Uterine Fibroids

Uterine fibroids, also called myomas or leiomyomas, are non-cancerous tumors that grow from the muscle layers of the uterus. They often appear during childbearing years and may be as small as a bean or as large as a melon. Similarly, they range in number from a single growth to multiple growths.

Facts and Figures

They are not associated with an increased risk of uterine cancer and hardly develop into cancer. Fibroids affect about 30% of all women by the age of 35 years and up to 80% of women by the age of 50 years. These are the reproductive years when estrogen levels are higher.

Many women have uterine fibroids at some point in their lives, but most of them do not know they have them because they usually cause no symptoms. The doctor may discover fibroids during a prenatal ultrasound or pelvic exam.

About 400, 000 women in Kenya suffer from symptomatic uterine fibroids. It is estimated that more than 70% of women of the African heritage of childbearing age have uterine fibroids.

Symptoms

The majority of women with fibroids do not observe any symptoms. Those that do, symptoms can be influenced by the number, size, and location of fibroids. To women who have symptoms, the common ones include:

  • Frequent urination
  • Heavy menstrual bleeding
  • Pelvic pressure or pain
  • Menstrual periods that last more than a week
  • Constipation
  • Difficulty emptying the bladder
  • Leg or backache pains

Causes

Doctors are not certain about the cause of uterine fibroids, but clinical experience and research studies point to the following factors:

Hormones: Estrogen and progesterone are the two hormones responsible for stimulating the development of the uterine lining during the menstrual cycle in preparation for pregnancy. They seem to enhance the growth of fibroids when they stimulate the development of uterine lining. Fibroids often have more receptors for progesterone and estrogen than normal uterine muscles. When these hormones decrease or stop producing during menopause, fibroids tend to shrink, which means they are connected.

Genetic changes: Several fibroids contain changes in genes that vary compared to those in normal uterine muscle cells.

Other growth factors: Substances that enable the body to maintain tissues such as insulin-like growth factor may influence fibroid growth.

Most doctors think uterine fibroids develop from a stem cell in the myometrium (smooth muscular tissue of uterus). A single cell divides many times and eventually develops a firm, rubbery mass different from the tissues around.

Risk Factors

Race: Black women are at increased risk of developing fibroids than women from other races. At the same time, black women develop fibroids at younger ages and are likely to develop larger or more fibroids.

Heredity: If your sister or mother had fibroids, you are at increased risk of developing them.

Environmental Factors: the factors include use of birth control, the onset of menstruation at an early age, deficiency of Vitamin D, obesity, drinking alcohol including beer, fruit and dairy, and having diets lower in green vegetables and higher in red meat. 

Diagnosis

Uterine fibroids are diagnosed through two methods:

Pelvic Exam: The doctor may feel some irregularities in the share of your uterus that may be suggesting the presence of fibroids. If you show symptoms of uterine fibroids, the doctor may order the following test.

Ultrasound Test: It uses sound waves to get a picture of the uterus to confirm and map as well as to measure fibroids. This is done by a doctor or a technician who moves the transducer (ultrasound device) over the abdomen (transabdominal) or puts it inside the vagina (transvaginal) to get images of your uterus.

If the doctor has reasons to conduct further tests, he or she may order lab test for a complete blood count (CBC) to establish if you have anemia due to extreme blood loss or other blood tests to rule out thyroid problems or bleeding disorders.

Other imaging tests that can be used to diagnose fibroids include magnetic resonance imaging (MRI), hysterosonography, and hysteroscopy.

Treatment

There are several options used to treat fibroids:

Surgery: The traditional surgery procedures include myomectomy, hysterectomy (removal of the uterus), and cryosurgery.

Noninvasive procedure: It is an MRI-guided focused ultrasound surgery (FUS). It requires no incision and is conducted on an outpatient basis. It is undertaken while inside an MRI scanner.

Minimally invasive procedures: They include uterine artery embolization, myolysis, robotic or laparoscopic myomectomy, endometrial ablation, and hysteroscopic myomectomy. Most of these technologies are available in Kenya today.

Medications: Medications include gonadotropin-releasing hormone (Gn-RH) agonists, progestin-releasing intrauterine device (IUD), tranexamic acid (Lysteda), and other medications such as oral contraceptives or progestins recommended by the doctor.

Alternative Medicine: Alternative medicines, mostly herbal treatments, are widely used in Kenya. Others mentioned in certain consumer books and health websites include black cohosh, specific dietary recommendations, magnet therapy, and homeopathy. CAUTION: None of these alternative medicines have been scientifically proven to support effective treatment of fibroids. Consult your doctor before you engage any of them.

For more information on treatment, doctors, and hospitals near you for diagnosis and treatment of fibroids, download the Uzima Health App from Google Play.

Sources

https://www.medicalnewstoday.com/articles/151405.php

https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288

https://www.standardmedia.co.ke/article/2000022920/the-modern-woman-s-disease

https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/diagnosis-treatment/drc-20354294