Fibroids are also known as leiomyomata. They are benign tumours of the myometrium and are very common, apparently in 1 in 25 women! Risk factors include a family history, Afro-Caribbean ethnicity and women approaching the menopause. Nulliparity/uniparity has been implicated as a risk factor, but many people are not sure whether this is a cause, or a result of pre-existing fibroids.
Their cause is unknown, however what is known is that they grow in response to oestrogens and progesterones. This causes several effects
- At menopause, when these hormone levels drop, Fibroids stop growing and often calcify.
- If HRT is used, the increasing hormone levels cause growth.
- Fibroid growth is cyclical.
Signs and Symptoms
- Hysteroscopic surgery can be used for submucosal or polypoid fibroids, usually preceded by GnRH agonists to decrease their size before surgery.
- Myomectomy - procedure in which the uterus is saved, often used for those who wish to conceive in the future, however there is an increased bleeding risk which may lead to hysterectomies, and all future deliveries have to be caesarean sections
- Hysterectomy - Can be done vaginally, abdominally or laprascopically.
- Uterine artery embolism - new treatment with an 80% success rate! The success rate is based on the fibroids shrinking by 50%<. There is however an increased readmission rate, and because it is a new treatment, the effects on future fertility are not yet clear.