Dr. Manoj Mohan
Specialist - Obstetrics & Gynecology
Aster Hospital, Old Airport Doha (Qatar)
Have you been facing troubles with pelvic pain that just would not go away? Or are you experiencing unusual periods that are painful, prolonged, and heavy? These signs are not meant to be taken lightly. According to research, anywhere between 40% to 80% of women have uterine fibroids – a condition that could be behind the above-mentioned symptoms.
But what are uterine fibroids? Is it a serious condition? Does it impact female fertility? Let us answer some of the most frequently asked and vital questions about uterine fibroids in the following article.
• What are uterine fibroids?
Uterine fibroids – also known as leiomyomas – are non-cancerous growth in the wall of the uterus, the main cavity, or the exterior of the organ. They often develop when a woman enters her reproductive age. These gro wths comprise connective tissue and uterine muscle. Fibroids usually vary greatly in size, often ranging from 1 mm to larger than 20 cm.
• What are the causes of uterine fibroids?
While the main cause of uterine fibroids remains unattributed, research indicates many possibilities.
• Hormonal changes during the menstrual cycle
• Genetic changes
• Body-tissue maintaining substances can promote fibroid growth
• Due to Extracellular matrix (ECM) - a material that promotes the sticking together of cells
• What are the major symptoms of uterine fibroids?
In many cases, uterine fibroids can be asymptomatic and are discovered during regular pelvic examinations and health check-ups. However, there is a list of common and often debilitating symptoms that women need to be wary of:
• Pelvic pain
• Heavy menstrual bleeding
• Prolonged menstruation that often lasts more than a week
• Abdominal pain
• Frequent urination and constipation
• Pregnancy issues such as unsuccessful attempts to get pregnant or miscarriages
• What are the risk factors of fibroids?
The single biggest known risk factor of fibroids is women reaching their childbearing years. Apart from that, race and heredity also play a role.
Other risk factors may include:
• Early onset of periods
• Vitamin D deficiency
• Consuming large amount of red meat
• Excess alcohol consumption
• Inadequate greens, fruits, and dairy in the diet
• What happens if fibroids are left untreated?
Since fibroids are benign, they are not linked to increased cancer risk. In many cases, they go away on their own – especially after menopause. Having minor fibroids also does not prevent women from getting pregnant. However, fibroids can always grow and multiply, leading to complications like heavy bleeding, and anaemia. In some cases, submucosal fibroids may also lead to infertility or cause pregnancy complications.
• How is diagnosis and treatment of fibroids performed?
Fibroids are diagnosed after observations of irregularities in the uterus in routine medical check-ups and following up with confirmation tests.
These often include:
• Blood tests
Other completely safe and advanced minimally-invasive techniques involve:
• Hysterosonography – Using saline water to expand the uterine cavity to make it easier for imaging.
• Hysterosalpingography – Using a dye to highlight the uterine cavity on X-Ray.
• Hysteroscopy – Inserting a lighted telescope to examine the uterine walls.
As for the treatment of fibroids, it is highly personalised in nature – depending upon the severity of the issue and the symptoms. In most cases, minute, asymptomatic fibroids often go away on their own – mostly after giving birth. Else, a plethora of treatment options is available for uterine fibroids.
• Medications that help reduce the size of fibroids
• Non-invasive procedures such as MRI-guided focused ultrasound surgery (FUS)
• Minimally-invasive procedures such as uterine artery embolization, radiofrequency ablation, laparoscopic or robotic myomectomy, hysteroscopic myomectomy, and endometrial ablation.
• Is uterine artery embolization reliable?
Uterine artery embolization is a novel technique that involves cutting the blood supply from the artery to the fibroids – thus leading them to shrink. This is achieved by injecting bioresorbable particles into the uterine artery. The results are often immediate – with 90% shrinkage achieved in almost 6 months. 99% of patients also experience immediate relief from bleeding and are free to return home in one day. Although fertility in women often reduces after embolization and also after radiofrequency ablation, close to 50% of women are still able to conceive in the future.
• What is myomectomy?
Myomectomy procedures enable your specialist to remove your fibroids without damaging the uterus. Myomectomy – whether laparoscopic or hysteroscopic – allows women to preserve their fertility and even conceive later on.
• When should one opt for a hysterectomy?
The removal of the uterus is often the last resort in complex cases of fibroids – or a viable option for women who no longer plan to get pregnant. The only permanent solution for fibroids is the removal of the uterus – as achieved in a hysterectomy. This surgical procedure is often done when fibroids are either too big, too deep, too many, or bleeding too much. An alternative to this is abdominal myomectomy – but the scarring can affect fertility.
At Aster Hospital, Old Airport, Doha (Qatar), we provide specialised consultation for major gynaecological conditions such as uterine fibroids. Our highly trained surgeons with extensive experience offer advanced expertise in minimally-invasive techniques to provide you relief from fibroids and complications, while also preserving fertility to a high degree.
For appointment, call 44 44 04 99