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Uterine Fibroid


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Uterine Fibroid

Uterine fibroids (also referred to as uterine leiomyomata, uterine leiomyomas, or uterine myomas) are benign tumors that originate in the uterus ( womb ). The medical term for fibroids is uterine leiomyomata (you-ter-in lie-oh-my-oh-mah-tah) Although fibroids are sometimes called tumors, they are almost always benign (not cancerous). Also called fibromyomas, leiomyomas or myomas, uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer. Most of the time, uterine fibroids aren't harmful. They too can cause heavy menstrual periods (menorrhagia), well as bleeding between periods.  Some of these can also be removed by hysteroscopic resection.  Many of these do not cause problems unless they become quite large.  They can grow quite large, but do not typically affect the size of the womb cavity. They are more likely to produce pressure symptoms than heavy periods or infertility. Uterine fibroid embolization, done under local anesthesia, is much less invasive than open surgery done to remove uterine fibroids. The procedure is performed by an experienced interventional radiologist, a physician specially trained to perform uterine fibroid embolization and similar procedures. Fibroids cause problems for about one in four women, most frequently during their 30s or 40s Fibroids can require emergency treatment if they cause sudden, sharp pelvic pain. It was found that after embolization and while awaiting surgery, many patients no longer had symptoms, and frequently the operation itself proved not to be necessary. Today uterine fibroid embolization is used as a stand-alone treatment for women who have symptom-producing uterine fibroids.

Fibroids are named depending upon where they lie. As many as three out of four women have uterine fibroids, but most are unaware of them as they often cause no signs or symptoms. They typically give the uterus a globular feeling on examination (like early pregnancy).Uterine fibroids are non-cancerous tumors that develop within or attach to the wall of the uterus, a female reproductive organ. They increase overall blood flow to the uterus and if large can distort and enlargen the internal cavity, even if they don't encroach onto it. An estimated 600,000 hysterectomies (removal of the uterus) are performed in the US annually, and at least one-third are for fibroids. Medications and newer, less invasive surgery can control the growth of fibroids. Discuss your options with your doctor. Consider seeking opinions from doctors in specialties such as obstetrics and gynecology, women's health, and interventional radiology. One such therapy, uterine artery embolization (UAE) , shows great promise in controlling symptoms caused by fibroids. In general, fibroids cause no problems and seldom require treatment. Medical therapy and surgical procedures can shrink or remove fibroids if they cause discomfort or troublesome symptoms. Although these tumors are called fibroids, this term is misleading because they consist of muscle tissue, not fibrous tissue. Submucosal (submucous) fibroids are located inside the uterine cavity beneath the lining of the uterus. Intramural fibroids are located within the muscular wall of the uterus.

Causes of Uterine Fibroid

The common Causes of Uterine Fibroid :

  • Linked to estrogen level - uterine fibroids may increase in size during pregnancy or when using birth control pills (when estrogen levels are high), and decrease in size after menopause when estrogen levels are low.
  • Evidence that progesterone may stimulate fibroid growth .
    prevalent in women with endometriosis - a condition in which fragments of the endometrium are found in other parts of (or on organs within) the pelvic cavity
  • African American heritage (occurring 3-9 times more often than in Caucasian women).
  • Being overweight, obesity .
  • The risk of fibroids decreases as the number of children borne to a woman increases.
  • A high body weight increases the risk of developing fibroids.
  • The cause of fibroids is unknown, but may be related in part to changes in oestrogen and progesterone levels.
  • Doctors have long recognised that fibroids are dependent on female hormones (chemical signals carried in the blood called oestrogens) for maintaining their growth and size. Once a woman reaches the menopause, fibroids will usually shrink.

Symptoms of Uterine Fibroid

Some common Symptoms of Uterine Fibroid :

  • Sensation of fullness or pressure in lower abdomen.
  • pain.
  • Urinary incontinence, frequent urination or urine retention.
  • Pelvic cramping or pain with periods.
  • feeling of fullness in the pelvic area (lower abdomen).
  • Constipation .
  • Frequent urination.
  • Pelvic pressure, “feeling full” in the lower abdomen, lower abdominal pain
  • Increase in urinary frequency.
  • Sudden, severe pain due to a pedunculated fibroid.

Treatment of Uterine Fibroid

  • Treatment for fibroids depends on your symptoms, the size and location of your fibroids, your age (how close you are to menopause), your desire to have children, and your general health.
  • Hysterectomy or myomectomy can be performed. Based on the size and location of the lesion, different approaches can be considered: laparotomy , laparoscopy , or hysteroscopy .
  • Other medical treatments such as anti-inflammatory medicines may help to relieve the pain of fibroids and some types of contraceptive pill may help.
  • Cutting out fibroids from the womb (called a myomectomy) in younger patients and in patients wanting children.
  • Using interventional radiology techniques, the Interventional physician occludes both uterine arteries, thus reducing blood supply to the fibroid(s).
  • Overall, the medical treatment reduces uterine and fibroid size (volumes), improves the anaemia and reduces the symptoms associated with fibroids. In some patients, it may allow the fibroids alone to be removed rather than the whole womb.