Fibroid is a serious concern for the health of women. It forms a mass of growth in the womb. These growths are not always cancerous. There are many questions about them that remain unanswered. This article provides clear, reliable answers to frequently asked questions about fibroids, including what they are, how they affect the body, treatment and more you need to know about fibroids.

Understanding fibroids 

What are fibroids?

Fibroids are elevated masses of growth in the uterus.¹ These growths are not cancerous and don't turn to cancer over time. Muscles and fibrous tissue make up the growth.²

What causes fibroids?

The particular cause of fibroids is not really known. There are factors that come into play, and these factors tend to support their growth. The reproductive hormones- estrogen and progesterone seem to help fibroids grow. These hormones bind to cells present in fibroids than in a normal cell of the uterine muscle. During menopause, fibroids shrink due to the drop in these hormone levels.¹

Who is at risk of developing fibroids?

Women within the age range of 30-40 are at a high risk of developing fibroids. This age falls within the childbearing age.

It is not restricted to this age range, as they can occur at any age.³ They occur and grow more quickly in African American women.

Symptoms and diagnosis

What are the common symptoms of fibroids? 

Most fibroids do not cause symptoms, but some women with fibroids can have:

• Heavy menstrual flow may even lead to anemia
• Painful cramps during the menstrual period
• A feeling of pressure in the lower abdominal region
• A swelling of the lower abdomen that is noticeable
• Frequent urge to urinate
• There is pain experienced during sexual intercourse
• Pain in the lower back
• Complications during pregnancy and labour. This leads to a high probability of undergoing a cesarean section to aid delivery
• Infertility and other reproductive issues, though rare⁴

Can fibroids be asymptomatic?

Most fibroids do not produce symptoms and do not need treatment beyond regular monitoring by a healthcare professional.

How are fibroids diagnosed?

So many times, fibroids are detected by a healthcare professional during a pelvic examination. 

Other tests that can confirm uterine fibroids and determine their size and location are:

• Ultrasonography: A noninvasive imaging procedure that uses sound waves to create pictures of internal organs
• Magnetic Resonance Imaging: A test that produces detailed images of internal organs using magnets and radio waves
• Computed Tomography Scan: An imaging technique that uses X-ray images from multiple angles to generate a detailed picture of internal organs
• Hysteroscopy: A procedure where a thin, flexible tube with a camera (called a scope) is inserted through the vagina and cervix into the uterus to examine fibroids
• Hysterosalpingography: A detailed X-ray procedure where contrast material is injected into the uterus, allowing X-rays to capture images of the uterine cavity
• Sonohysterography: An imaging method in which a small catheter is inserted into the vagina to inject saline into the uterus, enhancing the clarity of ultrasound images
• Laparoscopy: A procedure where a small incision is made in the lower abdomen and a thin, flexible camera is inserted to closely observe internal organs

Impact on health 

Can fibroids affect fertility or pregnancy?

Yes, fibroids can affect fertility and pregnancy. The extent to which they affect these depends on their size, number and location. The type of fibroids that change the shape of the womb can interfere with the implantation of the embryo or even increase the risk of miscarriage.⁵

When someone is pregnant, the complications fibroid causes is restriction of the growth of the foetus and a higher chance of delivering through caesarean section.^5,6

Are fibroids cancerous?

Uterine fibroids are non-cancerous growths. The majority of them do not become cancerous.

Do fibroids cause weight gain?

Fibroids on their own do not directly cause weight gain. The size of a fibroid can be so large that it could bring a feeling of heaviness, which may be mistaken for weight gain.⁷

Treatment options 

Do all fibroids need treatment?

No, not all fibroids require treatment. Many of them do not produce symptoms. They therefore do not cause any problems and require regular monitoring. Treatment becomes necessary if the fibroids cause symptoms such as heavy menstrual bleeding, pelvic pain, frequent urination or complications with fertility or pregnancy. ^{[6] [7]}

What are the treatment options available?

The treatment options available depend on the following:

• Whether there are symptoms from the fibroids or not
• If you want to become pregnant in the future
• The size and location of the fibroids
• The age of the patient and how close the patient is to menopause

1. Mild symptoms can be taken care of with over-the-counter pain relief medications
2. Iron supplements are used to prevent anaemia when there is bleeding
3. Birth control pills taken in low doses prevent the growth of fibroids and help control heavy bleeding
4. Gonadotropin-releasing hormone agonists shrink the fibroids
5. Surgical methods like myomectomy, hysterectomy

What are the risks of fibroid surgery?

Surgeries for fibroids have potential risks like bleeding, infection and injury to organs such as the bladder or intestines. Surgeries like hysterectomy lead to permanent loss of fertility because the womb is removed totally.¹,⁶

Living with fibroids 

Can fibroids come back after treatment?

Yes, fibroids can recur after treatment, especially in treatment options where the womb is still preserved. Surgery procedures like myomectomy remove fibroids but do not prevent new ones from forming. Research shows that fibroids recur in approximately 15% to over 30% of patients within five years following a myomectomy, particularly in younger women or those who had multiple fibroids removed.^1,6 The only definitive treatment that takes away the possibility of recurrence is hysterectomy, as it involves the complete removal of the uterus.

What questions should I ask my doctor if I have fibroids?

• How many fibroids are present in my body?
• What is the size of my fibroid(s)?
• Where exactly is my fibroid(s) located: on the outer surface, inner surface, or within the uterine wall?
• Is it likely that the fibroid(s) will increase in size?
• If they were previously detected, how quickly have they grown?
• How can I monitor whether the fibroid(s) are increasing in size?
• What types of problems might the fibroid(s) cause?
• Which tests or imaging techniques are most suitable for tracking fibroid growth?
• If the fibroid(s) start causing issues, what treatment options do I have?
• What is your opinion on treating fibroids through hysterectomy compared to other available treatments?

How can Lifestyle Changes help manage fibroids?

Lifestyle changes help to manage the symptoms of fibroids, thereby slowing their growth, but they do not cure the condition. Eating foods that help you maintain a healthy weight is very important, as excess body fat increases the production of estrogen in the body. Estrogen favours the growth of fibroids.¹ Reducing stress and minimising exposure to environmental toxins helps to balance hormones and manage fibroids.

Conclusion

Uterine fibroids are common and manageable, especially when it is identified early enough. Some may not cause symptoms, while others can be bad to the extent of affecting fertility.  

There are many treatment options that exist that bring relief to women. Regular check-ups, early conversations with healthcare providers, and being attentive to changes in your body can help in early detection. Don’t hesitate to seek medical attention if you experience symptoms.