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Fibroids

Fibroids are non-cancerous growths in the uterus and are also called uterine myomas or leiomyomas. They are a very common issue with up to 80% of women developing them by the time they hit 50. Most women however do not show any symptoms of it. Fibroid growths are enclosed inside the capsules attached to the walls of the uterus and do not spread to other parts of the body. There can be single or multiple fibroids and they are named after the place of its occurrence in the womb. These are the large ones.

Fibroids that are attached to the uterus by a stem may twist and can cause pain, nausea, or fever. Fibroids that grow rapidly, or those that start breaking down, also may cause pain. Rarely, they can be associated with cancer. A very large fibroid may cause swelling of the abdomen. This swelling can make it hard to do a thorough pelvic exam.

Fibroids also may cause infertility, although other causes are more common. Other factors should be explored before fibroids are considered the cause of a couple’s infertility. When fibroids are thought to be a cause, many women are able to become pregnant after they are treated.

When is treatment necessary for fibroids?

Fibroids that do not cause symptoms, are small, or occur in a woman who is nearing menopause often do not require treatment. Certain signs and symptoms may signal the need for treatment:

⇒ Heavy or painful menstrual periods that cause anemia or that disrupt a woman’s normal activities

⇒ Bleeding between periods

⇒ Uncertainty whether the growth is a fibroid or another type of tumor, such as an ovarian tumor

⇒ Rapid increase in growth of the fibroid

⇒ Infertility

⇒ Pelvic pain

Can medication be used to treat fibroids?

Drug therapy is an option for some women with fibroids. Medications may reduce the heavy bleeding and painful periods that fibroids sometimes cause. They may not prevent the growth of fibroids. Surgery often is needed later. Drug treatment for fibroids includes the following options:

⇒ Birth control pills and other types of hormonal birth control methods—These drugs often are used to control heavy bleeding and painful periods.

⇒ Gonadotropin-releasing hormone (GnRH) agonists—These drugs stop the menstrual cycle and can shrink fibroids. They sometimes are used before surgery to reduce the risk of bleeding. Because GnRH agonists have many side effects, they are used only for short periods (less than 6 months). After a woman stops taking a GnRH agonist, her fibroids usually return to their previous size.

⇒ Progestin–releasing intrauterine device—This option is for women with fibroids that do not distort the inside of the uterus. It reduces heavy and painful bleeding but does not treat the fibroids themselves.

As usual, if medicines don’t work, then one has to switch to surgical removal of the fibroid. The various surgical procedures involved in fibroid removal are Myomectomy or Hysterectomy. They are removed by open or laparoscopically depending on the individual and the number and size of the tumour. Alternative treatments are Uterine artery embolisation (UAE), Endometrial ablation or resection.