Symptoms:

The common signs and symptoms of uterine fibroids are:

• Heavy menstrual bleeding.
• Prolonged menstrual periods or bleeding between periods.
• Urinary incontinence.
• Constipation.
• Pain during intercourse.
• Back pain or leg pain.

Types of fibroids:

• Sub mucosal fibroids: Fibroids that grows in to the inner cavity of the uterus. It causes mainly prolonged, heavy menstrual bleeding.
• Subserosal fibroids: It projects to the outside of the uterus. It can some time press on bladder, causing urinary symptoms. It can press on rectum causing constipation or press on spinal nerves causing back pain.
• Cervical fibroids: These are found in the wall of cervix.

Causes:

It is caused from the smooth muscular tissue of the uterus. A single cell reproduces repeatedly, eventually creating a pale, firm, rubbery mass distinct neighboring tissue.

• Genetic alterations: Many fibroids contain alterations in genes that code for uterine muscle cells.
• Hormones: Estrogen and progesterone stimulate development of the uterine lining promote the growth of fibroids.
• Other chemicals: Like insulin like growth factor, may affect fibroid growth.

Diagnosis:

• Pelvic examination.
• Ultrasound scan.
• MRI scan.
• CT scan.
• Hysterosalpingography.
• Laparoscopy.

When to seek medical advice:

• Pelvic pain that does not go away.
• Heavy bleeding.
• Painful bleeding.
• Spotting or bleeding between periods.
• Pain with intercourse.
• Difficulty in emptying the bladder.
• Constipation.

Complications:

• Anemia due to blood loss.
• Severe, sharp pain in the lower abdomen.
• Sometimes infertility.
• Fibroids during pregnancy can cause miscarriage, premature labor and delivery, abnormal fetal positions and separation of the placenta from the uterine wall.

Treatment:

It includes medical and surgical treatment.

Medical treatment

Medications for uterine fibroids are given to regulate menstrual bleeding and pelvic pressure. They do not eliminate fibroids, but can shrink them in size.

Medications include: Gonadotropin-releasing hormone (Gn-RH) agonists produces opposite effects of natural hormone. Estrogen and progesterone levels fall, menstruation stops, fibroids shrink and anemia improves.

Androgens: They relieve fibroid symptoms.

Surgical treatment:

• Hysterectomy: Total removal of uterus.
• Myomectomy: Removal of fibroids. There are several types of myomectomies. Abdominal myomectomy, laparoscopic myomectomy, hysteroscopy myomectomy.