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 belly to bulge. When this happens, the fibroids can press on organs, resulting in increased pelvic pressure, a sudden and frequent urge to urinate, and difficulty passing bowel movements. Fibroids can also contribute to infertility, and pregnancy and childbirth complications.

However, the risk of the fibroid being cancerous remains low and, in most cases, does not cause any symptoms nor affect daily activities.

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 increases pressure against the uterus and prevents the uterus from contracting normally, resulting in longer and heavier menstrual bleeding.
• Abdominal cramps or discomfort
  As fibroids develop, they increase the surface area of the uterine lining, which can result in cramps between periods or a sensation of heaviness in their lower abdomen and pelvis.
• Menstrual period lasting for more than a week
  Fibroids may place excessive pressure on the uterus, or stimulate the growth of blood vessels, potentially resulting in a longer period, or spotting between periods.
• Frequent urination
  As the fibroids grow, the uterus also expands. When this happens, the uterus presses on the bladder, affecting its capacity to store urine and resulting in frequent urination.
• Backache and leg pain
  Some types of fibroids develop outside the uterus, such as in the lower back near the spinal column. When fibroids grow in size, they can press on nerves located along the spine, causing pain. On the other hand, fibroids can also pinch the nerves and blood vessels that extend down to the legs, which may also result in pain and discomfort.
• Constipation and bloated stomach
  Fibroids develop on the uterus, which is directly in front of the colon that controls bowel movement. When these fibroids get bigger, they can press against the colon, 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 gynae 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 fibroid and they may be useful for women who are not fit for surgery or decline surgery. Some medications for uterine fibroids may include:
  • Gonadotropin-releasing hormone (GnRH) agonists
  • Progestin-releasing intrauterine device (IUD)
  • Tranexamic acid (Lysteda, Cyklokapron)
  • 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 mitigated pelvic pressure. This treatment is suitable for women who have fibroid symptoms and desire to have children in the future.

• Hysterectomy

  A hysterectomy is the permanent solution to removing fibroid. 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. Outside pregnancy, the uterus sheds its lining monthly in the form of menstruation. 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 treat the symptoms of uterine fibroids. Additionally, a fibroid surgeon may also remove surrounding tissues and organs like the ovaries and fallopian tubes.