What Are Uterine Fibroids? Signs and Symptoms to Watch For

Lumps in the uterus are the most common tumors in the female reproductive system. These cysts are small tumours made up of smooth muscle cells and fibrous tissue connecting the cells in the uterus. It is believed that 20 to 50 percent of women of reproductive age may have uterine fibroids, although not all can be detected. Only one-third of uterine fibroids are detected during a physical examination.

A uterine fibroid is not a cancerous tumour, but a non-cancerous tumour that develops in or around a woman's uterus. Uterine fibroids are not associated with an increased risk of uterine cancer and they never turn into cancer. Uterine fibroids can vary in size, from being so small that they cannot be seen with the human eye to being so large that they can distort and stretch a woman's uterus.

A woman may have one or more uterine fibroids. In some cases, the uterus may expand so much due to the presence of multiple cysts that it reaches the woman's ribs. Many women are completely unaware that they have a cyst in their uterus because they do not notice any symptoms. Uterine cysts can cause excessive bleeding during menstruation, pelvic pain and frequent urination.

(Read more - Myomectomy)

Although these tumours are called fibroids, the term is misleading because these lumps consist of muscle tissue, not fibrous tissue. The medical term for fibroids is “leiomyoma”. It is a type of myoma or mesenchymal tumour.

There are mainly four types of uterine lumps as follows:

• Intramural - The most common type of uterine lump, which develops in the muscle layer of the uterus.
• Subserosal - These are the lumps that develop outside the uterine lining in the pelvis and can become very large in size.
• Submucosal - The lumps that develop in the muscle layer beneath the inner lining of the uterus are called submucosal and grow into the cavity of the womb.
• Pedunculated - In some cases, subserosal or submucosal lumps are attached to the uterus by a thin stalk of tissue. These are known as pedunculated cysts.

Most uterine cysts, even if large in size, do not cause any symptoms to indicate that a cyst is present. Some women find out because their doctor finds them during a routine checkup or ultrasound. However, your case may be different. The physical symptoms you have depend on the number of tumors in your uterus as well as their location and size. For example, submucosal cysts can cause heavy menstrual bleeding and difficulty getting pregnant.

If your tumor is very small or you are going through menopause, you may not have any symptoms. These cysts may decrease during and after menopause. This is because women going through menopause experience declining levels of estrogen and progesterone, which are the hormones that stimulate the growth of these cysts. If you do have any symptoms, they may include:

• Excessive bleeding during or after your menstrual cycle 
• Menstrual periods lasting longer than a week 
• Lower pressure, abdominal pain or feeling of fullness in your abdomen
• Swelling or enlargement of the abdomen
• Constipation
• Difficulty emptying your bladder or needing to urinate often
• Painful sex
• Miscarriage or infertility 
• Backache or leg pain

Although this is rare, sometimes the cyst can cause severe pain when it cuts off its blood supply and begins to die. If you have pelvic pain that does not go away, excessive bleeding, prolonged or painful menstrual periods, spotting or bleeding in between menstrual periods, difficulty emptying your bladder, etc., then see your doctor immediately as this can also be due to a lump in the uterus.

(Read more - Abnormal Uterine Bleeding)

There is no exact known cause of uterine lumps, but it is believed that they are linked to a hormone called estrogen. Estrogen is a female reproductive hormone produced by the ovaries (female reproductive organ). Uterine lumps usually develop during a woman's reproductive years (ages 16 to 50) as estrogen levels are highest in their body at this time. They tend to occur when oestrogen levels are low, as happens after menopause (when a woman's menstrual periods stop).

Uterine fibroids are a genetic problem and affected women often have a family history of the disease. Women of African descent are two to three times more likely to develop uterine fibroids than women of other races. According to researchers, there are many reasons that can lead to the formation of uterine fibroids, but none of these reasons are seen as a sure cause of these tumours. Some such reasons for the formation of uterine fibroids are as follows -

• It may be genetic.
• The female hormones estrogen and progesterone cause the growth of the cysts.
• The cysts grow rapidly during pregnancy, when hormone levels are high and shrink when anti-hormone medication is used. When a woman reaches menopause, the cysts stop growing or shrink.

Apart from the above reasons, there are some other reasons that can contribute to increasing the risk of uterine lumps -

• Being overweight or obese. 
• If you have never given birth to a child.
• If menstruation begins before the age of 10.
• Using birth control.
• Due to a lack of vitamin D. 
• Eating too much red meat and not eating enough green vegetables, fruits or dairy products can also increase this risk.
• Drinking alcohol can also increase the risk. 
• A study found that a high-sugar diet may be linked to a higher risk of uterine fibroids in some women. 

Nowadays, most doctors have come to realize that uterine fibroids do not always require intervention or at most only need limited treatment. If a woman with a uterine fibroid is not developing any symptoms, the best therapy in such cases is to wait and watch carefully for growth.

Depending on the size or symptoms of the fibroid, your doctor may recommend periodic pelvic exams and ultrasounds. Some women never have any symptoms or have any complications related to the fibroid, in which case no treatment is needed.There are many options to treat uterine fibroids, including surgical options such as hysterectomy, myomectomy, cryosurgery, MRI assisted high intensity focused ultrasound (MRgFUS) and uterine artery embolization (UAE).

Medicines can also be used for treatment. Some of the main medications prescribed by your doctor are mifepristone (RU-486), danazol (Danocrine), raloxifene (Evista), GnRH analogs (Lupron and others) and low dose formulations of oral contraceptives.Your doctor develops a treatment plan based on your age, size of the fibroids, and your overall health. Your doctor may use a combination of different treatments to treat you.Some natural treatments may also have a positive effect on uterine fibroids, including:

• Acupuncture therapy
• Yoga
• Massage therapy
• Gui Zhi Fu Ling Tang (GFLT), a traditional Chinese medicine formula
• Using warm compresses for cramping (avoid warm compresses if you experience heavy bleeding)

Making dietary changes may also help. For example, eat fewer meats and high-calorie foods. Instead, choose foods high in flavonoids, green vegetables, green tea, and cold-water fish such as tuna or salmon. One study found that eating fresh fruits and cruciferous vegetables such as arugula, broccoli, cabbage, cauliflower, collard greens, and turnip greens may help ease your discomfort. Cruciferous vegetables are rich in beta-carotene, vitamin B9, vitamin C, vitamin E, and vitamin K, and other minerals. They are also rich in fiber. Regular exercise can also reduce the risk of uterine fibroids. Losing weight if you are overweight and reducing your stress levels can also benefit you.

(Read more - What is the Normal Size of the Uterus?)

Uterine fibroids are a common problem in women, which occurs as non-cancerous growths in the muscles of the uterus. Heavy menstrual periods, abdominal pain, frequent urination, back pain, and infertility are common symptoms. Sometimes it is also found asymptomatic. Its main causes are hormonal imbalance (high levels of estrogen and progesterone), genetic predisposition, obesity and lifestyle changes.

Treatment: Small-sized fibroids can be cured with medicines and lifestyle modifications. Large-sized fibroids may require surgery, such as myomectomy (removal of the lump) or hysterectomy (removal of the uterus). Newer techniques such as uterine artery embolization also help shrink the fibroid. Regular doctor consultation is necessary for correct diagnosis and treatment.