Medical Guides - Fibroids

What Are Fibroids?
Fibroids are benign (non cancerous) tumors (or growths) of the womb. Fibroids are a tumor of smooth muscle are a known as leiomyomas. The smooth muscle makes up the bulk of the womb and is what contracts when you are in labour.

The tumors are oestrogen dependent. That means that they need oestrogen to stimulate them to grow.

Who gets them?
Obviously, as these are tumours of the womb, only women. They are very common and occur to some extent in 5% of all women. However, most of them cause no symptoms at all because they are too small. They occurr more frequently with age (until menopause) and in non-caucasian women (non-white).

Where do they get them?
There may be fibroids within the womb cavity, within the womb muscle wall or on the outside of the womb wall. They may be large or small. Ball shaped pear shaped and are often multiple in distribution.

What Symptoms Can I Expect?

Heavy periods are the most common presentation for fibroids. They can also cause longer than normal periods and less commonly bleeding after menopause.
Pain. This can be from heavy periods or torsion of a polyp or from red degeneration.A polyp is like an outgrowth that is pear shaped. Because it has a thin end it can twist upon itself and cut off its own blood supply. Thus it can strangulate itself. Red degeration is where the fibroid blood supply clots. This occurs more commonly in pregnancy. It causes severe pain and fever until the fibroid area degenerates usually without our help. The main problem here is making sure of the cause especially in a pregnancy.
Fertility may be affected. The fibroids may interfere with the implantation of a fertilised egg into the womb wall. Thus acting like an IUCD contraception.
An enlarged mass. Fibroids may indeed be very large and press on the bladder or other organs. If they are large then can usually be felt in the stomach by external examination.

How are they Treated?
Most of the time fibroids do not require any treatment whatsoever. If the fibroids do need treatment then usually it requires surgery. Either hystorectomy or myomectomy. That is total removal of the womb or removing only the fibroid if there is an easily accessible polyp or fibroid. Usually the most common treatment is hystorectomy but this will only suite those who have finished their families. Drugs can be used to suppress fibroids but they cause menopause symptoms and the fibroid may well just grow back after stopping the drug. After menopause most fibroids will shrink because they are stimulated by oestrogen. Thus if a women is close to menopause the decision is often to wait for menopause to treat the fibroids 'naturally'.

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