The exact cause of uterine fibroids remains largely unknown, but their growth seems to depend on estrogen, the female hormone
Dear Ask-a-doc,
I usually have heavy menstrual bleeding and very bad abdominal cramps during my periods. I recently visited my doctor, who asked me to have an ultrasound examination done, and it showed I have Uterine Fibroids. Since then, I have been very worried. How did I get fibroids? I heard you cannot give birth if you have fibroids. Is that true? I am young and wish to have children. Do I have to have my uterus removed? Is there a cure for fibroids? Worried.
Dear Worried,
Uterine Fibroids is the most common and benign (not cancerous) tumour affecting women, and is found in the uterus (womb). Fibroids are actually tumours of the smooth muscle that is normally found in the wall of the uterus. They can develop within the uterine wall itself or attach to it, and may grow as a single tumour or in clusters.
Uterine fibroids can cause excessive menstrual bleeding, pelvic pain, frequent urination, constipation and infertility (depending on location).
The exact cause of uterine fibroids remains largely unknown, but their growth seems to depend on estrogen, the female hormone. Uterine fibroids do not develop until after puberty, and usually after age 30. They shrink or disappear after menopause, when estrogen levels fall.
The size and location of the fibroid can reduce fertility by as much as 70 per cent — or not at all. The key issue is whether the uterine cavity is distorted, interfering with an embryo’s ability to implant and thrive.
The size, location and shape of the fibroid also determine the best treatment. Hysterectomy, or surgical removal of the uterus, is the only absolute cure for fibroids, but it shuts the door on future pregnancies, requires hospitalisation and can take you six weeks to fully recover.
Uterine artery embolisation is a popular alternative that typically involves only one night in the hospital and a week of rest. But some studies suggest it can affect ovarian function, so it’s not recommended for women who still want children.
Myomectomy, or removal of the fibroids while leaving the uterus intact, is the recommended treatment for women trying to get pregnant, but it carries a risk of recurrence. Fibroids can recur — unless the uterus is removed — and the risk varies slightly with each of the new procedures.
The medicines currently approved for treating fibroids can trigger early menopause, with symptoms that include hot flashes and, over time, bone loss.
Moreover, their benefits last only as long as the drugs are taken. As a result, they are usually prescribed to women in their late 40s or early 50s who are presumed to be close to menopause, when most fibroids shrink on their own.
DeaWorried, since you still want to get pregnant, and yet the fibroids are symptomatic, myomectomy may be the best option for you. Please discuss these options with your gynecologist before making a decision.
Regards,
Ask A Doc nation@askadoc.co.ke
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