Do you know what a fibroid is? If you answered no, you’re not alone. Yet a surprising number of women are living with fibroids — growths that develop in and around the womb—inside their bodies without even realising. It’s estimated that only around one in three people with fibroids have any noticeable symptoms, and many don’t discover that they have them at all until they have an unrelated gynaecological check-up. Before things start to sound too scary, you should know that fibroids are non-cancerous, and if they’re not leading to any pain or problems, they’re typically no cause for concern— in fact, they can disappear altogether without any need for treatment.
However, some fibroids can cause a significant amount of pain and discomfort, with symptoms ranging from mild and manageable with medication, to severe and requiring surgery.
“The most common symptoms are an increase in menstrual bleeding and/or a feeling of pain,” explains Dr Alex Garcia-Faura, Scientific Director at international fertility group Institut Marques. “Pain from fibroids is commonly associated with the days that you are menstruating, but usually subsides after taking painkillers like ibuprofen.”
“When the pain or the feeling of pressure is ongoing, or if it doesn’t ease off after taking common painkillers, then we would have to consider medical or surgical treatment.”
The symptoms associated with fibroids include heavy and painful periods, and pain in your back and stomach, as well as during sex. This means they can sometimes be mistakenly attributed to other conditions.
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“It’s unusual, but depending on the size and location of the fibroids, it is possible for them to compress the bladder or the bowel which can cause digestive or urinary symptoms,” Dr Alex says. “This can be confusing for a patient, but a medical examination will uncover the true cause of the problems.”
According to Dr Alex, there are no factors that predispose the onset of fibroids. However, the NHS states that they occur most often in those aged 30-50, and it’s thought they develop more frequently in those who are overweight or obese. “There are some factors which favour their growth and the appearance of symptoms,” he adds. “The key one is pregnancy, which causes a very intense hormonal stimulus on fibroids and increases their blood supply.”
The range in the sizes of fibroids is pretty dramatic – they can be as small as a pea or as large as a melon – and there are three main types: intramural, which develop in the muscle wall of the womb, subserosal, which develop outside the wall, and submucosal, which develop in the muscle layer beneath the womb’s lining and then grow into the actual cavity. Because of the area they grow into, some types of fibroids can also have an impact on your ability to conceive and carry a baby.
“They can make implantation difficult, and they occupy space within the uterine cavity which causes bleeding throughout the entire menstrual cycle,” explains Dr Alex. “When fibroids grow outside of the uterus, they do not affect fertility.”
Fibroids can increase the risk of miscarriage in your first trimester, or cause bleeding if the placenta implants near them. “However, it is the actual delivery of the baby and postpartum which can be the biggest cause of problems,” he notes. “Large fibroids can occupy the birth canal, where the baby should go through, and make vaginal delivery difficult. They can also interfere with labour contractions, causing them to be ineffective, and stopping the labour from progressing.”
“After the birth, fibroids can cause haemorrhages which can require a transfusion. In very specific cases, they can also result in a patient needing to undergo a post-partum hysterectomy.”
If you’re having pain associated with fibroids, or are concerned about any other symptoms that you think could be related, it’s important to speak to your doctor to find the correct course of treatment.
“In the simplest cases, analgesic treatment for pain or treatment with contraceptives to reduce menstrual bleeding is very effective,” says Dr Alex. “If the fibroids grow into the uterus, hysteroscopy [a procedure carried out via the vagina and cervix] is the best solution to remove them easily without hospitalisation.”
“In more complex cases, when multiple fibroids are found, or if they are large, medical treatment with stronger drugs may be necessary to reduce their size. Occasionally, abdominal or laparoscopic surgery will be the only solution.”
From: ELLE UK
