What are Uterine Fibroids? Causes, Symptoms & Treatment

Written By: Dr. Katherine Cheng

Uterine fibroids (子宮肌瘤), also known as leiomyomas, are common non-cancerous growths that develop in the muscular wall of the uterus. While most women aren't aware they have fibroids because they often cause no symptoms, their effects can range from mild to severe, depending on the number, size, and type of fibroids. In this blog, we will delve into the details of fibroids, who can get them, how they develop, the different types, and available treatments.

What are Uterine Fibroids?

Fibroids are benign tumours that originate from smooth muscle cells within the uterus. They can vary in size, grow very large, and can occur in different places in the uterus. While fibroids are not associated with an increased risk of uterine cancer, they can cause several health problems, including heavy menstrual bleeding, pelvic pain, and, in some cases, fertility issues. In extreme cases, some fibroids grow large enough to fill the stomach or pelvis area.

Who Can Get Uterine Fibroids?

Fibroids are most common in women of reproductive age, especially those between 30 and 40. However, they can occur at any age. Certain factors can increase a woman's risk of developing fibroids, such as family history, ethnicity (with African women at higher risk), obesity, and early onset of menstruation. These factors combined with hormonal imbalances can contribute to the development of fibroids.

How are Uterine Fibroids Developed?

The exact cause of fibroid development is unclear, but research and clinical experience point to several factors. Genetics plays a role, as the condition often runs in families. Hormones, specifically estrogen and progesterone, which support pregnancy, also promote the growth of fibroids. Additionally, growth factors and tissue injury can influence fibroid development. It's also important to note that fibroids tend to shrink after menopause when hormone production decreases.

Uterine Fibroid (Myoma or Leiomyoma) Symptoms

Uterine fibroids can vary significantly in how they affect women. While some women may not experience any symptoms, others may have symptoms that disrupt daily life. The fibroids' type, size, number, and location all contribute to the intensity of these symptoms.

Common Symptoms of Uterine Fibroids:

Heavy Menstrual Bleeding (Menorrhagia): One of the most common symptoms of uterine fibroids is abnormally heavy or prolonged menstrual periods. Some women may need to change their sanitary products every hour, and the heavy flow can last longer than a normal period (usually 2 to 7 days).
Pelvic Pain or Pressure: As fibroids grow, they can put pressure on surrounding organs, causing a sensation of heaviness or fullness in the pelvic area. Larger fibroids can lead to severe pain and discomfort.
Frequent Urination: Fibroids that press on the bladder can increase the frequency of urination and even make it difficult to empty the bladder fully.
Constipation or Bloating: When fibroids press on the rectum, they can cause difficulty with bowel movements, leading to constipation and bloating.
Painful Intercourse (Dyspareunia): Depending on the size and location of fibroids, some women may experience pain during sexual intercourse, particularly if fibroids are located in the lower part of the uterus.
Lower Back Pain: Large fibroids can cause pressure on the muscles and nerves of the lower back, leading to discomfort or pain that radiates down the back and legs.
Enlarged Abdomen: In cases where fibroids grow significantly, they can cause visible abdominal swelling, often mistaken for weight gain or pregnancy.
Anaemia: Due to heavy menstrual bleeding, women with fibroids can develop anaemia (low red blood cell count), which can result in pale or sallow skin, easy fatigability, weakness, and shortness of breath.

It’s important to note that while these symptoms are common with fibroids, not every woman will experience them. If you are experiencing any of the above symptoms, it is crucial to consult a healthcare provider for an accurate diagnosis and appropriate treatment.

Types of Uterine Fibroids

Fibroids are classified by their location in the uterus. Intramural fibroids, the most common type, develop within the uterine wall. Subserosal fibroids grow on the outer wall of the uterus, while submucosal fibroids grow just beneath the uterine lining and into the uterine cavity. Pedunculated fibroids develop a stem, a slender base that supports the tumor.

How are Uterine Fibroids Diagnosed?

Uterine fibroids are diagnosed through a series of tests and procedures which may include:

Pelvic Examination: This is usually the first step in diagnosing fibroids. During a routine pelvic exam, your doctor may feel irregularities in the shape of your uterus, potentially suggesting the presence of fibroids.

