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What exactly are fibroid tumors? |
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What causes fibroids? |
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Is there a concern that they could be cancerous? |
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What are the symptoms of fibroid tumors? |
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What exactly are fibroid tumors?
Fibroid tumors, medically known as myomas or leiomyomas of the uterus,
are almost always benign tumors. The normal uterine muscle tissue
looks pink while most fibroids are white in appearance. They were
originally called fibroids because they were white like fibrous
tissue. When the microscope was developed their true origin was
understood. Fibroids are generally round and therefore compared
to fruits when talking about their size. The blood supply that
feeds them comes from any location around them..
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What causes fibroids?
Each fibroid represents an individual mutation of a single uterine
muscle cell. They are 3 times more common in women of African
descent than Asian, Hispanic, and Caucasian women. They tend to
run in families. Current research is focused on chromosome 7 as
the possible site of the fibroid gene. Estrogen is involved in
fibroid growth. We know they will shrink after menopause or when
GnRH agonists(medications that temporarily stop ovarian estrogen
production) are given. Other factors influence growth however.
Progesterone antagonists, and agonist/antagonists compounds have
recently been demonstrated to also shrink fibroids and reduce or
stop menstrual flow. The great feature of these meds is the lack
of hot flashes and other menopausal symptoms of GnRH agonists
since they do not inhibit ovarian estrogen production.
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Is there a concern that they could be cancerous?
The incidence of cancer in fibroid tumors is 1-2/1000 cases.
Neither rapid growth nor degeneration has been shown to
predict cancer preoperatively. The American College of OB/GYN(ACOG)
recommends treating fibroids as benign. Women with small fibroids
and minimal problems should be encouraged to wait to intervene, as
it may not be necessary, without worry. The medical and surgical
options should be discussed in relation to symptoms and individualized
to the patient.
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What are the symptoms of fibroids?
Common symptoms are:
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Abnormal uterine bleeding
- As fibroids grow they can cause
heavier and abnormal bleeding. A woman may have heavy bleeding
that stops her from leaving her home for hours or even days
because the flow is so heavy that she will soak through and
on to her clothing in as little as 15-30 minutes.
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Increased cramping - As the normal uterine muscle
contracts during a menstrual period to reduce flow, the fibroid tumor acts as a space-occupying lesion. The
muscle contracts against the fibroid, and as the fibroid grows the woman may experience increased and prolonged
cramping that may be unresponsive to over-the-counter or prescription medications.
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Infertility - Fibroids appear to reduce fertility and
can increase the likelihood of miscarriage. Not all fibroids need to be removed before a woman tries to conceive.
It is important for a woman considering pregnancy to talk to her physician about her risk based on number, size,
and location of fibroids.
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Bladder pressure - The bladder is located behind the pubic
bone and above the uterus. As uterine fibroids grow and expand the uterus, this leaves less room for the bladder
to expand. This causes the woman to urinate more frequently. She may no longer be able to sleep through the night,
and have to get up several times to use the bathroom. Some women develop urinary incontinence because of enlarging
fibroids. Fibroid enlargement has been known to cause urinary retention and the need for catheterization.
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Rectal pressure - The rectum is located behind the uterus
and as the fibroids grow and expand, this may create the sensation of constipation, and make bowel movements
uncomfortable.
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Pain with intercourse - Enlarging fibroids can result in a backstop
to the normally flexible and soft portion of the posterior vagina. This
can cause pain during intercourse.
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Feeling an abdominal mass - As fibroids grow, they can expand
into the tummy area. Many women cannot buckle their jeans and begin
to look pregnant. The soft abdomen starts to feel hard.
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Pelvic and abdominal pain
- As fibroid tumors increase the uterus
from the size of an avocado to orange, grapefruit, cantaloupe,
or larger, it can push organs out of the way to expand. Depending
upon the location and size, pain may radiate from one or multiple
sources in the abdomen.
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