Uterine fibroids, also known as uterine leiomyomas or myomas, are muscle cell growths in the uterine (womb) wall that are benign (not malignant). They are the most prevalent pelvic tumour, affecting around 70% of women by the age of 50. This is a condition that affects women of all ages, but it is more common in those of childbearing age. Fibroids can range in size from invisible to the naked eye to the size of a grapefruit or greater. The majority of women with fibroids have no symptoms and do not require treatment.
Tests to find out uterine fibroids:
Uterine fibroids are often discovered by chance during a normal pelvic exam. Your doctor may see irregularities in the shape of your uterus, indicating the presence of fibroids. If you have symptoms of uterine fibroids, you may need the following tests:
Ultrasound: This test employs sound waves to capture an image of your uterus. It can confirm, map, and measure fibroids. A doctor or technician moves the ultrasound instrument, known as a transducer, across your abdominal area. This is known as transabdominal ultrasonography. Or, the device is inserted into your vagina to obtain photographs of your uterus. This is known as a transvaginal ultrasound.
Laboratory tests: If you have irregular monthly bleeding, you may require blood tests to determine the cause. A full blood count to check for anaemia owing to continuing blood loss may be one of them. Other blood tests can look for bleeding issues and thyroid abnormalities.
If an ultrasound does not provide adequate information, you may require additional imaging examinations, such as:
Magnetic resonance imaging, or MRI: This test can reveal more about the size and location of fibroids. It can also detect various sorts of tumours and help choose treatment options. An MRI is most commonly utilised in people with a bigger uterus or those nearing menopause, also known as perimenopause.
Hysterosonography: Hysterosonography is the use of sterile salt water (saline) to increase the area inside the uterus, known as the uterine cavity. This makes it easier to obtain photos of submucosal fibroids and the uterine lining if you’re attempting to conceive or have heavy menstrual flow. Another term for hysterosonography is a saline infusion sonogram.
Hysterosalpingography: Hysterosalpingography is the employment of a dye to highlight the uterine cavity and fallopian tubes on X-ray pictures. If you are experiencing infertility, your doctor may recommend it. This test can determine whether your fallopian tubes are open or blocked, and it can detect some submucosal fibroids.
Hysteroscopy: During this exam, your doctor inserts a small, illuminated telescope called a hysteroscope through your cervix into your uterus. The uterus is then filled with saline. This extends the uterine cavity, allowing your doctor to examine the uterine walls and fallopian tube apertures.
Symptoms:
- Abnormal uterine bleeding, such as heavy or protracted period
- Anaemia due to blood loss
- Constipation or Rectal Pain
- Large fibroids induce enlargement of the abdomen.
- Frequent urination or trouble urinating
- Menstrual pain.
- Pain during intercourse.
- Pelvic pressure
- Low backache
- Reproductive issues (such as infertility and miscarriage)
- Vaginal bleeding not related to menstruation
Treatments
There is no single optimum treatment for uterine fibroids. Numerous therapeutic options exist. If you have symptoms, consult with your healthcare team about how to seek relief.
- Watchful waiting: Many persons with uterine fibroids exhibit no symptoms. Alternatively, they have mildly bothersome symptoms that they can live with. If this is the case for you, watchful waiting may be the best option. Fibroids are not cancerous. They rarely interfere with a pregnancy. They frequently grow slowly — or not at all — and tend to diminish after menopause, when reproductive hormone levels fall.
- Medicines: Medicines for uterine fibroids target hormones that regulate the menstrual cycle. They address symptoms like heavy menstrual bleeding and pelvic discomfort. They do not remove fibroids, although they may diminish them. Medications include:
- Gonadotropin-releasing hormone (GnRH) agonists: These treat fibroids by preventing the body from producing the hormones oestrogen and progesterone. This induces a transient menopause-like state. As a result, menstrual cycles end, fibroids decrease, and anaemia often improves.
GnRH agonists include leuprolide (Lupron Depot, Eligard, etc.), goserelin (Zoladex), and triptorelin (Trelstar, Triptodur Kit). Many people get hot flashes when utilising GnRH agonists. Typically, these medications are taken for no longer than six months. That’s because symptoms recur when the medication is removed, and long-term use can lead to bone loss. Sometimes GnRH agonists are used with low-dose oestrogen or progestin. You could hear this referred to as add-back therapy. It can reduce negative effects and may allow you to take GnRH agonists for up to 12 months.
Your doctor may give a GnRH agonist to reduce the size of your fibroids before surgery. Alternatively, you may be prescribed this medication to assist you move into menopause.
- Gonadotropin-releasing hormone (GnRH) antagonists: These medications can treat heavy menstrual bleeding in persons with uterine fibroids who have not gone through menopause. However, they do not decrease fibroids. GnRH antagonists can last for up to two years. Taking them in conjunction with add-back therapy helps reduce negative effects including hot flashes and bone loss. Sometimes these medications already contain low-dose oestrogen or progestin. GnRH antagonists include elagolix (Oriahnn) and relugolix (Myfembree).
- A progestin-releasing intrauterine device: A progestin-releasing IUD can help with fibroids-related excessive bleeding. It simply alleviates symptoms, though. It does not shrink or remove fibroids. It also prevents pregnancy. Tranexamic acid (Lysteda; Cyklokapron). This nonhormonal medication can help with heavy menstrual cycles. You only take it on days when you’re bleeding heavily.
- Other medications: Your doctor may recommend other medications. For example, low-dose birth control medications can help regulate menstrual bleeding. However, they do not lower fibroid size. Nonsteroidal anti-inflammatory medicines (NSAIDs) can help decrease pain associated with fibroids, but they do not diminish fibroids-related bleeding. NSAIDs are not hormonal medications. Examples include ibuprofen (Advil, Motrin IB, and others) and naproxen sodium (Aleve). If you have excessive menstrual bleeding with anaemia, your doctor may recommend vitamins and iron supplements.
If you’re experiencing symptoms of uterine fibroids or seeking a comprehensive treatment plan, consulting a skilled gynaecologist is essential. For those in the UAE, numerous highly qualified gynaecologist in Dubai are equipped with the latest knowledge and technologies to provide personalized care. By partnering with a dedicated specialist, you can navigate your treatment journey with confidence, ensuring the best possible outcomes for your reproductive health and overall well-being.