Understanding Uterine Fibroids: Causes, Symptoms, and Treatment
The uterus is composed of a thick wall that can be divided into three layers: the outer serosal layer, the middle muscular layer, and the innermost endometrial layer. The endometrium is influenced by ovarian hormones, undergoing cyclical changes to prepare for the implantation and development of a fertilized egg. If no fertilization occurs, this layer sheds monthly, resulting in menstruation.
Do Contraceptives Cause Uterine Fibroids?
Various factors can contribute to the development of uterine fibroids, commonly known as leiomyomas. Elevated estrogen levels and the involvement of certain growth factors can lead to the formation of these nodular growths in the uterine wall.
What Are Uterine Fibroids?
Uterine fibroids are the most common benign tumors found in the female reproductive system. Studies indicate that approximately 20% of women between the ages of 30 and 50 are affected by fibroids, and there is a noticeable increase in cases in recent years. Although classified as benign, many cases may go unnoticed, yet they can pose significant health risks to various organs and lead to infertility. Therefore, early prevention and treatment are crucial.
Types of Uterine Fibroids
Fibroids can be classified into three clinical types based on their growth location:
- Intramural Fibroids: These are located within the muscular layer of the uterus and account for 60-70% of all cases.
- Subserosal Fibroids: These grow towards the outer surface of the uterus, making up about 20-30% of cases.
- Submucosal Fibroids: These extend into the uterine cavity and account for 10-15% of fibroids.
Fibroids can vary greatly in size, ranging from microscopic to weighing several kilograms.
Common Symptoms of Uterine Fibroids
The most frequently reported symptom of uterine fibroids is a change in menstrual patterns, such as shortened cycles, longer periods, or increased blood flow. Severe bleeding, particularly in a short time frame, can lead to significant anemia. As fibroids grow, they may compress nearby organs, causing symptoms such as frequent urination, constipation, ureteral obstruction, and renal pelvic swelling.
Typically, fibroids are painless, but complications can arise. For example, if a subserosal fibroid undergoes torsion, it can cause acute abdominal pain. Submucosal fibroids may stimulate uterine contractions, resulting in cramp-like pain, and red degeneration of fibroids can lead to intense discomfort. Additionally, fibroids can increase vaginal discharge and are sometimes discovered incidentally during routine ultrasound examinations.
What Are the Treatment Options for Uterine Fibroids?
Treatment for uterine fibroids can be divided into surgical and conservative approaches. Healthcare professionals often consider the patient’s age, fertility desires, clinical symptoms, and the size and location of the fibroids when devising a treatment plan.
Surgical intervention is recommended for cases with a uterus enlarged beyond three months of pregnancy, significant pressure symptoms, or excessive menstrual bleeding leading to secondary anemia. For younger women with fibroids who wish to preserve fertility and show no significant symptoms, conservative management may be appropriate if the uterus is smaller than that of a three-month pregnancy.
The most reliable method for diagnosing uterine fibroids is through transabdominal or transvaginal ultrasound, combined with a gynecological examination. This approach is simple and painless, making it an effective choice for evaluation.