Causes And Treatment Of Uterine Fibroids!

Uterine fibroids, also known as leiomyoma or myoma, are benign growths on the uterus, occurring mostly during the years of childbearing. Few of the common symptoms of fibroids are leg pain or backache, constipation, difficulty in emptying the bladder, frequent urination, pain or pressure in the pelvic region, menstrual periods stretching over a week and excessive menstrual bleeding.

Causes:

1. Certain genetic changes of the uterus which are different from the ones normally present in the muscle cells of the uterus can cause this disorder.

2. Certain hormones such as progesterone and estrogen that prepare the body for pregnancy are even responsible for triggering the development of fibroids.

3. Substances which help the body maintain its tissues trigger fibroid growth as well.

4. Family history, excessive consumption of alcohol and red meat while going low on foods such as dairy products, fruits, green vegetables and vitamin D, obesity, usage of birth control pills and early onset of the menstruation cycle are other factors that may escalate the risks of one suffering from fibroids.

Treatment:

1. Be careful and take a closer look: Fibroids are fundamentally non-cancerous and they hardly interfere with pregnancy. Often, they do not exhibit notable symptoms and are prone to shrinkage after menopause. Hence giving them and yourself some time might be the best option.

2. Medications generally aim at the hormones controlling the menstrual cycle and treating symptoms such as pelvic pressure and excessive menstrual bleeding. However, they do not treat fibroids completely but work towards contracting them. They include-

   • Gonadotropin-releasing hormone (Gn-RH) agonists to block estrogen and progesterone production

   • Progestin-releasing intrauterine device (IUD) to alleviate severe bleeding caused due to fibroids

   • Tranexamic acid to ease excessive menstrual periods

   • Progestins or oral contraceptives to regulate menstrual bleeding

   • Nonsteroidal anti-inflammatory drugs (NSAIDs) to ease pain associated with fibroids

Surgeries to Treat Fibroids:

Depending on symptoms and whether medical therapy has failed, the patient may have to undergo surgery. The following surgical procedures may be considered:

1. Hysterectomy: removing the uterus. This is only considered if the fibroids are very large, or if the patient is bleeding too much. Hysterectomies are sometimes an option to prevent fibroids coming back.

2. Myomectomy: fibroids are surgically removed from the wall of the uterus. This option is more popular for women who want to get pregnant.

3. Endometrial ablation: removing the lining of the uterus. This procedure may be used if the patient's fibroids are near the inner surface of the uterus; it is considered an effective alternative to a hysterectomy.

4. UAE (Uterine artery embolization): this treatment cuts off the fibroid's blood supply, effectively shrinking the fibroid.

5. Magnetic-resonance-guided focused ultrasound surgery: an MRI scan locates the fibroids, and sound waves are used to shrink the fibroids.

Latest Advancements:

Mifepristone: It, also known as RU-486, reduces heavy menstrual bleeding and imporves fibroid-specific quality of life. It competitively binds and inhibitsprogesterone receptors.

Ulipristal acetate: It is a progesterone receptor modulator that acts as a postcoital contraceptive. As progesterone promotes the growth of uterine fibroids, blocking its receptor may reduce their size.