Uterine fibroids also known as leiomyomas are non-cancerous growths in the muscle of the uterus/womb. They may cause your periods to be heavy and to be painful. They can also cause pain during sex as well as constant lower back pain. They can interfere in your ability to have a child depending on where they are located. They can be located in many places and depending on where
they are located determines what options your doctor may offer to treat them
Uterine fibroids are often described based upon their location within the uterus.
- Subserosal fibroids are located beneath the serosa (the lining membrane on the outside of the uterus), it extends beyond the wall of the womb and grow within the outside surface of the uterus tissue layer or may be attached to the outside surface by a pedicle.
- Submucosal (submucous) fibroids are located inside the uterine cavity found in the muscle beneath the inner lining of the uterus wall.
- Intramural fibroids are the most common type, located within the muscular wall of the uterus/womb.
- Pedunculated fibroids grow on a stalk of tissue known as a pedicle (like a mushroom), it extends inside or outside of the uterus cavity.
Once a fibroid develops, it can continue to grow until menopause. After menopause the estrogen levels fall, which makes the fibroid shrink in size gradually. Most fibroids produce no symptoms. Fibroids are often found during a regular pelvic examination.
When women do experience symptoms, the most common are the following:
- painful periods, increase in menstrual bleeding known as menorrhagia, sometimes with blood clots
- anaemia as a result of increase in menstrual bleeding
- pressure on the rectum, resulting in constipation
- pelvic pressure, lower abdominal pain
- lower backache or leg pain
- pain during intercourse, known as dyspareunia
- pressure on the bladder, which may cause frequent urination
- pregnancy/labour problems
- discomfort in the lower abdomen (feeling full) especially in the case of large fibroids
- infertility issues
- multiple miscarriages
If fibroids are large, there may also be weight gain and swelling in the lower abdomen.
Fibroids are treated in many ways. They can be treated by medications and by surgery. The removal of fibroids (myomectomy) can be done by laparoscopic surgery where we remove the fibroids through small incisions on the abdomen. Fibroids can also be removed hysteroscopically, where the submucosal fibroids are removed through the vagina without making any incisions on the abdomen. Call our office for more information on this topic and what surgical or medical options would be ideal for you.