Uterine Fibroids: Symptoms, Causes, and Diagnosis

In the labyrinth of women's health, having uterine fibroids stand as a common yet frequently misunderstood condition. These benign, often silent warriors can impact a woman's life in many ways, remaining innocuous for some while causing debilitating symptoms in others. Although considered non-cancerous, they may place a heavy burden on a woman's physical and emotional well-being.

What are Uterine Fibroids?

Uterine fibroids, also referred to as myomas or leiomyomas, are non-cancerous growths that occur within the muscular tissue of the uterus. These growths can vary in size, ranging from small seedlings to large masses, and may appear individually or in clusters. It is worth noting that uterine fibroids and myomas are essentially the same condition, with different names used interchangeably. This common gynecological issue primarily affects women of reproductive age.

What are the Common Symptoms of Uterine Myoma/Fibroids?

• Heavy Menstrual Bleeding - Uterine myomas or fibroids can cause heavy or prolonged menstrual periods, leading to anemia and fatigue.

• Pelvic Pain and Pressure - Large fibroids can result in pelvic pain and pressure or swelling in the lower abdomen.

• Urination Issues - Fibroids pressing on the bladder can cause increased urination frequency or difficulty urinating.

• Constipation - Growths in or near the rectum may cause constipation, diarrhea, or bowel obstruction.

• Lower Back Pain - Fibroids or myomas often result in chronic lower back pain as they exert pressure on the muscles and nerves of the lower back.

• Painful Sex - Fibroids in the uterine wall or near the cervix may induce pain or discomfort during sexual activity.

• Infertility or Pregnancy Complications - Depending on their size and location, fibroids may contribute to reproductive issues, such as interference with fertility or pregnancy-related disorders.

What Are the Types of Uterine Fibroids?

There are four main types of fibroids, each with its characteristics and location within the uterus.

• Intramural Fibroids - Intramural fibroids are the most common type of uterine fibroid. These fibroids take root within the muscular wall of the uterus, potentially leading to organ enlargement. These fibroids may cause heavy menstrual bleeding, pelvic pain, and frequent urination.

• Subserosal Fibroids - Subserosal fibroids grow outside the uterus and can be felt during a physical exam. These fibroids may cause pain in the lower back or legs and dysmenorrhea.

• Submucosal Fibroids - Submucosal fibroids bulge into the uterine cavity, interfering with fertility and resulting in heavy menstrual bleeding. They may also cause pain during sexual intercourse due to their uterine location.

• Pedunculated Fibroids - Pedunculated fibroids grow on a stalk or stem-like structure attached to the outside of the uterus. These types of fibroids may cause pelvic pain or dysmenorrhea.

What Causes Uterine Fibroids?

The exact cause of uterine fibroids is not completely understood, but researchers believe that genetic, hormonal, and environmental factors contribute to their development. Some of the factors that may play a role in the formation of this condition include:

• Genetic Factors - Evidence suggests that uterine fibroids have a genetic component. Women with a family history of fibroids are more likely to develop them.

• Hormones - Estrogen and progesterone, the primary female reproductive hormones, appear to promote the growth of fibroids by stimulating cell proliferation and increasing blood flow to the fibroid tissue.

• Growth Factors - Insulin-like growth factors and similar substances impact fibroid growth by binding to receptors on fibroid cells, triggering signals that encourage cell division and growth. This stimulation leads to the production of proteins involved in tissue growth, ultimately contributing to the enlargement of fibroids.

• Extracellular Matrix (ECM) - The extracellular matrix (ECM) is a network of proteins and carbohydrates that provide structural support to cells. Abnormalities in the ECM can play a role in the development and growth of uterine fibroids by providing a supportive environment for the fibroid cells to proliferate and survive.

• Environmental Factors - While the evidence is limited, some studies suggest that certain lifestyle factors, such as diet and exposure to environmental toxins, may play a role in the development of uterine fibroids.

How Are Uterine Fibroids Diagnosed?

During the uterine fibroid or myoma consultation in the Philippines, your doctor will likely begin with a physical exam to check for any signs or symptoms associated with fibroids. This may include feeling for any lumps in your abdomen or pelvis. Your doctor may also order imaging tests, such as an ultrasound for uterine fibroids, to better look at the size and location of any fibroids present. Other diagnostic tests include:

• Pelvic Exam - This helps determine the size and location of the uterus and detect any abnormalities.

• Ultrasound - This diagnostic test produces images of the uterus using high-frequency sound waves. It can be performed transabdominally or transvaginally to detect fibroids.

• Lab Tests - For women with abnormal menstrual bleeding, the doctor may request a complete blood count (CBC) to check for signs of anemia, which can be caused by excessive bleeding.

• Magnetic Resonance Imaging (MRI) - This imaging technique provides detailed images of the uterus and pelvic organs, enabling the identification of fibroid size, location, and type.

• Hysterosonography - This test involves the use of saline in order to expand the uterine cavity. Doing so facilitates a more precise visualization of submucosal fibroids and uterine lining.

• Hysteroscopy - In this test, a thin, telescope-like instrument is inserted through the cervix into the uterus. Saline may be injected into the uterine cavity, allowing the doctor to visually examine the uterine cavity and the opening of the fallopian tube.

Once you are diagnosed with uterine fibroids, your doctor will discuss available treatment options, which may involve surgical or nonsurgical approaches. Treatment can range from medications to alleviate symptoms like heavy menstrual bleeding to surgical procedures for removing the fibroid(s). However, no treatment may be required if you are not experiencing any symptoms. Your doctor will guide you in determining the most suitable course of action based on your situation.

St. Luke's Medical Center offers comprehensive diagnosis and management for women with uterine fibroids. Our experienced team of OB/GYNs and specialists can help you find the best treatment for fibroids. Learn more about our services or schedule an appointment today by calling +632 8723 0101 or +632 8789 7700.