Uterine Fibroids
Uterine fibroids are benign growths of muscular tissue in the uterus. Uterine fibroids are fairly common - medical experts believe that as many as three in four women may have fibroids in their uterus, but because uterine fibroids rarely cause problems, most women are totally unaware that they have them. Uterine fibroids are sometimes referred to by doctors as “tumors,” however, these types of fibroids almost never develop into cancer. If a woman has a large number of fibroids in her uterus, or her uterine fibroids grow to a significant size, she may encounter some difficulties in getting pregnant.
Symptoms
Many women who have uterine fibroids experience no symptoms at all. If they do have symptoms, these are likely to include:
Heavy and/or prolonged menstrual bleeding
Bleeding in between periods
Pain in the pelvic and/or abdominal area
Pain in the back or legs
Constipation
Urinary incontinence and/or frequent urination
Fibroids And Fertility
Uterine fibroids range in size from the very, very small to the very large. If multiple fibroids grow in the uterus or a particularly big fibroid develops, the positioning of the reproductive organs may be affected. The uterus, for example, may become enlarged or distorted in shape. The fallopian tubes may become blocked or twisted. Such distortions or blockages may prevent sperm cells from reaching the fallopian tubes, which the sperm cells have to do if they are going to fertilize an egg. In this way, fertility can be reduced. Distortions of the uterus may create an unsuitable environment for the implantation of an embryo. This means a woman might lose a pregnancy because the embryo can’t find a place to settle and grow. Uterine fibroids are associated with a slightly increased risk of miscarriage.
Treatment
If you have uterine fibroids and you are experiencing unpleasant symptoms, or if you have had difficulty getting pregnant or have experienced repeated pregnancy loss, your doctor is likely to recommend treatment for you uterine fibroids. Treatment is directed at shrinking or removing the fibroids.
Drugs
Several types of drugs are used to treat uterine fibroids:
Gonadotropin-releasing hormone agonists induce an artificial state of menopause. This reduces the levels of estrogen and progesterone in the body. Uterine fibroids are sensitive to these hormones. The low estrogen and progesterone levels cause the fibroids to shrink. Gn-RH agonists may be used to shrink fibroids prior to surgery. Once the treatment stops, ovulation resumes and the patient is (hopefully) able to get pregnant.
Androgens are synthetic drugs similar to the male hormone testosterone. These drugs also cause fibroids to shrink but they may have unpleasant side effects (including excess hair growth and deepening of the voice).
Oral contraceptives, progestins and anti-inflammatory pain killers can help control the symptoms of fibroids (heavy menstrual bleeding and pain) but they do nothing to resolved fertility problems in the long term.
Surgery
A surgical procedure called a myomectomy may be performed to remove uterine fibroids from a woman who still wants to get pregnant. The type of surgery used (conventional, keyhole, etc.) will depend on the number of fibroids present and their location in the uterus, as well as on the health of the patient.
A hysterectomy (the removal of the uterus itself) may be performed to relieve the symptoms of uterine fibroids in a woman who doesn’t wish to have any more children. Once the surgery has been completed, it won’t be possible for her to get pregnant again.
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