By Dr. Suranga Hettipathirana
Although Fibroids are non-cancerous, benign fibrous growths that develop in or around the uterus, they can often present numerous complications that hinder a patient’s daily lifestyle. Affecting a significant 40% of women in their childbearing age, these growths are made up of muscle and fibrous tissue, and vary in size. They’re sometimes known as uterine myomas or leiomyomas. Many women are unaware they have fibroids because they do not present any symptoms.
While the exact cause of fibroids is unknown, they have been linked to fluctuations in the female reproductive hormone oestrogen, which is produced by the ovaries. Fibroids have a tendency to develop during a woman’s reproductive years, from the age of 16 to 50 when oestrogen levels are at their highest. However, they tend to shrink when oestrogen levels are low, after menopause, when the menstrual cycle stops. They can grow anywhere in the womb and vary in size considerably. Some can be the size of a pea, whereas others can be the size of a melon.
Among the several types of fibroids that have so far been identified, the most common is intramural fibroids, which develop in the muscle wall of the womb, while subserosal fibroids develop outside the wall of the womb, in the pelvis and have a tendency to become very large. Submucosal fibroids develop in the muscle layer beneath the womb’s inner lining and grow into the cavity of the patient. In some cases, subserosal or submucosal fibroids are attached to the womb with a narrow stalk of tissue. These are known as pedunculated fibroids.
Recognizing the growth of Fibroids in your body
Although, many women are unaware they have fibroids as they do not present any symptoms, those who do may experience heavy or painful menstrual flow, abdominal discomfort, lower back pain, a frequent need to urinate, bowel problems, pain or discomfort during sex. In rare cases, further complications caused by fibroids can affect pregnancy or cause infertility.
Who are most at risk?
There are several notable risk factors that can induce the development of fibroids. Most often, fibroids have been most known to develop in women between the ages of 30 – 50, particularly in those who are overweight or obese because these conditions increase the level of oestrogen in the body. More often than not, genetics too play a role in fibroid formation. If your mother or sister had fibroids, you are at an increased risk of developing them. Finally, diets heavy in red meat is also associated with an increased risk of fibroids while green vegetables, fruits, and dairy decrease risk.
Diagnosing fibroids
As they are mostly asymptomatic, the presence of fibroids is generally diagnosed incidentally when patients get examined for other conditions. They could be detected during a pelvic examination coupled with an abdominal examination. A large proportions of patients do not know the existence of a fibroid until it has been detected during a routine examination.
Other ways to diagnose fibroids include a trans-vaginal ultrasound scan, which uses a small instrument called a transducer that’s placed in the vagina, trans-abdominal ultrasound scan, which uses an ultrasound scan to look at pelvic organs. Magnetic Resonance Imaging (MRI) also provides a two-dimensional view of an internal organ or structure while a hysteroscopy examines the uterine cavity for any abnormal masses. In addition to these procedures, fibroids could also be detected during other vaginal examinations as well.
What are the treatment options available for Fibroids in Sri Lanka?
Fibroids don’t need to be treated if they aren’t causing symptoms. Over time, they’ll often shrink and disappear without treatment, particularly after menopause. If you do have symptoms, medication to help relieve the symptoms will usually be recommended first. There are also medications available to help shrink fibroids. If these prove ineffective, surgery such as a myomectomy or hysterectomy may be performed; depending on the age and fertility wishes of the patient. A myomectomy is usually recommended to those of a young age with fertility wishes, while a hysterectomy is recommended for patients over the age of 40. Both these procedures can be done using less invasive techniques such as laparoscopy.
As an internationally accredited, multi-specialty chain of hospitals, Hemas Hospital, Thalawathugoda and Wattala, offer an exceptional and comprehensive care portfolio for women, including treatment options for uterine fibroids to endometriosis and other complications that could impact sterility. They offer the most recent minimally-invasive treatment for all such conditions. Together with the skilled and purpose-trained team of doctors, clinicians and nurses operating state-of-the-art specialized equipment, laparoscopic procedures conducted here use minimal incisions and enable patients’ faster recovery period, shorter stays in hospital, less pain and least amount of scarring, which is aesthetically more suited for female patients. This is deemed to be far more effective and efficient alternative to traditional open surgery.