Uterine fibroids are noncancerous tumors that can grow inside or outside the uterus, caused by a gene malfunction. Symptoms include abnormal menstrual bleeding, cramping, and digestive problems. Treatment options include medication, surgery, and uterine artery embolization.
Uterine fibroids are noncancerous tumors that grow on the inside or outside of the uterus. Some fibroids are entirely contained within the muscular walls of the uterus and others protrude from the uterine wall. Another type of fibroid, called a pedunculated fibroid, grows on a stalk-like structure attached to the surface of the uterus.
Fibroids are thought to develop as a result of a malfunction in a gene that regulates the growth of uterine cells. When the gene is dysfunctional, cells start dividing more rapidly, resulting in the formation of a benign tumor. Certain risk factors are thought to increase the likelihood of a woman developing one or more fibroids. These risk factors include the use of contraceptive drugs in early adolescence and a high consumption of red meat. Women of African descent also have an increased risk of fibroids.
Most fibroids are small and asymptomatic. For some women, however, fibroids can cause significant pain and discomfort. Possible symptoms of fibroids include abnormal menstrual bleeding, severe uterine cramping, and digestive problems. Some women have fertility problems, and pregnant women have an increased risk of complications such as abruptio placentae, in which the placenta separates from the wall of the uterus. A pedunculated fibroid has similar risk factors and can cause more pain than fibroids of other types. This is because extreme pain can occur if the stalk of a pedunculated fibroid becomes twisted.
Because most fibroid cancers are asymptomatic, fibroids are usually diagnosed during routine gynecological exams. When fibroids are asymptomatic, treatment is often not necessary, but the woman’s doctor may monitor the tumor at regular intervals. Due to the structure of the tumor, a pedunculated fibroid is more likely to produce symptoms, and therefore the diagnosis is often made based on the symptoms, followed by an ultrasound to determine the location and size of the tumor.
Treatment of pedunculated fibroid can be done in three ways. Symptomatic treatment includes drugs to control pain and heavy menstrual bleeding. For example, oral contraceptives might be recommended for women with uterine fibroids because they can reduce the heaviness of menstrual bleeding. Some medications can temporarily shrink fibroids and reduce pain.
Because medications can only provide temporary symptomatic relief, women with painful pedunculated fibroids may opt for surgical removal or shrinkage of the fibroid. Fibroids can only be removed permanently and completely through surgery, but some women opt for a less invasive procedure called uterine artery embolization. In this procedure, shrinkage of the fibroid is achieved by reducing its blood supply; the tumor is not completely removed, but the shrinkage usually leads to an improvement in symptoms. Neither surgery nor uterine artery embolization can prevent new fibroids from growing.
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