Uterine fibroids are a common condition of the uterus. It is estimated that as many as half of all females of reproductive age have fibroids at some point. Most cases are not diagnosed and therefore most women do not even know that they have these growths. There may be no symptoms or very mild symptoms and no further medical attention is sought. However, some women may experience severe symptoms as a result of these growths.
How To Spot Uterine Fibroids
About 60% of uterine fibroids cases are symptomatic. However, these symptoms are not always associated with fibroids and without a gynecological examination the fibroids remain undiagnosed. This is largely due to the fact that uterine fibroids do not cause any specific symptoms. The growths usually shrink later in life and may therefore not require any medical treatment unless symptoms are severe.
Symptoms of uterine fibroids depend on several factors such as the size, location and number of fibroids that are present. It is important to understand how and from where uterine fibroids arise in order to understand the nature of the symptoms in this condition. Fibroids are smooth muscle growths that arise from the middle muscular layer of the uterus known as the myometrium. These tumors can be very small or large to the point that it significantly enlarges the uterus. Similarly there may be just a single fibroid or multiple growths.
The only way to know if uterine fibroids are present or not is though diagnostic investigations. The need for investigations may be dependent on the medical history and any findings during a physical examination. However, fibroids cannot be conclusively diagnosed by the symptoms alone. Even if masses can be felt during a physical examination, further diagnostic investigation is needed to confirm that these masses are fibroids.
Imaging techniques (scans) such as an ultrasound, CT (computed tomography) scan, MRI (magnetic resonance imaging) and HSG (hysterosalpingography) may help with the diganosis. More aggressive techniques to identify the fibroids may include hysteroscopy, endometrial biopsy and laparoscopy. Sometimes uterine fibroids are discovered routinely during investigations for other conditions.
What do uterine fibroids do?
As mentioned, most cases of uterine fibroids do not cause any symptoms and may never be identified. These masses can resolve on its own without any medical treatment. However, when uterine fibroids persist especially if it is large and multiple and causing symptoms then the fibroids need to be removed. It is important to note that the symptoms of uterine fibroids mentioned below may also be caused by other gynecological conditions.
Heavy and Prolonged Periods
Abnormal periods is one of the common signs of uterine fibroids. The periods are both heavy and prolonged, lasting longer than 7 days. This is known as menorrhagia. However, heavy and prolonged periods are not unique to uterine fibroids. There may also be spotting before and after the periods, and some women may also experience bleeding between periods (intermenstrual bleeding).
Pelvic Discomfort and Pain
Another feature of uterine fibroids is discomfort and pain. This may vary from a feeling of pressure to overt pain which is usually felt in the pelvic region but may extend to the lower abdomen and even the low back. Sometimes this pressure feeling may be described as a bloated sensation. The pain can be continuous or intermittent. Pain during sexual intercourse may also be reported. However, there may also be no discomfort or pain in many cases of fibroids.
Infertility and Pregnancy
Uterine fibroids may cause problems with falling pregnant for several reasons. Fibroids can block fallopian tubes, prevent sperm from reaching the egg cell and affect the implantation of the fertilized egg on the uterine wall. Furthermore uterine fibroids can also cause problems in pregnancy and even lead to miscarriage, premature labor and placental abruption.
Due to the close proximity between the uterus and bladder, several different urinary symptoms may arise with uterine fibroids. However, this is more likely to occur where the fibroids are large and impinging on the bladder. These urinary symptoms of fibroids may include frequent urination, urinary incontinence (leaking of urine) and difficulty emptying the bladder. Sometimes a blocked ureter may prevent urine emptying from the kidney but this is a rare complication of uterine fibroids.
Back and Leg Pain
Lower back pain is a common sign of uterine fibroids along with pelvic pain. This may be due to referred pain from the uterus to the back but it can also arise when the fibroids press on lower back structures. Similarly the fibroids may compress the nerves that supply the legs thereby leading to leg pain.
Another possible complication of uterine fibroids is constipation. This is more likely to arise when larger fibroids press on the rectum which lies behind the uterus. In these cases, passing stool can be difficult and there may also be pain during a bowel movement.
NB: Symptoms like constipation and pain during bowel movements should not be assumed to be due to fibroids when fibroids are known to be present. These bowel symptoms need to be assessed independently by a medical professional.
Do uterine fibroids cause cancer?
Many different abnormal growths arise in the body during the course of life. Some are benign and others are malignant (cancerous). It is also possible for a benign growth to become pre-cancerous or even develop into cancer. Fibroids are benign (non-cancerous) and do not increase the risk of uterine cancer. The vast majority of fibroids are benign although one very rare type of uterine fibroid, known as leiomyosarcoma, is cancerous.
The recent concern about the uterne fibroids and uterine cancer revolves around certain types of fibroid surgery. One type of uterine fibroid removal surgery known as laparoscopic power morcellation breaks the fibroid to then remove it through a small incision. However, there is the risk that if uterine cancer is present then this procedure may spread the cancer. Therefore laparoscopic power morcellation is not advised these days for fibroid removal.