Uterine Fibroids - Cause, Symptom, Diagnosis and Treatment | Dr. Maunil Bhuta

What is Uterine Fibroids?
Uterine fibroids are an extremely common condition in which solid tumors develop in the uterus. Fibroids are not cancerous and do not increase the risk for uterine cancer. It is not known what causes fibroids, but studies suggest genetics and prolonged exposure to estrogen may increase your risk of developing fibroids. Symptoms can include heavy and prolonged periods, bleeding between periods, pressure in the abdomen and pelvic pain. Fibroids are most often found during a routine pelvic exam or incidentally noted on imaging. If treatment is needed, it may include medications or surgery.

2. What causes fibroids?
The cause of fibroids is not known. Research suggests each tumor develops from an abnormal muscle cell in the uterus and multiplies rapidly when encountering the estrogen hormone, which promotes the tumor’s growth.

3. Who is at risk for fibroids?
Women in their reproductive age are most likely to be affected by fibroids.
Other risk factors may include:

• Family history of fibroids
• Obesity
• Diet high in red meat
• High blood pressure

4. Uterine Fibroids Symptoms
It is common that women who have fibroids do not experience any noticeable symptoms. Other women with fibroids experience severe symptoms that interfere with their daily lives. Common fibroid symptoms include:

• Heavy or prolonged periods
• Bleeding between periods
• Abdominal discomfort and/or fullness
• Pelvic pain
• Lower back pain
• Bladder symptoms, such as frequent urination or difficulty emptying the bladder
• Bowel symptoms, such as constipation or excessive straining with bowel movements

Women with fibroids can also experience:

• Infertility
• Complications during pregnancy
• Pain during intercourse

4. How are fibroids diagnosed?
Fibroids are most often found during a routine pelvic exam. During this exam, your health care provider will press on your abdomen and may feel a firm, irregular mass that might indicate a fibroid.
To diagnose uterine fibroids, your doctor may order one of the following tests:
Pelvic Ultrasound- A procedure during which a small instrument, called a transducer, is either inserted into the vagina or pressed over the abdomen to produce pictures of the internal organs using sound waves. The doctor can see the size, shape and texture of the uterus and evaluate any growths.
Magnetic resonance imaging (MRI)- This is a form of advanced imaging technology that provides highly detailed images of internal organs. These images help your provider determine the exact location and characteristics of fibroids and, if needed, plan minimally invasive treatments.
Hysterosalpingography- This is a type of X-ray exam of the uterus and fallopian tubes. Your doctor will use a special dye to more easily visualize these organs and determine if the fibroids have blocked your fallopian tubes.
Hysteroscopy. This is a visual exam of the canal of the cervix and the interior of the uterus using a viewing instrument (hysteroscope) inserted through the vagina.

5. Latest minimally invasive treatment options to treat uterine fibroids 
Uterine artery embolization (UAE), also called uterine fibroid embolization, is a newer technique. This minimally invasive procedure shrinks fibroids by cutting off their blood flow. An interventional radiologist performs UAE, using X-rays for guidance. Health care providers are looking at this procedure’s long-term implications regarding fertility and regrowth of the fibroid tissue.

Magnetic resonance guided focused ultrasound, also a newer technique, focuses sound waves on fibroids that are at the front of the uterus. The potential effects on fertility are not yet understood.
Radiofrequency ablation of fibroids is another newer technique, during which — under laparoscopic and ultrasound guidance — heat is applied into the fibroids to make them smaller and softer. The potential effects on fertility are not currently well understood.