Fibroids

What are fibroids?

Fibroids are benign tumors that develop in the muscle tissue of the uterus. These tumors are common and can vary in size and number, with their location affecting the symptoms.

How quickly do fibroids grow?

The growth rate of fibroids varies. Some fibroids may grow slowly over time, while others may increase in size more rapidly. Hormonal factors and genetic predispositions can influence the growth rate.

Fibroid symptoms

Common symptoms that may occur with fibroids include:

• Increased menstrual bleeding: Fibroids can cause heavy and prolonged menstrual periods, leading to increased bleeding.
• Pelvic pain: Some women may experience pain or discomfort in the pelvic area, especially during menstruation.
• Pressure in the abdomen: Larger fibroids can cause a feeling of pressure or fullness in the abdomen.
• Frequent urination: Fibroids pressing against the bladder can result in increased frequency of urination.
• Swollen abdomen: Fibroids can result in a swollen abdomen or a feeling of bloating.
• Pain during sexual activity: Pain or discomfort during intercourse can be a symptom in some cases.

Many women with fibroids may also be asymptomatic and not experience any clear discomfort. A proper medical assessment is crucial to diagnose and manage fibroids in an individually tailored manner. If you suspect you have fibroids, consult your general practitioner or healthcare provider for further evaluation.

Causes and Risk Factors

While the exact cause of why fibroids (myomas) develop is not fully understood, we know that several interacting factors play a role:

• Hormonal influence: Fibroids are highly dependent on the hormones estrogen and progesterone. They tend to grow during fertile years when hormone levels are at their peak and usually shrink after menopause when production decreases.
• Genetics: There is a clear hereditary component. If your mother or sister has had fibroids, the likelihood of you being affected is higher.
• Lifestyle and environment: Factors such as early menstruation (before age 10), obesity, and vitamin D deficiency have been linked to an increased risk in some studies.

Treatment Methods

Treatment is always adapted to the woman's age, the severity of symptoms, and whether there is a desire for future pregnancy.

1. Medical Treatment

The first choice is often to reduce symptoms rather than removing the fibroid itself:

• Hormonal IUD or birth control pills: Can reduce heavy bleeding and pain.
• Tranexamic acid: Over-the-counter or prescription medication that helps the blood clot better during menstruation.
• GnRH agonists: Medication that places the body in a temporary "artificial menopause" to shrink the fibroids before surgery.

2. Non-surgical Procedures

• Uterine Artery Embolization (UAE): Small particles are injected into the blood vessels that supply the fibroid. When the blood supply is cut off, the fibroid dies and shrinks.

3. Surgical Procedures

• Myomectomy: The fibroids themselves are surgically removed while the uterus is preserved. This is often the primary choice for women planning pregnancy.
• Hysterectomy: The entire uterus is removed. This is the only permanent solution that guarantees fibroids will not return.

Why is Location Important?

It is not just the size that determines treatment, but where in the uterus the fibroid is located:

• Submucosal: Located just under the lining and often causes heavy bleeding.
• Intramural: Grows within the muscular wall itself.
• Subserosal: Grows on the outside of the uterus and more often causes pressure symptoms against the bladder or bowel.