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This document provides information regarding uterine fibroids. It will explain details about the definition, types, various symptoms , causes and risk factors of uterine fibroids
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UTERINE FIBROID PREPARED BY:JAIN SHINO MSC NURSING(OBG & GYNEACOLOGY)
DEFINITION Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas (lie-o-my-O-muhs) or myomas, uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer.
Types of uterine fibroids Intramural fibroids: These fibroids are embedded into the muscular wall of your uterus. They’re the most common type. Submucosal fibroids: These fibroids grow under the inner lining of your uterus. Subserosal fibroids: This type of fibroid grows under the lining of the outer surface of your uterus. They can become quite large and grow into your pelvis. Pedunculated fibroids: The least common type, these fibroids attach to your uterus with a stalk or stem. They’re often described as mushroom-like because they have a stalk and then a wider top
Symptoms • Heavy menstrual bleeding • Menstrual periods lasting more than a week • Pelvic pressure or pain • Frequent urination • Difficulty emptying the bladder • Constipation • Backache or leg pains
CAUSES • Genetic changes. Many fibroids contain changes in genes that differ from those in typical uterine muscle cells. • 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. • Fibroids contain more estrogen and progesterone receptors than typical uterine muscle cells do. Fibroids tend to shrink after menopause due to a decrease in hormone production. • Other growth factors. Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth. • Extracellular matrix (ECM). ECM is the material that makes cells stick together, like mortar between bricks. ECM is increased in fibroids and makes them fibrous. ECM also stores growth factors and causes biologic changes in the cells themselves.
Risk factors Obesity and a higher body mass index (BMI). Family history of fibroids. Not having children. Early onset of menstruation (getting your period at a young age). Late age for menopause.
DIAGNOSIS AND TESTS Ultrasonography: This noninvasive imaging test creates a picture of your internal organs with sound waves. Magnetic resonance imaging (MRI): This test creates detailed images of your internal organs by using magnets and radio waves. Computed tomography (CT) scan: A CT scan uses X-ray images to make a detailed image of your internal organs from several angles. Hysteroscopy: During a hysteroscopy, your provider will use a device called a scope (a thin, flexible tube with a camera on the end) to look at fibroids inside your uterus. The scope is passed through your vagina and cervix and then moved into your uterus. Hysterosalpingography (HSG): This is a detailed X-ray where your provider injects contrast material and then takes X-rays of your uterus. Sonohysterography: In this imaging test, your provider places a small catheter in your vagina and then injects saline into your uterus. This extra fluid helps to create a clearer image of your uterus than you would see during a standard ultrasound. Laparoscopy: During this test, your provider will make a small cut (incision) in your lower abdomen. A thin and flexible tube with a camera on the end will be inserted to look closely at your internal organs.
MANAGEMENT AND TREATMENT Over-the-counter (OTC) pain medications: These medications help manage pain and discomfort caused by fibroids. OTC medications include acetaminophen and ibuprofen. Iron supplements: If you have anemia from excess bleeding, your provider may also suggest you take an iron supplement. Birth control: Birth control can also help with symptoms of fibroids — specifically, heavy bleeding during and between periods and menstrual cramps. There are a variety of birth control options you can use, including oral contraceptive pills, rings, injections and intrauterine devices (IUDs). Gonadotropin-releasing hormone (GnRH) agonists: These medications work by shrinking fibroids. They’re sometimes used to shrink a fibroid before surgery, making it easier to remove the fibroid. However, these medications are temporary, and if you stop taking them, the fibroids can grow back. Oral therapies: Elagolix is a new oral therapy to manage heavy uterine bleeding in people who haven’t experienced menopause with symptomatic uterine fibroids. It can be taken for up to 24 months. Talk to your provider about the pros and cons of this therapy. Another oral therapy, tranexamic acid, treats heavy menstrual bleeding in people with uterine fibroids.
Complications Pain that becomes unmanageable. Swelling of your abdomen or pelvic area. Excessive bleeding. Anemia. Infertility (this is rare).
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.
