Uterine fibroids (myomas)

Uterine fibroids – also called myomas – are noncancerous growths of the uterus that develop in women during their childbearing years. 

A medical illustration of uterine fibroids

They increase in prevalence with age, and tend to shrink during and after menopause. 

Fibroids develop from the muscular tissue of the uterus: ongoing cell division creates rubbery masses that grow and become distinct from surrounding tissue. Fibroids range in size, can be single or multiple, and may in some cases distort and enlarge the uterus. 

It is believed that three out of four women will experience uterine fibroids during their lives; although some may remain symptom free. 

Causes of uterine fibroids are not clear, although it is believed genetics and hormone production may play a role. While fibroids generally don’t interfere with conception and pregnancy, submucosal fibroids (which grow into the uterus) may impair implantation and growth of an embryo. 

What are its symptoms?

Symptoms of uterine fibroids include the following: 

  • Longer than normal menstrual periods (seven days and more)
  • Pelvic pressure or pain
  • Heavy menstrual bleeding
  • Severe menstrual pain
  • Frequent urination
  • Constipation
  • Back pain and leg pain
  • Anaemia

How is it diagnosed? 

Diagnosis of uterine fibroids usually occurs during a routine pelvic or internal examination by a doctor. If you are experiencing symptoms, a number of tests may help confirm a diagnosis. These include:

  • An ultrasound over the abdomen or inside the vagina can detect and measure uterine fibroids by producing images of the uterus. 
  • A full blood count to check for anaemia, or any bleeding and thyroid disorders
  • An MRI (magnetic resonance imaging) scan can show the size and location of fibroids to help establish treatment options
  • A hysteroscopy, which involves inserting a small, lighted telescope (a hysteroscope) via the cervix into the uterus, and injecting saline into the uterus, allows your doctor to check the uterine walls and openings of the Fallopian tubes. 

What are your treatment options? 

Treatment options vary, based on severity of symptoms, age and whether you wish to conceive a child. For those with mild symptoms, no treatment may be necessary. Treatment can include:

1. Medications: These can treat symptoms of heavy bleeding and pelvic pressure by targeting hormones that regulate menstrual cycle; medication can also be used to shrink fibroids before surgical options; drugs for pain may also be prescribed, as well as iron and vitamin supplements for those suffering from heavy bleeding.

2. MRI-guided focused ultrasound surgery: This procedure uses sound waves from a transducer (while you’re in an MRI scanner) to locate and destroy areas of fibroids. 

3. Uterine artery embolization: This is a minimally-invasive procedure where embolic agents are injected into the arteries supplying the fibroids with blood to cut off the blood supply, causing them to shrink and die. 

4. Myolysis: This laparoscopic procedure involves using a laser or electric current to destroy fibroids and shrink their blood vessels.

5. An abdominal myomectomy: This is an open abdominal surgery for the removal of fibroids and may be performed for multiple, large or deep fibroids. 

6. Hysterectomy: This major surgery where the uterus is removed needs careful consideration and should be discussed with your doctor. 

Can it be prevented? 

Unfortunately, there is little evidence available on how to effectively prevent uterine fibroids. 

To find out if you are a good candidate for uterine artery embolization, visit www.fibroids.co.za.

IMAGE CREDIT: 123rf.com

The accuracy of this information was checked and approved by physician Dr Thomas Blake in July 2016