitors, such as letrozole or anastrozole, can lower estrogen levels and slow fibroids' growth. However, these drugs can also cause menopausal symptoms and bone loss, and they are not approved for treating fibroids.
-
Nonsurgical procedures. If you have severe symptoms or large fibroids that interfere with your fertility or quality of life, you may consider a nonsurgical procedure that destroys or removes the fibroids without altering the rest of your uterus. These procedures include:
-
A UAE is a procedure in which small particles are injected into the blood vessels that supply fibroids, stopping their blood flow and causing them to shrink and die. It can reduce bleeding, pain, and pressure associated with fibroids, but it can also result in side effects such as fever, infection, cramping, nausea, and vaginal discharge. In addition, it may affect your fertility and increase your risk of complications during pregnancy and delivery.
-
By injecting a thin needle into the fibroid and applying heat, radiofrequency ablation (RFA) can reduce the fibroids' size and symptoms. However, it can also cause side effects, such as bleeding, infection, and damage to the surrounding organs. During pregnancy and delivery, it may also affect your fertility and increase the risk of complications.
-
Using focused ultrasound (FUS), high-intensity sound waves are used to heat and destroy fibroids. This procedure can reduce their size and symptoms. It can, however, cause side effects like pain, skin burns, nerve damage, and blood clots. It may also negatively affect your fertility and increase your risk of complications during pregnancy and delivery.
-
The fibroids or the entire uterus may need to be removed through surgery if you have severe symptoms or large fibroids that cannot be treated with medication or nonsurgical procedures, or if you have completed your childbearing. There are three main surgical options for uterine fibroids:
-
It involves removing the fibroids while preserving the uterus, relieving the symptoms and improving fertility. However, it can also result in bleeding, infection, scarring, and recurrence of the fibroids. In order to determine what type of myomectomy you need, you need to know the number, size, and location of your fibroids. Abdominal myomectomy involves a large incision in the abdomen, laparoscopic myomectomy involves a small incision in the abdomen and uterus, and hysteroscopic myomectomy involves the vagina and cervix.
-
As part of a hysterectomy, all parts of the uterus are removed, as well as the ovaries and fallopian tubes. This can eliminate fibroids and prevent them from recurring. However, it can also cause complications, such as bleeding, infection, injury to the surrounding organs, and early menopause. It also means you can no longer get pregnant or have periods. The hysterectomy can be performed through a large incision in the abdomen (abdominal hysterectomy), a small incision in the abdomen (laparoscopic hysterectomy), or through the vagina (vaginal hysterectomy).
Prevention of Uterine Fibroids
There is no sure way to prevent uterine fibroids, but you may be able to reduce your risk or slow down their growth by making some lifestyle changes, such as:
-
Maintaining a healthy weight. Being overweight or obese can increase your estrogen levels and stimulate the growth of the fibroids. Losing weight can help balance your hormones and shrink the fibroids.
-
Eating a balanced diet. Eating a diet rich in fruits, vegetables, whole grains, and lean proteins can provide your body with essential nutrients and antioxidants that can protect your cells from damage and inflammation.
-
Avoiding or limiting processed foods, red meat, alcohol, caffeine, and sugar can help reduce your estrogen levels and prevent the fibroids from growing larger or faster.
-
Drinking plenty of water and fluids can help flush out toxins and waste products from your body and prevent dehydration and constipation, which can worsen the symptoms of the fibroids.
-
Exercising regularly. Physical activity can help improve your blood circulation, reduce stress, balance your hormones, and strengthen your muscles and bones. It can also help you lose weight and prevent obesity-related health problems.
-
Managing stress. Stress can trigger the release of hormones, such as cortisol and adrenaline, that can affect your immune system, inflammation, and fibroids. You can relax and improve your mood and well-being by finding healthy ways to cope with stress, such as meditation, yoga, breathing exercises, hobbies, or counseling.
-
Supplements or herbs. Some natural remedies, such as vitamins, minerals, or herbs, may be beneficial to your uterine health and fibroid symptoms. Before taking supplements or herbs, however, you should always consult your doctor, as they may cause side effects or allergic reactions or interact with your medications. There are several supplements or herbs that can help with fibroids, including:
-
A vitamin D supplement is essential for the health of your bones and immune system, as well as helping to prevent or shrink fibroids. Researchers have found that low vitamin D levels are associated with fibroids more than those with adequate levels. Vitamin D can be obtained from sunlight, fortified foods, or supplements.
-
Iron is an important mineral for red blood cells and oxygen transport, as well as preventing or treating anemia, a common complication of heavy menstrual bleeding caused by fibroids. The iron you need comes either from animal sources, such as meat, poultry, fish, or eggs, or from plant sources, such as beans, lentils, nuts, seeds, or leafy greens. Taking iron supplements can also cause side effects, such as constipation, nausea, or liver damage, so be careful not to overdo it.
-
Green tea is full of antioxidants, such as catechins, that can fight free radicals and inflammation, as well as inhibit the growth and induce the death of fibroid cells. Several studies have shown that green tea extract can reduce fibroids' size and number and improve their quality of life. If you drink green tea or take green tea supplements, you should be aware of the caffeine content, which can cause insomnia, anxiety, or palpitations.
-
Turmeric contains curcumin as its main active ingredient, which has anti-inflammatory, anti-tumor, and anti-oxidant properties, as well as the ability to modulate estrogen and progesterone receptors and reduce the expression of growth factors in fibroids. Research has shown that curcumin can reduce fibroids in size and weight, improve symptoms, and increase fertility in people with fibroids. Take curcumin supplements or add turmeric to your food, but be careful not to take too much, since it can cause bleeding, stomach upset, and kidney stones.
