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Uterine Fibroids

What are uterine fibroids?

Uterine fibroids are benign or noncancerous growths in or on the uterus. They grow from the muscle of the uterus and are made of fibrous connective tissue and smooth muscle cells. They range in size from as small as a grain of rice to as big as a melon. 

There are different types of uterine fibroids based on where they are found, these are:

Intramural fibroids

  • grow within the muscle of the uterine wall
  • may grow big and enlarge the uterus

Submucosal fibroid

  • fibroids that bulge into the uterine cavity

Subserosal fibroids

  • forms on the outside of the uterus
  • may grow big and enlarge the womb causing it to appear lopsided

Pedunculated fibroids

  • develops from a subserosal or submucosal fibroid and hangs from a stalk inside or outside the uterus
uterine fibroids

What are the causes of uterine fibroids?

There are no known exact causes of uterine fibroids but there are several factors that have been associated with uterine fibroids, these are:

  • Genetics: genetic changes have been observed in fibroids that are not usually observed in the uterus.
  • Hormones: oestrogen and progesterone, the hormones responsible for the menstrual cycle have been known to encourage the growth of uterine fibroids.
abdominal pain

What are the symptoms of uterine fibroids?

A majority of women with uterine fibroids do not experience any symptoms, but for those that do, the symptoms are as follows:

  • Heavy periods
  • Long lasting periods
  • Constipation
  • Backache
  • Leg pains
  • Pain or pressure in the pelvic region
  • Frequent urination
  • Pain during sex
  • Spotting or bleeding in between periods
  • Bloating or feeling a fullness in your lower abdomen
  • Difficulty emptying bladder
  • Enlarged or distended abdomen

Are uterine fibroids painful?

Some women with uterine fibroids experience back pain, menstrual pain, sharp and intense abdominal pain, and pain during sex.

Who is at risk of uterine fibroids?

Women with the following factors are at an increased risk of uterine fibroids:

  • Family history: women with family members with uterine fibroids have an increased risk of developing it themselves.
  • Age: fibroids become more common as women age but after menopause, they shrink and are less likely to form.
  • Weight: women who are overweight or obese have an increased risk of uterine fibroids.

How are uterine fibroids diagnosed?

Most of the time, uterine fibroids are discovered by chance. 

Uterine fibroids can be diagnosed in the following ways:

  • Pelvic examination: uterine fibroids can be discovered during a pelvic examination where your pelvis is physically palpated to feel for any abnormalities. 
  • Ultrasound: ultrasounds use sound waves to create images of your internal organs. It can also be used to detect uterine fibroids.
    • Magnetic resonance imaging (MRI): used to create images of your internal organs and can be used to identify uterine fibroids.
  • Computed tomography scan (CT-scan): similar to an MRI, it is used to create images of your internal organs to identify uterine fibroids.
  • Hysteroscopy: a scope is passed through your vagina, into your cervix, and used to detect uterine fibroids in your uterus.
  • Laparoscopy: a small incision is made in your abdomen and a thin, flexible tube with a camera and light attached at one end is inserted to look for uterine fibroids.

What are the treatment options for uterine fibroids?

The treatment for uterine fibroids depends on their size, where they are located, and what symptoms they are causing. If uterine fibroids are small and not causing any symptoms, they can be left untreated. They will be monitored at follow-up appointments to ensure they are not growing, and no other changes are occurring.

If your uterine fibroids are big, growing, or causing symptoms then the following treatment options are available:

Medications

  • Painkillers: over-the-counter painkillers can be used to alleviate any pain you may be feeling with your uterine fibroids.
  • Hormonal pills: helps control your menstrual cycle and bleeding but does not shrink the fibroids.
  • Gonadotropin-releasing hormone (GnRH) agonists: helps to shrink your uterine fibroid by triggering a temporary menopause but due to its side effects is not suitable for long-term treatment.

Surgery

  • Myomectomy: surgical procedure that removes fibroids. 
  • Hysterectomy: only for severe cases and for women who are not planning on getting pregnant in the future. The whole uterus is removed in this procedure.

Uterine fibroid embolisation: a catheter is placed in the artery of your uterus to block blood flow to the fibroids, causing them to shrink, hence reducing symptoms.

CT scan

Frequently asked questions

  1. Are uterine fibroids cancerous?
    The vast majority of uterine fibroids are not cancerous. Very rarely, fibroids turn out to be cancerous.
  2. Can uterine fibroids go away on their own?
    No, they do not go away on their own but generally shrink after menopause.
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#09-08 Mount Elizabeth Medical Centre
Singapore 228510

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