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Fibroids

Fertility 

Fibroids are benign tumors of the uterus, or womb. They grow from the muscle cells of the uterus and may protrude from the inside or outside surface of the uterus or they may be contained within the muscular wall.

Fibroids are very common. About 40% of women at the age of 40 will have them, although not all will experience symptoms.

What causes fibroids ?

The growth of fibroids seems to be related to the reproductive hormone oestrogen. When these hormone levels decrease at menopause, many of the symptoms of fibroids begin to resolve.

Fibroids in women, treatment for fibroids

Who is at risk for getting fibroids ?

  • Women with one or more pregnancies that extended beyond 5 months have a decreased risk of fibroid formation
  • Use of birth control pills – Use of birth control pills can protect against fibroids
  • Ethnic background – Fibroids are 2 to 3 times more common in African American women than in Caucasians

What symptoms are associated with fibroids ?

The majority of fibroids are small and do not cause any symptoms at all. The symptoms are related to the number, size, and location of the fibroids.

  • Increased menstrual bleeding
  • Pelvic pressure and pain
  • Problems with pregnancy and fertility

How are fibroids treated ?

  • Medications called gonadotropin-releasing hormone (GnRH) analogs are the mainstay of medical treatment for fibroids. Most women taking these medicines have a cessation of the menstrual period and a significant reduction in uterine size. The lack of periods can help women correct anemia before surgery.
  • Surgical treatment
    • Hysterectomy (removal of the uterus)
    • Myomectomy (removal of a fibroid)
      • Laparoscopic myomectomy
      • Hysteroscopic myomectomy
  • Uterine artery embolisation

In deciding on the most appropriate treatment for fibroids, a number of factors should be considered. Certainly one of the most critical is whether or not childbearing has been completed. Although hysterectomy provides excellent relief of symptoms, women who wish to become pregnant in the future may choose myomectomy.

Any treatment needs to be individualised to the patient’s symptoms and goals of treatment which will vary amongst individuals.
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