Imaging Tests: These can provide a more definitive diagnosis. The commonly used imaging tests include:

Ultrasound: This is the most commonly used method for detecting fibroids. A transducer is moved over the abdomen (transabdominal) or inside the vagina (transvaginal) to create images of the uterus and ovaries. This test can measure the size, location, and number of fibroids.
Magnetic Resonance Imaging (MRI): An MRI provides a more detailed image of the uterus, making it helpful in confirming the diagnosis and for determining the size and location of fibroids.
Hysterosonography: Also known as saline infusion sonogram, this test uses sterile saline to expand the uterine cavity, making obtaining images of the uterus and endometrium easier. It can be beneficial in determining whether fibroids extend into the uterine cavity (submucosal fibroids).

Other Tests: In some cases, other tests may be necessary to rule out other diseases or conditions that may mimic or coexist with fibroids. These may include hysteroscopy, laparoscopy, or endometrial biopsy.

Which Size of Uterine Fibroid is Dangerous?

Fibroids can range from as small as a seed to as large as a melon. The potential risks associated with fibroids depend largely on their size and location within the uterus.

Small Fibroids (<5 cm):

Potential Impact: Small fibroids, especially those less than 1-2 cm in diameter, often cause no symptoms and are usually detected during routine pelvic exams. While generally not dangerous, they may still cause symptoms if they are located in sensitive areas, such as near the uterine lining or pressing on the bladder.

Medium Fibroids (5-10 cm):

Potential Impact: Fibroids in this size range can cause moderate symptoms such as heavier menstrual bleeding, pelvic pain, and frequent urination. In some cases, they may interfere with fertility or cause complications during pregnancy.

Large Fibroids (>10 cm):

Potential Impact: Large fibroids, sometimes as big as a grapefruit or larger, can cause more severe symptoms and complications. These include:
- Severe pelvic pain or pressure: Large fibroids can put pressure on the surrounding organs, including the bladder, rectum, and bowel, leading to discomfort and obstructive symptoms with urination or bowel movement..
- Risk of infertility or pregnancy complications: Large fibroids can distort the shape of the uterus and interfere with implantation, increasing the risk of infertility. They may also cause pregnancy complications, such as miscarriage or preterm birth.
- Abdominal distention: In some cases, large fibroids can grow so large that they extend into the abdomen, causing visible bloating or distention that can be mistaken for pregnancy or weight gain.

Treatments for Uterine Fibroids

Treatment for fibroids depends on the severity of your symptoms, the fibroids' size and location, and whether you're pregnant or planning to conceive. If you are relatively asymptomatic and the size of fibroids is small, you can regularly monitor fibroids' growth. Medication could sometimes relieve symptoms of heavy menstrual flow. Non-surgical procedures such as Uterine Artery Embolisation and high-intensity focused ultrasound are the treatment options.

Surgical options include myomectomy, which removes the fibroids and hysterectomy, which removes the uterus. Hysterectomy is usually the last resort and is only considered when other treatments have failed or if the fibroids are huge.

What naturally kills fibroids? Natural remedies to maintain a healthy weight and a balanced diet can also help manage symptoms of fibroids. Some research suggests that green tea may help reduce the size and number of fibroids, but more research is needed to confirm these findings.

Q&A for Uterine Fibroids

Q: What are uterine fibroids?
A: Fibroids, also known as uterine fibroids, are non-cancerous growths that develop in or around the womb (uterus). The growths are made from muscle and fibrous tissue and vary in size. They are most commonly found in women during their reproductive years.
Q: How are uterine fibroids diagnosed?
A: Fibroids are often found during a routine pelvic exam. If your doctor suspects you have fibroids, they may recommend further tests such as ultrasound, MRI, or hysteroscopy to confirm the diagnosis and assess the size and location of the fibroids.
Q: Can uterine fibroids lead to cancer?
A: It's very rare for fibroids to turn into cancer. Fibroids are mostly benign (non-cancerous) growths.
Q: Can lifestyle changes help manage uterine fibroids?
A: While the exact cause of fibroids is unknown, certain lifestyle changes may help manage symptoms or potentially slow the growth of fibroids. These include maintaining a healthy weight, having a balanced diet, doing regular exercise, limit the intake of alcohol,

Uterine fibroid is common during reproductive years. Although they can cause discomfort and complications, there are several treatment options available, ranging from medication to surgery. If you suspect you have fibroids or are experiencing symptoms, it's essential to seek medical attention promptly.

At OT&P Healthcare, we provide a comprehensive range of services to help manage and treat fibroids and other women's health issues. Our team of dedicated professionals is committed to providing the highest quality care to all our patients. Schedule an appointment with a doctor if you have concerns about fibroids or other women's health issues. We're here to help you navigate your health journey and provide the best possible care.