What are fibroids and can they affect your fertility?
Quick facts
- Fibroids are non-cancerous growths in and around the uterus.
- While their cause is unclear, they tend to increase and decrease in size depending on how much oestrogen is in the body. They’re therefore thought to be linked to hormones.
- Fibroids can form in a variety of sizes, ranging from the size of a pea to the size of a small melon.
Are fibroids cancerous?
It’s extremely rare for a fibroid to turn cancerous. In fact, this occurs in less than one in 1,000 cases. Having fibroids doesn’t increase your risk of getting other forms of cancer in the uterus.
If they're not cancerous, why should I be concerned?
Fibroids can cause symptoms that make every day life difficult, particularly around your period. They can cause severe cramps, sharp stabbing sensations in your tummy, back aches and pain or discomfort during sex.
In rare cases, complications can impact pregnancy and cause infertility, so it’s important to get checked and monitor symptoms.
Who gets fibroids?
While 1 in 2 women are estimated to develop fibroids, only 40% of them will experience symptoms. So you could go your whole life without realising you have them.
What are some other risk factors?
Ethnicity
Black women are more likely to develop fibroids. The reason for this is still unknown.
Family history
If your mother has had fibroids, your risk of having them is about three times higher than average.
Obesity
Being overweight increases the risk by 2-3 times the average. Doctors think this is because the level of oestrogen is higher in women who are overweight.
Age
Fibroids are more common during your 30s and 40s. After menopause, they usually shrink.
What symptoms should I look out for?
Speak to a doctor if you’re experiencing:
- Painful or heavy periods
- Bleeding in between periods
- Bloating or feeling heavy in the abdomen
- Pain or discomfort during sex
- Lower back pain
- Frequent urination (fibroids can put pressure on your bladder)
- Constipation
- Leg swelling
Can fibroids affect my fertility?
While most women with fibroids don’t experience issues with fertility or pregnancy, complications can show up in rare cases.
Fibroids located inside the uterus cavity can block the fallopian tubes or prevent implantation, causing infertility.
Pregnant women with fibroids might experience more painful pregnancies when red degeneration occurs. This is when a fibroid outgrows its blood supply, causing some of its cells to die.
Fibroids that draw on large blood supplies can sometimes cause miscarriages.
Other potential complications include:- Increased bleeding after labour
- The baby coming out bottom-first
- Preterm birth (when a baby is born before 37 weeks of pregnancy have been completed)
- Increased chance of cesarean sections
How are fibroids diagnosed?
Examination
Many women only discover they have fibroids during an unrelated scan or vaginal exam. A doctor will usually request an ultrasound to confirm it’s a fibroid. A blood test should also be done to check for anaemia in women who have heavy periods.
Hysteroscopy
Another way to diagnose fibroids is through a hysteroscopy. A small camera is inserted into the uterine cavity to view the uterus and fibroids.
Small fibroids can be treated through a hysteroscopic resection, where an electrode is attached to the camera and low currents of energy are used to remove tissue from the fibroid.
MRI scan
An MRI scan may be done if a fibroid grows rapidly, becomes excessively large or forms after menopause. This is to check if the fibroid is cancerous.
How are fibroids treated?
Many women decide not to treat their fibroids, since they often become smaller over time. However, for those who experience symptoms, treatments can be life-changing. In each case, your doctor should make you aware of your options and any risks or side effects.
Relieving period symptoms
Depending on your circumstances, a doctor may prescribe medication to reduce painful or heavy periods.
Shrinking fibroids
There are a number of treatments that shrink fibroids, which helps to relieve symptoms.
Hysterectomy
This procedure removes the entire uterus, eliminating the possibility of fibroids growing back. In most cases, a small incision is made and the surgery is done with the help of a camera.
Myomectomy
This surgery removes individual fibroids. Large or multiple fibroids are removed through a bikini-line incision, while smaller fibroids (10cm or less) can be removed with smaller incisions. There is always a chance that fibroids will grow back in the future.
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