Affecting around 35 per cent of women, fibroids can hamper day to day living as it causes heavy painful periods, pain in the legs, painful sexual intercourse, swelling in the lower abdomen (especially if fibroids are large), backache, constipation, discomfort in the lower abdomen (especially if fibroids are large), frequent urination and even anaemia as a result of heavy bleeding. Nearly 1,000 women with fibroids responded to the Harris Interactive survey, and close to one-third of those with jobs said they missed work because of symptoms, including heavy or prolonged menstrual bleeding, cramping and fatigue.
“Fibroids are caused as a result of hormonal oestrogen stimulation in the smooth muscle cells of the uterus. In addition to its occurrence in women in the childbearing group, race plays a role in the incidence of fibroids. It is inconclusive exactly why women develop these tumours. Genetic abnormalities, abnormalities in the vascular (blood vessel) system, and tissue response to injury have all been suggested to play a role in the development of fibroids,” said Dr. Rajesh Devassy, Specialist Gynaecologist at Medeor 24×7 Hospital, Dubai. “Family history is a key factor, since there is often a history of fibroids developing in women of the same family. During the first trimester of pregnancy, about a third of fibroids will enlarge and then shrink after the birth. In general, fibroids tend to shrink after menopause, but postmenopausal hormone therapy may cause symptoms to persist.”
The location of the fibroid in relation to the uterus and uterine cavity is very important. In addition to bleeding and pelvic pressure, fibroids can cause recurrent miscarriage, infertility, premature labour, and labour complications.
Many women suffer through heavy menstrual bleeding without looking at the factors that they cause it. In most cases the condition is often diagnosed when a woman has trouble conceiving or having a difficult pregnancy.
“Uterine fibroids can reduce fertility in several ways. They can change the shape of the cervix which affects the number of sperm that can enter the uterus. It can also change the shape of the uterus can interfere with the movement of sperm and embryo or the fallopian tubes can be blocked by fibroids,” the Doctor explained. “Blood flow to the uterine cavity can be affected by a fibroid and this can decrease the ability of an embryo to implant itself to the uterine wall and develop.”
Having a family member affected with the condition increases your likelihood of developing the condition. Recent studies have shown that a blood relation with someone who has suffered from fibroids increases a woman’s chances of acquiring it.
“If a woman gets a fibroid at, or before 45 years, then first degree relatives (daughter/sister/niece), would have a six times (31%) higher risk of getting it too, compared to 5% relatives of women who didn’t have fibroids. We also know that hormones called estrogen feed the fibroids and once a lady reaches her child bearing age she could be at a risk of developing fibroids. Fibroids are quite
common in 40-70 per cent of women in the reproductive age group, which is from the menarche, or the first menstrual cycle, to the menopause stage. Red meat eating women face a three times higher risk than vegetarians. Also, that fish eaters have less incidence of fibroids,” Dr. Rajesh said.
There are medications to shrink fibroids such as Ulipristal that block progesterone receptors in fibroids resulting in normal flow during menstruation. Another drug available, given as injections reduces oestrogen and progesterone levels to achieve a temporary post-menopausal state. However, in the long run these medications sometimes do not provide a permanent solution and can cause other medical conditions.
For optimal treatment and cure, minimally invasive procedures are recommended. In laparoscopic or robotic assisted surgeries, your surgeon accesses and removes fibroids through several small abdominal incisions instead of one single very large cut on your abdomen resulting in faster recovery time.
“We make a small incision near the belly button and insert the laparoscope fitted with a camera into the abdomen. Through other small incisions the surgical instruments are inserted. The fibroid is then cut into smaller pieces and removed through the small incisions. This type of surgery results in less blood loss and therefore patients are able to return to normal activity much faster,” Dr. Rajesh explained.
“Women have long suffered in silence with fibroid and especially its typical symptoms such as heavy menstrual bleeding, back aches and pain and discomfort in the lower back or legs. They can be easily treated when diagnosed and we at Medeor 24×7 Hospital, Dubai are committed to raising awareness on these medical conditions to ensure a healthy population,” said Dr. Mohammed Berer, Medical Director at Medeor 24×7 Hospital, Dubai.