Fibroids are benign tumours, which grow on the outside, inside or within the smooth muscle in the wall of the uterus. They are not cancers. In very rare cases, a rapidly growing fibroid may become cancerous. This happens to one in a thousand pre-menopausal women, although the risk rises to one in a hundred for women diagnosed with rapidly growing fibroids after menopause.
Fibroids are very common. Approximately 30 percent of women have fibroids large enough to cause symptoms. Some studies suggest that many more women have fibroids but most fibroids do not cause symptoms. Fibroids that remain small may never require treatment. Since the female hormone estrogen appears to encourage their growth, fibroids usually shrink at menopause and rarely cause problems after this time.
We do not understand why fibroids occur. Women whose close female relatives have fibroids are more likely to develop symptoms, suggesting that the cause is partly genetic. Fibroids are also much more common among African-Canadian women – as many as 50 percent of African American women over the age of 35 have fibroids.
Causes and Risk Factors of Uterine Fibroids
The cause of uterine fibroids is unknown, but some researchers suspect that the tendency to develop uterine fibroids is: inherited attributed to ethnicity (African-American and women of Jewish descent are three  times more likely to develop uterine fibroids than Caucasian women) linked to estrogen level - uterine fibroids may increase in size during pregnancy or when using birth control pills (when estrogen levels are high), and decrease in size after menopause when estrogen levels are low. prevalent in women with endometriosis - a condition in which fragments of the endometrium are found in other parts of (or on organs within) the pelvic cavity
The two most common symptoms of fibroids are:
Heavy Menstrual Bleeding A menstrual period typically lasts four or five days. Women with fibroids often have longer periods, which may last seven or more days. These periods may be unusually heavy, sometimes requiring a woman to change her pad or tampon hourly. In addition to the inconvenience, heavy bleeding may also cause anemia and fatigue. Bleeding between periods is not usually a sign of fibroids; however, women who experience this problem should check with their doctor.
Pressure in the Pelvis When a fibroid grows large, it can cause a feeling of pressure in the pelvis. It is sometimes possible to feel a hard spot where large fibroids are present. Large fibroids distort the shape of the uterus and cause it to press on other organs. This pressure may cause:
Treatment of Fibroids The most important question to ask is whether or not the fibroids need to be treated at all. The vast majority of fibroids grow as a woman gets older, and tend to shrink after menopause. Obviously, fibroids that are causing significant symptoms need treatment. While it is often easier to treat smaller fibroids than larger ones, many of the small fibroids never will need to be treated. So just because we can treat fibroids while they are small, it doesn't follow that we should treat them. The location of the fibroids plays a strong influence on how to approach them. A gynecologist experienced in the treatment of fibroids can help you determine if they need to be treated.
Treatment with medicines: There are not any currently available medicines that will permanently shrink fibroids. Often heavy bleeding can be decreased with birth control pills. There are a number of medications in the family of GnRH agonists, such as Depo-Lupron, which induce a temporary chemical menopause. In the absence of estrogen myomas usually decrease in size. Unfortunately, the effect is temporary, and the fibroids rapidly go back to their pre-treatment size when the medication is discontinued. Mifepristone, better know as the 'French abortion pill or RU-486, may decrease the size of myomas, and abnormal uterine bleeding. It's use is promising, but it is not currently available in the United States.
Surgical treatment of fibroids: There have been a number of procedures recently promoted for treatment of fibroids. Some are truly new. Others are being marketed as new in order to promote the sale of expensive instruments, without offering any real advantages. Many new procedures prove over time to be major advances; we may look back on others as not so wonderful.
With any new procedure, it is important to look at studies published in peer-reviewed medical journals as well as promotional materials by a physician, clinic, or instrument manufacturer. In deciding whether any procedure is for you, you should look at advantages and disadvantages of all available options. Seek out centers where all options are available. If there is only one treatment on the "menu" you can be sure that will be the only option offered.
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