You are suffering from severe pelvic pain and have sought help from your friends and family!
Some told you that it is a normal menstrual pain, while others might have told you about uterine fibroids.
This condition raises concerns and confusion, such as:
“Why do I have uterine fibroids?” or “Do fibroids cause cancer?”
In this blog, I will guide you and answer questions you might have about the topic.
What’s happening in my uterus?
I will begin with the simplest question, “What are fibroids?”
The non-cancerous growths that arise from the muscle tissue of the uterus are called uterine fibroids,
These are firm, dense knots or lumps, may vary in size, from incredibly tiny, like a grain of rice, to quite large, sometimes even the size of a melon. You could have just one or multiple fibroids scattered within or on your uterus.
These subserosal fibroids develop on the outer surface of the uterus.
Submucosal fibroids in the uterine cavity can be tricky to manage.
When either of them attaches themselves to the uterus with a thin stalk, they are called pedunculated fibroids.
If you ask, “Do fibroids cause cancer?”, I would say that the chances are 1 in 1000. However, you must visit your doctor if you are seeing these signs.
Can you tell me what causes uterine fibroids to grow?
Hormones: Fibroids tend to flourish during a woman’s reproductive years when these hormone levels are high. This is why they often shrink or disappear after menopause, when hormone levels naturally decline.
Genetics: Family history plays a role.
Other Growth Factors: Substances in your body that help with cell growth and repair, like insulin-like growth factors, might also contribute.
Lifestyle: Factors like obesity and certain dietary patterns (e.g., diets high in red meat and low in green vegetables) have been linked to a higher risk, but more comprehensive studies are ongoing.
What are the symptoms of having uterine fibroids?
For many women with fibroids, experience no symptoms at all. However, when symptoms do show up, they can range from mildly annoying to significantly disruptive.
Heavy or Prolonged Menstrual Bleeding (Menorrhagia): Periods might last longer than seven days, be unusually heavy, or involve large clots. This can often lead to anemia (low blood count), making you feel constantly tired, weak, and dizzy.
Pelvic Pressure or Pain: You might feel a constant sense of fullness, heaviness, or discomfort in your lower abdomen. Sometimes, it’s a sharp, acute pain.
Frequent Urination: If fibroids press on your bladder, you might feel the need to ur urinate more often, or even find it difficult to fully empty your bladder.
Backache or Leg Pains: If fibroids press on nerves in your pelvis or lower back.
Reproductive Challenges: In some cases, fibroids can make it difficult to conceive (infertility) or lead to complications during pregnancy, such as miscarriage or premature labour, particularly if they affect the uterine cavity or block fallopian tubes.
So, “Are fibroids dangerous?” The short answer is yes, because they can impact your life’s quality and health.
Does size matter for uterine fibroids?
I’ve had patients ask me, “Which size of fibroid is normal?”, or “Which size of fibroid is dangerous?”
Let me clarify, the size is not the concern, its impact is.
Symptoms Caused: A tiny fibroid, if it’s a submucosal one (growing into the uterine cavity), can cause incredibly heavy bleeding, severe pain, or even fertility issues. In contrast, a very large fibroid (think the size of an orange or grapefruit) sitting quietly on the outside of the uterus (subserosal) might cause no symptoms at all, or perhaps just a feeling of pressure on your bladder or bowel.
Location: As we discussed, where a fibroid is located often dictates its impact far more than its absolute measurement. A fibroid near your fallopian tubes or cervix might interfere with conception, while one pressing on your bladder might cause frequent urination.
Rate of Growth: While rare, a very rapid increase in fibroid size might sometimes warrant a closer look from your doctor.
Looking at uterine fibroid treatment options
Watchful Waiting (Expectant Management):
If your fibroids are small, not causing symptoms, or if you’re close to menopause (when fibroids often naturally shrink), your doctor might simply suggest monitoring them with regular check-ups and ultrasounds.
Medical Management:
These treatments focus on managing symptoms and, in some cases, temporarily shrinking fibroids.
Supplementary tablets: Iron Supplements are essential to combat anemia caused by heavy bleeding.
Hormonal Medications:
Birth control pills or other hormonal contraceptives can help regulate your menstrual cycle and reduce heavy bleeding.
