Monday, September 28, 2020

How much do you know about uterine fibroids?

Women are given wonderful organs of reproduction which are present from birth until the end of their lives. These organs are of deepest concern, for they are often subject to special types of illness against which they must be constantly on guard.

According to research, it has been discovered that most women suffer from uterine fibroids but they are not even aware of it.

A uterine fibroid (known medically as a leiomyoma or myoma) is a non cancerous (benign) growth of smooth muscle and connective tissue. Fibroids are a mixture of muscle tissue from the uterus and thread like fibers of connective tissue. Uterine fibroids vary in size from microscopic to lesions of considerable size and their texture is similar to that of an unripe peach.

Eighty percent of women suffer from uterine fibroids. While the majority shows no symptoms, one in four ends up having severe symptoms that require treatment. It is advisable that every woman in her child bearing age should have at least a pap smear once a year.
According to Eunice Kennedy “uterine fibroids grow as a single growth or in clusters; some women can have up to a hundred.”

Uterine fibroids grow in different parts of the uterus and they are named according to which part of the uterus they occupy. Most fibroids grow within the wall of the uterus. Health care providers put fibroids into three groups based on where they grow.

Submucosal – these are fibroids that grow just underneath the uterine lining
Intramural – are fibroids that grow in between the muscles of the uterus
Subserosal – are fibroids that grow on the outside of the uterus
Some fibroids grow on the stalks that grow out from the surface of the uterus or into the cavity of the uterus. These are called pedunculated fibroids.

The major causes of uterine fibroids can be attributed to heredity. Family history may play a role since there is often a history of fibroids development in women of the same family. It is thought that a muscle cell in the uterus may be programmed from birth to develop into a fibroid sometime – perhaps many years after puberty. This is so because after puberty, the ovaries produce more hormones, especially estrogen, higher levels of these may help fibroids to grow.

It is believed that uterine fibroids start off as a single muscle in the uterus. For reasons that are not known, this cell changes into a fibroid tumor and starts to grow and multiply. Therefore uterine fibroids are closely linked to a genetic predisposition and a subsequent development of susceptibility to hormone stimulation.

Fibroids can occur in any woman of reproductive age. Fibroids occur in women between the ages 30 and 50. Most women of African origin develop fibroids at a younger age .The occurrence of fibroids is about twice as common in black women as in white women.

For many women, fibroids cause no problems. More than half of the women do not know they have them until their doctor tells them so. Fibroid tumors are associated with a number of signs and symptoms. They are associated with heavy menstrual periods. The period may last for more than seven days and the menstrual flow may be very heavy causing discomfort. With such symptoms it is advisable for one to consult their gynecologist.

Fibroids can grow so big such that they end up putting pressure on other organs like the bladder, leading to frequent urinating. If they press on the bowel, this may lead to constipation. Most women experience pain in the pelvis. If a fibroid does not get enough blood they need to survive, they degenerate or die. This may cause severe lasting pain for days or weeks.

According to recent research, uterine fibroids are thought to be the cause of almost 15% of the cases of infertility. The tumors interfere with implantation of fertilized ovum. They may cause compression on the fallopian tube thereby interfering with the motility of sperm or egg.

Fibroids, especially those located in the cavity of the uterus, increase the chance of a miscarriage or to go into labour before due date. Large fibroids can interfere with a normal pregnancy by interfering with the fetus which may lead to premature rapture of membrane. They may also increase the chance that the baby is not positioned to come out head first. This can increase the chance of a cesarean section.

However, new research suggests that amidst all these complications .There are quite a number of ways that can be adopted to avoid uterine fibroids.

Since most of it is related to oestrogen women are advised to avoid estrogenic foods. The more estrogen the body is confronted with, the more fibroids are likely to grow. It is also advisable to maintain a proper body weight. Fat cells carry estrogen such that the more adipose tissue you carry the more estrogen you produce. Also to avoid situations that promote lack of ovulation like the use of family planning tablets.

For women with uterine fibroids that are not causing symptoms the best therapy may be watchful waiting. If the woman is experiencing anemia caused by prolonged menstruation, moderate to severe pain, infertility, urinary tract or bowel problems she will require therapy. The location and size of fibroids determines the treatment that has to be implemented.

Always remember that consulting a doctor or gynecologist is advisable.

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Sunday Standard September 27 – 3 October

Digital copy of Sunday Standard issue of September 27 - 3 October, 2020.