Uterine Fibroids: Spreading Awareness

7 min readNov 14, 2020

Fibroids are non-cancerous growths that develop in or around the uterus. By the age of 50, up to 80% of black women and up to 70% of white women have fibroids and about 30% to 25% of these require treatment.

Most women aren’t aware they have fibroids since only around 1 in 3 experience symptoms.

These can include:

heavy period or painful periods
abdominal (tummy) pain
lower back pain
a frequent need to urinate
constipation
pain or discomfort during sex

What implication does this condition have?

Fibroids are the leading cause of hysterectomy in premenopausal women. They are associated with significant morbidities including pelvic pain, excessive vaginal bleeding ( that can cause anemia), recurrent miscarriage, pre-term birth, infertility, and abortion.

Seeing a GP

Since fibroids often don’t cause symptoms they are usually discovered by chance. To confirm the diagnosis an ultrasound scan is the media used.

There are three types of ultrasound scan and two of these are used to detect fibroids:

Abdominal ultrasound scan — where ultrasound probe is on the outside of your tummy ( the one that is usually used during pregnancy to see the foetus)
Transvaginal ultrasound — where a small ultrasound scope is inserted into the vagina.

Between the two the abdominal ultrasound is better to detect large fibroids that the transvaginal ultrasound may not detect.

Why do fibroids develop?

We don’t know the reason behind why they develop however the formation of fibroids had been liken to the hormone oestrogen.

It has been found that women in their reproductive years (16–50) are more likely to develop fibroids and that they tend to shrink when oestrogen level are low, like after menopause.

Who gets fibroids?

It is a very common condition, with 1 woman in 3 that develops uterine fibrosis in their lifetime.

Factors that increase a women’s risk of developing firboids:

Age. Women in their 30s and 40s are more likely to develop them while after menopause fibrosis usually shrink.
Family history. Having a family member that had uterine fibrosis increases your risk. A woman’s who’s mother had fibrosis is three times more likely than average to develop this condition.
Ethnic origin. African-American women are more likely to develop fibrosis than white women.
Obesity. Women that are more overweight or obese are more at risk as they have higher levels of oestrogen. For very heavy women, the risk is two to three times greater than average.
Eating habits. Eating a lot of red meat and ham are factors that increase a woman’s risk, on the other hand women that eat plenty of vegetables are less likely to develop fibrosis.

Types of fibroids:

Fibroids can develop anywhere in the womb and can vary considerably in size.

believe it or not, these are all fibroids!

There are three different types of fibroids, these are:

Intramural fibroids — the most common type that develops in the muscle wall of the uterus.
Subserosal fibroids — thee develop outside the wall of the uterus into the Elvis and can become very large in size.
Submucosal fibroids — develop in the muscle layer beneath the uterus’ inner lining and grow into the cavity of the womb.
Pedunculated fibroids — Subserosal or Submucosal fibroids that are attached to the womb with a narrow talk of tissue.

where fibroids can be located and how that changes their name

What are fibroids made up of? Deeper biological insight

They are tutors made up of smooth muscle cells and fibrous connective tissue. A higher likelihood of developing fibroids in women of colour versus white and in monozygous twins than dizygotic all indicate that these have a genetic component.

Photographs of tissue slices showing differences in gross apperanaces of fibroids.

How are uterine fibroids treated:

The choice of what treatment works best for each women depends on various factors:

Whether the patient has symptoms from the fibrosis.
If the patient wants to become pregnant afterwards.
The size and location of the fibrosis.
The age of the patient and how far she is from menopause.

Fibroids can be treated through medication or surgery.

Medication

Ibuprofen or acetaminophen: prescribed for mild pain.
Iron supplements: to correct anemia or prevent becoming anemic if you have heavy bleeding.
Birth control drugs: these do not make fibrosis grow and can help to control heavy bleeding.
Gonadotropin releasing hormone agonists (GnRHas): the most of these that is used is Lupron. These drugs can shrink your fibroids and are implanted, given by injection or nasal spray. Most women don’t get a period when on GnRH which is a very big relief for many women that suffer from heavy bleeding. Even though most women tolerate well GnRHas there have numerous side effects such as depression, hot flashes, not being able to sleep, joint pain or decreased sex drive. These drugs however are very expensive, can cause bone thinning and therefore are limited to a six moth use or less, they only give temporary relief from fibroids symptoms and once you stop taking the medication the fibrosis often grow back quickly.

Surgery

Myomectomy: It involves the removal of fibroids without taking out the healthy tissue. It’s the best option for women that want to get pregnant later or wish to keep their uterus for other reasons. Fibroids can grow again once this surgery has been performed and this could cause more trouble.
Hysterectomy: Surgery to remove the uterus.Fibroids is the main cause of hysterectomy and it is the only way to make sure that uterine fibrosis are cured. even though hysterectomy is a safe it carries a signifiant risk of complications and it takes several weeks for a woman to recover from it.
Endometrial ablation: The lining of the uterus is removed or destroyed to control very heavy bleeding. This can be done with several procedures like: laser, wire loops, boiling water, electric current, microwaves, freezing, and other. It is is considered minor surgery and women recover quickly from it. About half of women who have this procedure have no more menstrual bleeding. About three in 10 women have much lighter bleeding. But, a woman cannot have children after this surgery.
Myolysis: A needle is inserted into the fibroids and electric current or freezing is used to destroy the fibroids. It is not recommended for women who want to have children and is usually best fit for smaller fibroids.
Uterine Fibroid Embolization (UFE), or Uterine Artery Embolization (UAE): It is a minimally invasive procedure that is one of the most effective but however it doesn’t stop fibroids from growing in the future.

Graph showing prevalence of each method between 2003- 2013.

More resources

This video includes women talking about their experince with fibroids and I would highly recommend watching it:

If you are intersted on the emotional toll that fibroids have on women you can look at this article.

For more information about uterine fibroids contact the following organizations:

American College of Obstetricians and Gynecologists(link is external)Phone: 202–638–5577
Center for Uterine Fibroids(link is external)Phone: 800–722–5520
National Institute of Child Health and Human Development, NIH, HHSPhone: 800–370–2943 (TDD: 888–320–6942)

Facts and statistics:

Do uterine fibrosis turn into cancer?

Uterine fibrosis are almost always being ( non cancerous). Rarely (less than one in 1,000) a cancerous fibroid will occur. This is called leiomyosarcoma. Doctors think that these cancers do not arise from an already-existing fibroid. Having fibroids does not increase the risk of developing a cancerous fibroid. Having fibroids also does not increase a woman’s chances of getting other forms of cancer in the uterus.

How fibroids change during pregnancy: research suggests that two thirds of fibroids will grow or shrink during pregnancy. Small fibroids identified in the first trimester are more likely to grow throughout pregnancy compared to larger fibroids.The majority of large fibroids do not grow during pregnancy.First trimester lower uterine segment fibroids are likely to change position by the end of pregnancy.

Fibroids in the world:

Which countries are the most active in fibroids research

Where is uterine fibroids diagnosis the most effective and not

Vocabulary index:

Monozygous twins: identical twins that originate from one single fertilised zygote (egg)

Dizygotic twins: fraternal or non-identical twins. These occur when two eggs are fertilised by two separate sperm. Important: these no do have the same genes.