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Fibroid Uterus

Fibroid Uterus:

Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas or myomas, uterine fibroids aren’t associated with an increased risk of uterine cancer.


Many women who have fibroids don’t have any symptoms. In those that do, symptoms can be influenced by the location, size and number of fibroids.
  • Heavy menstrual bleeding
  • Menstrual periods lasting more than a week
  • Pelvic pressure or pain
  • Infertility if fibroid is projecting in the cavity or distorting the cavity.
  • Frequent urination
  • Difficulty emptying the bladder
  • Constipation
  • Backache or leg pains
  • Rarely, a fibroid can cause acute pain when it outgrows its blood supply, and begins to die or there is torsion of pedunculated serosal fibroid or red degeneration of fibroid during pregnancy.

Fibroids are generally classified by their location. Intramural fibroids grow within the muscular uterine wall. Submucosal fibroids bulge into the uterine cavity. Subserosal fibroids project to the outside of the uterus.

Causes- Exact cause is not known but research and experience points towards following:

  • Hormones- Estrogen and progesterone, two hormones that stimulate development of the uterine lining during each menstrual cycle in preparation for pregnancy, appear to promote the growth of fibroids.
  • Genetic change-. Many fibroids contain changes in genes that differ from those in normal uterine muscle cells.
  • Heredity- If your mother or sister had fibroids, you’re at increased risk of developing them.

Pregnancy and fibroids:

  • Fibroids usually don’t interfere with getting pregnant. However, it’s possible that fibroids, especially submucosal fibroids — could cause infertility or pregnancy loss.
  • Fibroids may also raise the risk of certain pregnancy complications, such as placental abruption, fetal growth restriction and preterm delivery. As mentioned above pregnancy can lead to degeneration of fibroid with acute pain in abdomen.


Pelvic examination- Uterine fibroids are frequently found incidentally during a routine pelvic exam. Your doctor may feel irregularities in the shape of your uterus, suggesting the presence of fibroids.

Ultrasound- Ultrasound is the mainstay to confirm the diagnosis and to map and measure fibroids..

Magnetic resonance imaging (MRI)- This imaging test can show in more detail the size, number, and location of fibroids, identify different types of tumors and help determine appropriate treatment options.


They are used to shrink fibroids and reduce anemia. They are in injection form and should not be given for more than six months as they can reduce your bone mass.

Ulipristal acetate-

is a progesterone receptor modulator. As progesterone promotes the growth of uterine fibroids, blocking its receptor may reduce their size. The dose used for this indication can inhibit ovulation and lead to amenorrhoea which will be of benefit to women who have heavy menstrual bleeding related to their fibroids. Treatment should begin in the first week of a menstrual period. The single daily dose in the form of a tablet is given for 3 months.


In recent years, clinical studies have shown that mifepristone treatment for 3 months can significantly reduce the size of uterine fibroids to achieve complete amenorrhea, improve bleeding thereby anemia, and reduce other clinical symptoms.


If you have fibroids that don’t distort your inner uterus, a progestin-releasing IUD can relieve heavy bleeding and pain caused by the fibroids. A progestin-releasing IUD provides symptom relief only and doesn’t shrink fibroids or make them disappear.

Uterine Artery Embolization or Fibroid embolization-

can shrink a fibroid. Your doctor will inject polyvinyl alcohol (PVA) into the arteries that feed the fibroid. The PVA blocks the blood supply to the fibroid, which makes it shrink. You may have nausea, vomiting, and pain in the first few days afterward.

MRI-guided HIFU –

fibroid treatment that pairs MRI with special sound waves called high intensity focused ultrasound (HIFU). The treatment is called MR-guided HIFU.

  • Have small- or medium-sized fibroids
  • Experience symptoms
  • Have not reached menopause
  • Want to keep the chance to get pregnant.

Surgical Treatment:


Surgery to remove fibroids. If you plan to become pregnant, your doctor may recommend this over other procedures. You’ll need to wait 4 to 6 months after surgery before you try to conceive. In most women, symptoms go away following a myomectomy. A myomectomy may be abdominal surgery, or your surgeon may use a hysteroscope or laparoscope to remove the fibroids without having to make a large cut on your abdomen.


Hysterectomy is a permanent solution for Fibroids. If a reproductive function is no more needed and there are very large and multiple fibroids with severe symptoms then a decision for hysterectomy can be taken to improve quality of life.