Fibroids may sound like alien creatures from Doctor Who-but they’re actually non-cancerous growths made up of muscle and fibrous tissue. They grow inside the womb and can vary hugely in size. Some measure in at just a centimeter or so, while others can become enormous, taking over the whole abdomen.
The little walnut sized ones are really common, occurring in half of women of reproductive age. Most women have no idea they are there because they have no symptoms at all. The bigger ones are much more likely to make their presence known.
All about fibroids
Fibroids are also known as leiomyomas or myomas, so if you’ve heard those names used, don’t worry, they’re all referring to the same thing. They can grow in different parts of the womb and they are named after where they’re found:
Subserous fibroids grow on the outside of the womb. They expand into the pelvis and can grow to a massive size.
Intramural fibroids grow inside the muscular wall of the womb
Submucosal fibroids are found on the inside of the womb. They grow on the inner wall of the womb expanding into the space inside the uterus.
In general, fibroids grow and develop slowly. Higher levels of the hormone oestrogen can speed things up a little. Rarely, a fibroid can become cancerous. This only happens in between one in five hundred and one in two thousand women.
What are the symptoms of fibroids?
Most women with fibroids suffer no pain. But one in three affected women may suffer from problems. These can be related to the size of the fibroid pressing on other pelvic structures and the increased surface area of the inside of the womb:
- Heavy periods often with clots and cramps
- Aching pain in the abdomen or in the lower back, rarely this can become intense if the fibroid twists or outgrows its blood supply
- A need to empty your bladder more frequently
- Deep pain during sex
- Sometimes fibroids can affect pregnancy or cause infertility, particularly if they are bigger or grow on the inside of the womb
Who gets fibroids?
Fibroids can grow in any woman from puberty, right up to the time of the menopause. Their growth is thought to be driven by the hormone oestrogen, so they tend to shrink away after the menopause. The risk of getting fibroids increases with age and they also tend to affect greater numbers of African-Caribbean women. If you are overweight, you’re also more likely to develop them, probably due to the higher hormone levels.
How are fibroids diagnosed?
Your surgeon will take a full history, find out all about any problems you are having and examine you. Large fibroids can often be felt on vaginal or abdominal examination and the womb may feel bulky and enlarged. Often fibroids are discovered almost by accident on a scan that was arranged for a separate problem.
Mr Khazali may organise tests to check for anaemia, which is common if you’ve had very heavy periods and can leave you feeling tired, weak, breathless and unwell. Investigations may also be arranged to fully assess the size and position of your fibroids.
An ultrasound is usually arranged. This can be done abdominally or internally through the vagina to get a good view of your womb. It’s an excellent way of examining fibroids, although occasionally an MRI scan may be done for further detail.
How are fibroids treated?
The right treatment of fibroids really depends on the symptoms you are experiencing and how much of a problem they are to you. It will also depend on their size and location and whether you are planning to have children in the future.
Often the fibroids can be safely left and monitored, with medication used to treat any pain or heavy bleeding. If they need removal through surgery, Mr Khazali is experienced at operating in a way that is minimally invasive so that you have a rapid recovery time, a shorter stay in hospital and less scarring.