WHAT ARE FIBROIDS?

Uterus (womb) is made up of Endometrium (inner lining) & Myometrium (muscular wall). Fibroid is an abnormal growth of cells in the myometrium (see pic). The term "fibroid" is misleading. The cells are not fibrous; they are composed of abnormal muscle cells. Uterine fibroids are almost always benign.

SEX OR AGE MOST AFFECTED

Fibroids affect 20% to 40% of all women over 35. They don't develop after menopause.

• Most often no symptoms .
• More frequent menstruation frequently associated with large clots and discomfort. (Polymenorrhoea)
• Increased menstrual flow and discomfort. (Menorrhagia)
• Bleeding between periods. (Metrorrhagia)
• Painful sexual intercourse or bleeding after intercourse.
• Anemia (weakness, fatigue and paleness).
• Feelings of pressure on the urinary bladder or rectum, if large.
• Feeling of a lump in the lower abdomen.

CAUSES

Unknown; however, fibroids may be hereditary. Some studies indicate that:

• Women with fibroids may have higher levels of the human growth hormone.
• Birth-control pills, especially those with large amounts of estrogen, may stimulate the growth of fibroid tumors.

• Use of oral contraceptives.
• Genetic factors.

HOW TO PREVENT

Cannot be prevented at present.

• Most often a chance diagnosis on a routine pelvic ultrasonography.
• Menstrual abnormality and physical exam by a doctor.
• Ultrasonography.

POSSIBLE COMPLICATIONS

Malignant change in the fibroid tumor (occurs in less than 0.5%). This rare complication is usually signaled by very rapid growth.

PROBABLE OUTCOME

If surgery is not warranted prior to menopause, these tumors may decrease in size without treatment after menopause.

Fibroids can often be removed surgically without removing the entire uterus. The ability to conceive continues as long as the uterus remains. In cases where family is complete or in elderly women total removal of uterus (hysterectomy) is recommended.

TREATMENT

GENERAL MEASURES

• If your doctor recommends surgery, ask for a full explanation and discussion before making a decision. Fibroids are generally removed surgically if they cause excessive bleeding, are growing fast, produce pressure symptoms or interfere with conception or pregnancy.
• Record dates of bleeding and number of pads used each day.

• NO medical treatment. If you have a small fibroid, don't take contraceptive pills with a high estrogen content. Estrogen may cause fibroids to enlarge. Consider other forms of contraception, such as a diaphragm, cervical cap, IUD, condom, or contraceptive foam, sponge or jelly.
• Your doctor may prescribe iron supplements if you are anemic from excessive blood loss.

ACTIVITY

No restrictions.

DIET

No special diet.

CONTACT YOUR DOCTOR IMMEDIATELY, IF

• You have abnormal menstrual flow.
• A fibroid has already been diagnosed, and symptoms become more severe.
• You saturate a pad more often than once an hour.