Dr Alice Huang

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Fibroids

Fibroids, also known as uterine leiomyomas or myomas, are non-cancerous (benign) tumours, commonly seen in women of childbearing age.

Fibroids are composed of muscle cells and other tissues. They develop in and around the wall of the uterus. They can cause differing degrees of symptoms and may compromise fertility depending on their size and site on the uterus.

Understanding fibroids, including their impact, how they are diagnosed, and available treatment options, is essential for those affected and for healthcare providers managing this common condition.

Statistics & Impact

Fibroids are incredibly common, affecting up to 80% of women by the age of 50.

They are most prevalent in women in their 30s and 40s, but they can occur at any age during a woman’s reproductive years. The exact cause of fibroids is unknown, though factors such as hormones (oestrogen and progesterone), family history, obesity, and ethnicity play a role in their development.
While many women with fibroids experience no symptoms, others may face significant discomfort and complications, such as heavy menstrual bleeding, pelvic pain, fertility issues, and pregnancy complications.

Symptoms & Diagnosis

The majority of women with uterine fibroids may have no symptoms. Other women may experience:

  • Infertility
  • Heavy or prolonged menstrual bleeding
  • Pelvic pressure or pain
  • Frequent urination
  • Constipation
  • Backache or leg pain
  • Difficulty in emptying your bladder

 

Diagnosis of uterine fibroids may involve a pelvic examination, followed by ultrasound evaluation. Other imaging techniques such as MRI scan and CT scan may also be employed.

Treatment Options

Treatment for fibroids depends on several factors, including symptom severity, fibroid size and location, age, health status, and desire for future pregnancies. Options range from watchful waiting for women with mild symptoms to medication and surgery for those with severe or persistent issues.

Some treatments target the symptoms of fibroids, such as medication for heavy or prolonged menstrual bleeding or pain medication for pressure or pain symptoms. Other treatment options are targeted at treating the fibroids. These include:
  • Medical hormonal treatments
  • Surgical treatments including:
    • Hysteroscopic myomectomy – removal of fibroids through endoscopic surgery through the cervix
    • Open myomectomy – removal of fibroids through the abdomen
    • Hysterectomy or removal of the uterus
    • Endometrial Ablation
    • Myolysis
    • Uterine artery occlusion
  • Radiological treatments including:
    • Uterine Artery Embolization (UAE)
    • Magnetic Resonance Guided Focused Ultrasound (MRgFUS)
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What are the risks during pregnancy associated with fibroids?

Some studies indicate that the presence of uterine fibroids during pregnancy increases the risk of complications such as first trimester bleeding, breech presentation, placental abruption, increased chance of caesarean section and problems during labour.

Conclusion

Fibroids are a common health concern for women, but advancements in medical research and treatment options continue to improve the quality of life for those affected.

By staying informed about fibroids and actively participating in your healthcare decisions, your can effectively manage your symptoms and reduce the impact of fibroids on your lives. Whether through medication, non-surgical procedures, or surgery, effective treatment is available, and you should feel empowered to seek care that best meets your needs and lifestyle.

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