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Uterine Fibroid
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What is a Uterine Fibroid?

A uterine fibroid is a non-cancerous or benign tumor that forms in the smooth muscle, or myometrium, and the connective tissue of the uterus. Fibroids commonly occur during the mid and latter part of a woman's reproductive years and they are the most commonly-occurring non-cancerous tumors in women.

The location of the fibroids and how they grow are the determining factors for symptoms and health problems. Fibroids that grow inside the uterus are more likely to be a problem than those that grow outside. They may grow singly or in multiples, with estrogen and progesterone being responsible for their growth.

What are the symptoms of fibroids?

Most women who have fibroids experience no symptoms. When fibroids grow larger they can cause painful periods, heavy flow during a period, painful intercourse, frequent and urgent urination. Fibroids may also cause fertility problems in some women but this is not common. Between 20% and 40% of all women are diagnosed with uterine fibroids but only a small number of these will have symptoms or require treatment.

The symptoms generally depend on the actual location of the fibroids and their size. In addition to the general symptoms described above there might be pain in the lower back, bloating of the abdomen or pain when passing motions. Infertility is also a symptom in some 3% of women. During a pregnancy, fibroids have been implicated in premature labor, miscarriage and unusual positioning of the fetus.

Uterine fibroids have some features in common with endometriosis and several of the symptoms are similar to those of endometriosis.

Are there any risk factors with fibroids?

There are certain risk factors associated with uterine fibroids. Black women are twice as likely to have fibroids as white women. Fibroids are more common with women who are overweight, possibly because body fat is a secondary source of estrogen. Uterine fibroids only occur during the years a woman is reproductive and they shrink after she has gone through menopause. They are rarely present during a pregnancy.

Genetic links have been found with the occurrence of uterine fibroids, so you might have a greater risk of having them if a close female relative has had fibroids.

How are fibroids diagnosed?

Often fibroids are diagnosed during a woman's annual internal examination. Larger fibroids can be felt by the doctor during an internal exam but the most reliable diagnosis is achieved by ultrasound. This technology allows the technician to accurately locate and measure the fibroids. MRI can also be used in the diagnosis of fibroids inside the uterus.

How are fibroids treated?

Uterine fibroids are not a condition that has to be treated; they can often be effectively managed. Many doctors adopt an observation approach in the treatment, meaning that the patient is monitored and observed on a regular basis over a period of time. Periodic ultrasounds provide any evidence of the growth of the fibroids or any complications that might require a more proactive approach.

Hormone or drug therapy is a treatment option that is often used as the first stage of treatment. This is aimed at reducing the severity of symptoms or the size of the fibroids.

Uterine fibroids may be surgically removed if the associated symptoms are proving too troublesome. In severe cases, a hysterectomy is usually performed, during which the entire uterus is removed. A less serious case might be able to be treated by removal of the fibroid. With this procedure, new fibroids might develop in the future, but this operation is still a viable option, especially for women who still wish to have children.

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