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 Fibroids (also known as leiomyomas, myomas, myofibromas, fribomas, or fibromyomas) are the most common type of growth found in a woman’s pelvis. These are benign growths (non-cancerous tumours) developed from muscle tissue and attached to the muscular walls of the uterus during a woman’s reproductive years. According to the Women's Wellness Centre at KK Women’s and Children’s Hospital, fibroids rarely develop into cancer (sarcoma).
The location, number, size and rate of growth of the fibroids differ from woman to woman. Those that grow inside the muscle wall of the uterus – called intramural fibroids – are the most common. Fibroids may grow as a single tumour, or in clusters of up to a hundred, and can range from being pea-sized to large, round growths that are more than 5–6 inches wide that fill the pelvis or abdomen completely. They are a common occurrence in women, especially those between the ages of 30 and 50, although women in their 20s sometimes have them.
Causes
It is not clear what causes fibroids. Heredity is thought to be a possible factor, predisposing muscle cells in the uterus to develop into fibroids during the reproductive years. An increased level of the female hormone oestrogen produced by the ovaries from puberty onwards appears to be a possible stimulant for their growth. This might explain why fibroids usually grow during pregnancy and shrink during menopause, after which new ones tend not to develop. Hormonal drugs that contain oestrogen, such as birth control pills, may also cause fibroids to grow.
Signs & symptoms
Many women with fibroids are not aware of the condition until they feel symptoms such as:
• Pelvic pain
• Abdominal distension
• Heavy or lengthy menstrual bleeding (menorrhagia)
• Difficult or frequent urination
• Constipation
• Pain or discomfort during sex
• Reproductive problems, such as infertility, multiple miscarriages or early labour
Treating fibroids
Unless they cause problems, fibroids can be left untreated and only need regular monitoring (2–3 times per year) by your doctor. But fibroids with non-minor symptoms, left untreated, can increase in size and may cause complications such as difficulty in conceiving, even miscarriage.
If necessary, fibroids can be treated medically or surgically. Treatment options for fibroids include:
- Hormone therapy such as gonadotropin–releasing hormone agonists (GnRH-a) which halts the intrinsic production of hormones that may cause the fibroids to grow. Smaller fibroids cause fewer problems and are easier to remove surgically. However, this is only a “stop gap” measure before surgery, because it induces menopause and should not be used on a long-term basis.
- Other medication to treat symptoms. Tranexamic acid, birth control pills and anti-inflammatory medicines such as ibuprofen and mefanamic acid may help to decrease the amount of menstrual blood flow.
- Surgical treatment for fibroids includes myomectomy to remove the fibroids, which preserves fertility but presents a 50 per cent risk of regrowth if more than three fibroids are removed. Hysterectomy, the removal of the whole uterus, is the only permanent cure for fibroids, but it results in infertility.
- MRI-guided ultrasound waves. This is a new medical treatment to “kill” fibroids, and is suitable for women with only a few fibroids.
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