GnRH agonists (e.g., Leuprolide): These injections temporarily put your body into a “menopausal state” by reducing estrogen, which can significantly shrink fibroids. They’re often used short-term before surgery to make fibroid removal easier. However, they come with menopausal side effects like hot flashes.
Tranexamic Acid: A non-hormonal medication specifically designed to reduce heavy menstrual bleeding.
Minimally Invasive Procedures (Non-Surgical):
Uterine Fibroid Embolization (UFE) / Uterine Artery Embolization (UAE): An interventional radiologist inserts a tiny catheter into an artery and injects small particles that block the blood supply to the fibroids. Starved of blood, the fibroids shrink and often die. It’s a great choice for many women who want to avoid surgery and preserve their uterus.
Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS): This non-invasive technique uses high-intensity ultrasound waves to heat and destroy fibroid tissue, all while guided by an MRI.
How to remove uterine fibroids? This is another question patients ask me.
Surgical Management:
Surgical options are considered for severe symptoms, very large fibroids, or when medical treatments haven’t been effective.
Myomectomy: This procedure involves surgically removing only the fibroids while leaving your uterus intact. It’s often the preferred choice for women who wish to preserve their fertility or simply keep their uterus.
Abdominal Myomectomy (Open Surgery): Involves a traditional incision in the abdomen.
Laparoscopic Myomectomy (Keyhole Surgery): Uses small incisions and specialized instruments for a less invasive approach.
Hysteroscopic Myomectomy: Used specifically for submucosal fibroids, where instruments are inserted through the vagina and cervix into the uterus, with no external incisions.
Hysterectomy is a definitive cure for fibroids, but it means you can no longer become pregnant. Hysterectomy is usually considered for women with very large or numerous fibroids, debilitating symptoms, or when other treatments have failed, especially if they have completed their family.
Our traditional Indian diets, rich in diverse whole grains, lentils, and fresh vegetables, can be a great asset in managing overall health, including potentially mitigating risk factors for fibroid growth. However, with modern lifestyles often leading to more processed foods and sedentary habits, it’s crucial to maintain a balanced approach. Practices like yoga and other traditional wellness techniques can also complement uterine fibroids treatments by helping manage stress and pain.
Uterine fibroids are a common, non-cancerous condition that affects many women. While they can certainly bring challenging symptoms, remember that they are not malignant, and a range of highly effective treatment options exist. The “best” path for you will always be a personalized one, determined in consultation with your doctor.
The most important step you can take is to be attuned to your body, recognize any new or worsening symptoms, and have an open, honest conversation with your healthcare provider.
Dr. Pankhuri Gautam has been working with patients suffering from uterine fibroids to provide practical and personalized treatment plans.
What questions or concerns do you have about fibroids that we haven’t covered yet?
Schedule a consultation today!
Frequently Asked Questions
I’ve been diagnosed with a small fibroid, but I have no symptoms. Do I still need treatment, or will it just go away on its own?
If your small fibroid isn’t causing any symptoms like heavy bleeding or pain, it often doesn’t require immediate treatment. Many women live with small, asymptomatic fibroids throughout their lives without any issues. They usually don’t just “go away” on their own before menopause, but they often stop growing or even shrink after menopause when hormone levels drop.
Can lifestyle changes, like diet and exercise, help shrink or prevent fibroids from growing?
While lifestyle changes alone may not “shrink” existing large fibroids significantly, they play a very important role in overall health and can potentially help manage symptoms and prevent new fibroids from growing.
I am planning to conceive soon. Will my fibroids affect my ability to get pregnant or have a healthy pregnancy?
Fibroids can sometimes affect fertility and pregnancy, but it largely depends on their size and, most importantly, their location. Fibroids growing inside the uterine cavity (submucosal fibroids) or those blocking the fallopian tubes are more likely to impact conception or lead to complications like miscarriage or premature labor. However, many women with fibroids, especially small ones or those on the outer wall of the uterus (subserosal or intramural), have successful pregnancies without any issues. If you are planning to conceive, it’s crucial to discuss your fibroids with your gynecologist so they can recommend the best course of action.
