Dr. Sidiq Aldabbagh, MD - OBGYN

What are fibroids?

 

Uterine fibroids are benign lumps that grow in the uterus. Almost 50% of women will get uterine fibroids by the age of 50. These are benign (non-cancerous) lumps but can lead to symptoms that can affect the quality of your life.

 

What causes fibroids?

 

The exact cause of fibroids is not known, but they are more common in African American Women. Fibroids usually grow slowly and can sometimes reach impressive size even up to the size of a full term pregnancy!

Fibroids are estrogen-dependent and therefore are uncommon before the age of 20 and tend to shrink after menopause.

 

What are the common symptoms?

 

Fibroids are known to cause period-related symptoms. Heavy periods, intermenstrual bleeding and fatigue due to anemia are common symptoms. With increasing size, fibroids can be felt as a tummy mass and can press on the bladder leading to frequency and urgency of micturition. Sometimes, they outgrow their own blood-supply and can become painful.

 

How do you make a diagnosis?

 

An ultrasound scan is the best way to detect the size and location of uterine fibroids.

 

What are the fibroid treatment options?

 

Treatment depends on the size and location of the fibroids and symptoms caused. Asymptomatic fibroids can be left alone.

 

Management of symptoms:

to reduce the heaviness of periods and treat anemia

 

• Hysteroscopic resection: Suitable for intra-cavity (submucous) fibroids
• Laparoscopic myomectomy: Suitable for fibroids up to 10cm in size
• Open myomectomy: Reserved for very large and numerous fibroids
• Uterine artery embolization: Treatment to block blood supply of fibroids leading to shrinkage
• Hysterectomy (Vaginal, laparoscopic or open): A permanent solution suitable for women with severe symptoms who have completed their family

 

Can fibroids affect pregnancy?

 

In presence of fibroids, pregnancy often progresses without any problems but it can also be a rocky relationship! Fibroids can make it more difficult to get pregnant and can also increase the risk of miscarriage or premature delivery. You are more likely to have a breech presentation or transverse lie and need a cesarean section.

Bleeding after delivery can also be a problem. See your doctor to see if removal of fibroids is necessary before getting pregnant.

 

Is there a risk of fibroids turning malignant?

 

This is very rare and is quoted as 1 in 1000. If the fibroids are growing at a very rapid rate, malignancy is suspected and need to be evaluated ASAP.