Uterine Fibroids

Uterine fibroids are non-cancerous growths on the uterus. They are fairly common amongst women of childbearing age—about 30% of women above the age of 35 will have uterine fibroids.

Uterine fibroids, also called myomas or leiomyomas, are composed of muscle and fibrous tissue. They come in different sizes, ranging from the size of a seedling to a bulky mass. Large fibroids can cause the abdomen to distend. When this happens, the fibroids can press on organs, resulting in increased pelvic pressure, frequent urge to urinate and difficulty passing motion. They can also cause heavy prolong menstrual bleeding. Fibroids can also contribute to infertility along with pregnancy and childbirth complications.

However, the risk of the fibroid being cancerous remains low and for the majority of women, it does not cause any symptoms nor affect daily activities.

Uterine Fibroids Symptoms

As uterine fibroids vary in size and numbers, women who display signs and symptoms often experience the following problems:

• Heavy menstrual bleeding
  The growth of uterine fibroids distorts the uterine cavity and endometrium (lining of the uterus) resulting in longer and heavier menstrual bleeding.
• Abdominal cramps or discomfort
  As fibroids enlarge, they increase the surface area of the uterine lining, which can result in cramps during periods or discomfort in their lower abdomen and pelvis.
• Menstrual period lasting for more than a week
  Fibroids may distort the uterine cavity resulting in prolong menstrual bleeding and even spotting between periods.
• Frequent urination
  As the fibroids grow, the uterus also expands. When this happens, the enlarged uterus presses onto the bladder resulting in frequent urination.
• Backache and leg pain
  Some fibroids may protrude out from the uterus compressing the lower back near the spinal column. When fibroids increase in size, they can press onto nerves located along the spine, causing pain. Similarly, fibroids can also constrict the nerves and blood vessels that extend down to the legs, which may also result in pain and discomfort.
• Constipation and bloated stomach
  When fibroids enlarge and protrude out posteriorly against the colon, faecal bowel movements can be obstructed resulting in bloating or constipation.

Uterine Fibroids Treatment

If you experience any of the above symptoms, we advise you to seek treatment. Options at our gynaecology clinic include observation, medication or surgery.

• Medication
  Medication may be prescribed to relieve pain and reduce heavy menstrual flow. This will help alleviate the discomfort temporarily. There are also drugs available to reduce the size of fibroids and they may be useful for women who are not fit for surgery or decline surgery. Some medications to treat uterine fibroid symptoms include:
  • Gonadotropin-releasing hormone (GnRH) agonists
  • Progestin-releasing intrauterine system (IUS)
  • Tranexamic acid
  • Contraceptive pills
• Myomectomy

  This is a surgical procedure to remove the fibroids while leaving the uterus intact. With myomectomy, there is a chance of the fibroids recurring in the future.

  Patients who undergo this type of fibroid surgery experience decreased heavy menstrual bleeding and relief of pelvic pressure. This treatment is suitable for women who have fibroid symptoms and desire to have children in the future (fertility preservation).

• Hysterectomy

  A hysterectomy is the permanent solution to resolving fibroid problems. It involves removing the entire uterus which means that the patient will not be able to conceive in the future. The uterus, or womb, is where the foetus grows and develops. The uterus sheds its lining monthly in the form of menstruation so after a hysterectomy, a woman will also no longer have her monthly periods.

  A hysterectomy is a recommendation made only when other treatments have failed to resolve the symptoms of uterine fibroids. Additionally, during fibroid surgery surrounding tissues and organs like the ovaries and fallopian tubes may also be removed.