Signs Of Uterine Fibroids – What Causes Uterine Fibroids? Symptoms And Treatment – Uterine Fibroids – Symptoms And Causes
A fibroid uterus is the most common benign tumour of the female genital tract. Although fibroid still remains the most popular term with the common people, but its usage in the medical literature has become obsolete and replaced by better and more scientific terms such as leiomyoma, fibromyoma or simply myoma.
In medical terminology when a term ends with post-fix ʻomaʼ, it signifies a tumour which means ʻa new growthʼ. Leiomyoma, thus, is a simple, innocent and benign tumour arising from the smooth muscle of the uterine wall (myometrium). Fibroid or leiomyoma of the uterus is extremely common and is the second most common cause of the pelvic mass after pregnancy. It accounts for about 10 per cent of all gynaecological patients attending a hospital. In our own series of 500 hysterectomy specimens, leiomyoma were found in 48 per cent of the cases.
Fibroids are rare before the age of 20. They are in microscopic forms between 20 and 30 years, then become large enough to produce symptoms between the age of 35 and 45 years. It has been estimated that every fourth woman after the age of 35 develops a fibroid uterus which may or may not produce symptoms.
Aetiology of a fibroid uterus – What Causes Uterine Fibroids? Symptoms And Treatment
Very little is known about the cause of fibroid formation in the uterus. Knowledge gained from the study of patients suffering from myomas reveals that the tumours develop almost entirely during the reproductive years, enlarge during pregnancy and also in women who are on oral contraceptives, and regress to some extent after menopause.
It has also been observed that myomas are more commonly seen in nulliparous women than in multiparous women. These facts suggest that some abnormal hormonal phenomenon is responsible for tumour formation.
Comments such as “Those uteri which do not produce children, produce fibroids”, “A uterus which is deprived of pregnancy consoles itself with myoma” and “fibroids are the rewards of virtue, babies the fruits of sin” made by some of the medical scientists and authors are worth mentioning.
Symptoms And Signs – What Causes Uterine Fibroids? Symptoms And Treatment
- When symptoms appear, they are varied depending upon the site, size, number and duration of tumour(s) in the uterus and any other associated complication or abnormality.
- Symptoms may be in the form of menstrual disturbance, mass, pressure, pain, anaemia, infertility and or vaginal discharge. The most common symptom, however, is menorrhagia. It is a menstrual disturbance characterised by increased duration of bleeding or increased loss of blood or both, but the regularity of the menstrual cycle remains unaltered.
- Rarely, certain other forms of menstrual disturbances such as frequent menstruation (polyymenorr hoea), painful menstru ation (dysmenorr hoea) and intermen strual bleeding (metrorrhagia) may also occur.
- When irregular and continuous bleeding occurs in a woman of menopausal or post-menopausal age, there may be the possibility of associated cancer of the uterine cavity which needs thorough investigation.
- Most women feel a sensation of heaviness or weight in the pelvis or lower abdomen associated with an increased vaginal discharge. A fibroid is often a cause of infertility, anaemia and abdominal swelling. Pain may be the presenting symptom when the fibroid is complicated by tension, degeneration, adhesion, extrusion or malignancy.
- On examination, there is a pelvic mass which is hard in consistency, non-tender, movable from side to side made up of irregular enlargement of the uterus (uterus plus tumour).
Uterine Fibroids And Pregnancy
A uterine fibroid and pregnancy may coexist in the same patient and complications of pregnancy are extremely common in such cases. The fibroid may lead to abortion, premature labour, malpresentation of the foetus, ante-partum haemorr hage, obstructed labour, uterine inertia, post-partum haemorrhage and infection after child birth. During pregnancy a fibroid may show enlargement and degenerative changes, particularly of the red type causing acute severe abdominal pain, tenderness, vomiting and fever. On examination of the uterus, there may be a single or multiple tumours. Usually there are multiple – on an average five-25 but up to 200 have been recorded.
All fibroids arise from the substance of uterine muscle; some remain limited to the muscular wall (intramural), some project on its surface (subserous) and a few grow towards the uterine cavity covered by endometrium (submuceous). Long-standing myomas undergo various types of degenerations because their blood supply cannot keep pace with their rate of growth and get changed in their physical appearances. A fibroid may shrink (atrophy), become waxy (hyaline), soft (fatty), liquify (cystic) reddish beef-like (red) and stony hard (calcification). Cancerous change is very rare.
Uterine Fibroids Treatment – Uterine Fibroid Removal
There is no single uniform formula for the treatment of a fibroid uterus. In fact, there are many modes of treatment available and the choice of one is made after consideration of total clinical conditions which will also require a detailed discussion between the patient and her treating doctor.
The choice has been made more difficult with the introduction of newer technologically advanced methods which are very costly. The real solution lies in finding out its cause and then removal of the cause so that fibroids are not formed; till then the women will have to suffer.