HOW TO STOP FIBROIDS FROM DESTROYING YOU, EVEN AT YOUR MATURE AGE
THE SCOURGE OF FIBROIDS
Hi all,
This is Victor, I am a Consultant Clinical Specialist Sonographer, with over 15 years post qualification experiences, I have worked as a sonographer in Nigeria for over 14 years, I lived and worked in The Republic of Ireland [Europe] as a Specialist Sonographer
I have decided to start writing into my blogs to communicate with my entire community.
UTERINE FIBROIDS
Fibroids are common, benign growths of womb (uterine) muscle. They are present in around 1/4-5 of white women and 1/2 black women. They are most common toward the end of the reproductive years. They exist sometimes singly, but most often are multiple and range in size from microscopic to filling the whole of the lower abdomen! They are more common in obese women and those who have no children, there probably is some genetic determinant and they are less common in smokers.
Most fibroids do not cause symptoms, but overall symptomatic fibroids account for about one third of all hysterectomy operations.
Fibroids are named according to where they are found in your womb.
Intramural fibroids grow within the muscular wall of the womb.
Subserous fibroids grow from the outside wall of the womb into the pelvic cavity. They can become very large.
Submucous fibroids grow from the inner wall of the womb into the space inside the womb.
Pedunculated fibroids grow from the outside of your womb. These fibroids are almost free of the wall of your womb and are only attached by a narrow stalk.
Fibroids range from the size of a pinhead to up to 20cm across.
Fibroid growth is very slow and can be stimulated by hormones, especially oestrogen. A hormone is a chemical found naturally in your body. Fibroids tend to become smaller and reduce in number when oestrogen levels fall, such as after the menopause.
CAUSES
The reason why women get fibroids isn’t known. Although oestrogen seems to make the fibroids grow, it’s not thought to be responsible for their initial development.
You are more likely to get fibroids if you:
[1]are in your 30s or 40s
[2]are overweight
[3]are African-Caribbean – African-Caribbean women are three times more likely than white women to get fibroids
[4]have no children or had your last child at a young age
[5]have a family history of fibroids
SYMPTOMS
Symptoms relate to the location of the fibroids and its size. Important symptoms include abnormal gynaecologic haemorrhage[bleeding], heavy or/and painful periods, abdominal discomfort or bloating, back ache, urinary frequency or retention, and in some cases infertility. There may also be pain during intercourse depending on the location of the fibroids.
During pregnancy they maybe the cause of miscarriage, bleeding, premature labour, or interference with the position of the fetus.
Fibroids don’t usually cause symptoms. However, you may get one or more of the symptoms listed below, often depending on where the fibroid is within your womb.
Heavy periods, sometimes leading to anaemia, can occur in up to a third of all women with fibroids.
Large fibroids can lead you to feeling some pain in your tummy (abdomen).
If the fibroid(s) is pressing on your bladder, you may need to pass urine more often than normal.
If the fibroid(s) is pressing on your rectum, it can cause constipation.
You can get severe pain if a fibroid growing on a stalk twists or if a fibroid outgrows its blood supply causing it to break down, but this is rare.
DIAGNOSIS
Fibroids are often diagnosed and discovered on pelvic examination, where the uterus feels larger than expected with hard round lumps felt arising from the surface. Ultrasound scan can tell where the fibroids are located and give an idea of their size. Sometimes they are detected on laparoscopy (looking into the abdomen with a small telescope) or hysteroscopy (looking into the uterus with a fine telescope). Hysteroscopy is particularly useful for seeing the submucous fibroids and assessing how much of the uterine cavity is involved.
COMPLICATIONS
FIBROIDS AND PREGNANCY
Most women with fibroids have a normal pregnancy and delivery. In around two-thirds of women, the fibroids stay at a constant size or shrink.
Submucosal fibroids can affect the shape and internal environment of the womb, which can make it more difficult to become pregnant.
Problems such as miscarriage, premature labour and bleeding can happen, but they are rare.
If you are pregnant and have fibroids, you should consider seeking specialist pregnancy care from an obstetrician (a doctor specialising in pregnancy and childbirth).
FIBROIDS AND CANCER
Fibroids very rarely become cancerous.
TREATMENT
If you don’t have any symptoms, or if they are only mild, you don’t need treatment.
If you are getting symptoms, there is a range of treatments available. Your doctor will explain which is most suitable for you.
[1] Medicines
There is no medicine that cures fibroids. However, hormone-based treatments can help relieve the symptoms.
Treatment with gonadotrophin releasing hormone analogues (GnRH analogues) can lower your oestrogen level. This usually shrinks the fibroids. GnRH analogues such as goserelin (eg Zoladex) or leuprolin acetate (eg Prostap SR) are often prescribed for three to four months before surgery (see Surgery) to make it easier to remove fibroids.
GnRH analogues can cause side-effects such as hot flushes and, long-term, osteoporosis (thinning of the bones). Therefore, you can only take GnRH analogues for a maximum of six months. Taking progestogen hormone replacement therapy or tibolone (Livial) at the same time reduces the chances that you will get side-effects.
[2]Non-surgical treatments
[a]Uterine artery embolisation (UAE)
This treatment blocks the blood supply to a fibroid, causing it to shrink. It’s performed under a local anaesthetic, meaning that the feeling in the area will be completely blocked but you will stay awake during the operation.
UAE gives relief from symptoms such as bleeding and pain for at least two-thirds of women treated. Side-effects and complications with UAE are lower than with open surgery.
The National Institute for Health and Clinical Excellence (NICE) states that UAE is a relatively new treatment with uncertain long-term results. If you are considering UAE, please talk to your gynaecologist (a doctor specialising in identifying and treating conditions of the female organs).
[b] Endometrial ablation
An endometrial ablation is a procedure to remove the lining of your womb or an individual fibroid using laser energy or ultrasound. You can still get pregnant after an endometrial ablation.
[c] Magnetic Resonance Guided Focused Ultrasound [HIFU]
Surgery
There are a number of surgical options including those outlined below.
A myomectomy is an operation to remove fibroids leaving the womb in place. It may be done through cuts in the tummy or through your vagina using keyhole surgery. A myomectomy is usually only offered to women who prefer the option to become pregnant in the future.
A hysterectomy is a major operation to remove the entire womb, usually via a “bikini-line” cut in the tummy or, if the fibroids are not too large, via the vagina. It’s not possible to get pregnant after a hysterectomy.
Sometimes it’s possible for these operations to be performed by keyhole surgery.
For accurate assessment of your fertility situation, contact us at JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria.
For FREE Consultation and FREE Counseling. Also for Quality and Accurate Medical Diagnostic Tests Contact JOAS MEDICAL DIAGNOSTIX
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