Uterine Fibroid

Uterine fibroids are non-cancerous growths of muscle and connective tissue that develop within the wall of the uterus (womb). They are very common, especially in women of reproductive age, and can range in size from tiny nodules to large masses that distort the uterus.

Symptoms

- Heavy or prolonged menstrual bleeding
- Painful periods
- Pelvic pressure or pain
- Frequent urination
- Back pain
- Pain during intercourse
- Constipation
- Difficulty getting pregnant or pregnancy complications

Causes and Risk Factors

- Family history of fibroids
- Obesity
- Early onset of menstruation
- Late menopause
- Not having been pregnant

Diagnosis

- Pelvic examination
- Ultrasound
- MRI or other imaging if needed

Treatment Options

1. Watchful Waiting
- If fibroids are small and not causing symptoms, regular monitoring may be all that is needed.

2. Medications
- Pain relief - NSAIDs (ibuprofen, naproxen) for cramps and pain.
- Hormonal therapy - Birth control pills, progestin-releasing IUDs, or hormone injections to reduce bleeding and pain.
- GnRH agonists/antagonists - Medications that shrink fibroids by lowering estrogen and progesterone levels; used short-term or before surgery.
- Tranexamic acid - Non-hormonal medication to reduce heavy bleeding.
- Iron supplements - For anemia due to heavy bleeding.

3. Minimally Invasive Procedures
- Uterine fibroid embolization (UFE/UAE) - Blocks blood supply to fibroids, causing them to shrink.
- Radiofrequency ablation - Destroys fibroid tissue using heat via laparoscopy or other approaches.
- Endometrial ablation - Removes or destroys the uterine lining; not suitable for women wishing to preserve fertility.

4. Surgical Options
- Myomectomy - Surgical removal of fibroids, preserving the uterus; can be done via laparoscopy, hysteroscopy, or open surgery — preferred for women wishing to have children.
- Hysterectomy - Complete removal of the uterus; the only definitive cure for fibroids, but eliminates the possibility of pregnancy.
- Other surgeries - Laparotomy (open surgery), hysteroscopic or laparoscopic approaches depending on fibroid size and location.

When to Seek Treatment

- Heavy, prolonged, or painful periods
- Anemia from blood loss
- Pelvic pain or pressure
- Urinary or bowel problems
- Fertility issues