The Current Perspectives on Uterine Fibroids

Also referred to as myomas or leiomyomas, uterine fibroids are benign tumors that grow from the muscle layers of the uterus or womb.

These non-cancerous tumors can vary in sizes, ranging from a pea to a melon.

Many fibroids cause no issues at all. In fact, a majority of women don’t even know they have it in the first place. Women with fibroids can get pregnant, carry it to term, and give birth normally.

However, some fibroids, depending on location and size, can lead to back or abdominal pain, vaginal bleeding, constipation, and urinary problems.

In other cases, they may cause the belly to swell. In which case, the woman will have difficulties conceiving or carrying the pregnancy to term.

Fibroid treatments vary based on the location and size of the growth, along with the surgeon’s skills. According to statistics, new fibroids grow in about 10 to 50% of cases after a successful removal – but only about 20% of these women will need further treatment.

Modern management of fibroids

While uterine fibroids are asymptomatic, they may still cause debilitating symptoms in a woman.

Luckily, there are different approaches to treat the condition:

• Pharmacologic options like gonadotropin-releasing hormone agonists and hormonal therapies
• Surgical procedures like hysterectomy, myolysis, myomectomy, magnetic resonance imaging-guided focused ultrasound surgery, uterine artery embolization, and laparoscopic uterine artery occlusion.

The right procedure for a patient would depend upon a range of issues, including the patient’s desire to conceive, the importance of womb preservation, the severity of symptoms, and characteristics of the tumor.

Thanks to innovation, the current treatment options for fibroids are:

• Minimally invasive (or even non-invasive)
• Have long-term data to back up their safety and efficiency
• Are easy to perform
• Have low to no chances of the fibroid reoccurring
• They preserve fertility
• And come at a cost-effective price

Risk factors

Age and race

A US study that was performed on random women of ages between 35 and 49 years revealed that those from the African-American descent above 35 years old were at a 60% risk of getting uterine fibroids, and the number increased to more than 80% by age 50. Caucasian women, on the other hand, had a 40% chance by age 35, and 70% by 50.

These women were screened by the medical record, self-report, and sonography. Again, the cumulative incidence shows an increase with age – though the prevalence decreases as women get older. From the results, the older premenopausal womb has lower chances of getting fibroids. 

Early-onset of periods

Older studies identified early menarche as a risk factor for uterine fibroids development – but newer ones are confirming this to be true. In addition to fibroids, early age at menarche also possess a higher risk for preeclampsia, type 2 diabetes, metabolic syndrome, cardiovascular disease, obesity, and different forms of cancer. 

Other possible factors

Recent studies suggest that caffeine and alcohol intake can increase the chances of developing fibroids. Parity is also inversely linked to the risk of fibroid development. Contemporary interest in the impact of dynamics like hormonal, dietary, metabolic, and environmental factors, as well as stress and uterine infection, are ongoing.

Classification

Not all fibroids are the same – they vary in size, location, and even their growth rate. Fibroids can be classified into three categories, depending on where they are located in the uterus: intramural, subserosal, submucosal, and pedunculated fibroids. A woman can have one or all of these fibroids.

Signs and symptoms

As mentioned earlier, uterine fibroids can be asymptomatic.

However, many women experience a multitude of symptoms, including:

• A feeling of pelvic pressure
• Abnormal bleeding
• Back, pelvic or abdominal pain
• Urinary retention or incontinence 
• Infertility

Miscarriage

Again, fibroid management will depend on the presenting symptoms. Treatment strategies are often personalized according to the location and size of the fibroid, the severity of symptoms, the patient’s age, and how close or far they are from menopause. 

Conclusion

Uterine fibroids are prevalent among women in the childbearing age. But this doesn’t make the condition any less of a nuisance.

Women who experience the signs and symptoms of fibroids should get in touch with uterine fibroid specialists for a checkup. The doctor will perform a series of tests and exams to identify the issue and recommend the best possible course of action to take.

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