FIBROID

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PATIENT: Hello doctor, could you please tell me all about Uterine Fibroid?. 


DOCTOR: Uterine Fibroid is the tumour of the muscles in the womb (uterus). 

PATIENT: Huh!!! Tumour? Like a cancer?. 


DOCTOR: Tumour simply means an abnormal growth. And Instead of the name "Tumour", doctors prefers to call it "Neoplasm". 
Neoplasm can be Cancerous or Non Cancerous. 
When it is cancerous, doctors calls it a "Malignant Neoplasm". This is a "cancer". 
When it is non cancerous, doctors calls it a "Benign Neoplasm". 

For the record ma,

Fibroid is a non cancerous tumour (i.e a benign neoplasm) and NOT a cancer (i.e a malignant neoplasm) 

PATIENT: Okay, but are there Muscles in the womb?. 

DOCTOR: Yes ma'am. It is these muscles that helps pregnant women to deliver by contracting to expel the baby alongside the placenta from the womb (uterus). Without the muscles, no amount of "Push" will be effective in delivering the baby. 

PATIENT: Hmmm... It's getting clearer. But why is it that some people with fibriod finds it difficult to concieve or have miscarriages and some do experience abnormal or excessive menstrual bleeding?. 

DOCTOR: I'll explain... 
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INTRODUCTION 

Uterine Fibroid is a benign tumour of the smooth muscles in the uterus. Mostly, they are slowly growing tumors and can be there for many years unnoticed. Women with fibroid may have different complaints from one another based on where the fibroid is located in the uterus. Let's take a look at the picture below to see the areas where fibroid could be located within the muscles of the uterus.

 

A NORMAL UTERUS

UTERUS WITH FIBROID

HOW DOES FIBROID DEVELOP?

The reproductive age of a woman starts around the age of 12. By this time, her ovaries becomes activated and start to release egg (ovum) once a month. This marks the beginning of her menstrual cycle (this is called menarche) which will go on until when she is about 51 years of age by which time the ovaries would have finished their jobs and start to shrink and no more eggs will be released (this is called menopause). 

Apart from releasing egg monthly, the ovaries also produce sex hormones (i.e estrogen and progesterone) which are responsible for coordinating the monthly Menstrual Cycle in a choreographic fashion. 
The cessation of their production by the ovaries when it shrinks marks Menopause. 

Apart from directing the Menstrual Cycle, these sex hormones are also capable of stimulating the growth of the uterine muscles. Normally, the uterine muscles has receptors (i.e sensors) for this sex hormone receptor but very minimal. 

However, one or more cells of the uterine muscles may develop more of these receptors and because these sex hormones continues to float around in a woman's body until she enters menopause, the uterine muscles that has developed more receptors for them too continues to grow disproportionately than the other muscles with fewer normal numbers of receptors. 

However, when menopause is dawn and the ovaries shrunken, the production of these hormones by the ovaries will also stop. The uterine fibroid becomes starved of the sex hormones growth signal and they too would start to shrink. 

Hence fibroids naturally do not grow after menopause, they resolve.  

WHAT IS FIBROID LIKELY TO CAUSE? 

1. Abnormal vaginal bleeding- when it is located so close to the innermost part of the wall of the womb (uterus) where it can encroach into the endomtrium (endometrium is the layer that is shed during menstrual period). Bleeding can also be heavy, lasting more than 7 days. The Fibroid with this capabilities is labeled "submucosal fibroid"  as seen in the diagram above.

2. Infertility- submucosal fibroid can also prevent implantation of fertilized egg. 

3. Miscarriage- it can grow directly into the cavity thereby preventing the competing for space with the developing baby in the womb. 

4. Constipation- because the rectum lies behind the womb (uterus), fibroid may compress on the rectum thereby making it difficult to defecate. See picture below. 

5. Frequent urination- because the bladder lies in front of the womb (uterus), fibroid may compress on the bladder thereby making it difficult for it to store up more urine thereby making you feel pressed often. See picture above. 

6. Difficulty in urinating- the fibroid could be so big in size that it'll compress the bladder, thus making it difficult for urine to be passed out from it.

7. Lower Abdominal pain- pain suggest a fast growing fibroid. 

Above all,

You can have fibroid and not experience any of this. A lot of women with fibroid do not experience any of this and when they entered menopause, the fibroid shrinks. 

WHO IS AT RISK OF FIBROID 

1. Family History- if your mother or sister has fibroid, you are  3 times at risk than other women. 

2. Race- it is commer among black women. 

3. Early Menarche- meaning that if you start menstruating early years. 

4. Birth Control Pills. - if you are taking birth control pills.

5. Obesity.

6. Eating a lot of Red Meats.

WHAT ARE THE TREATMENT OPTIONS FOR FIBROID 

Based on your doctor's assessment one of the following treatment options may be used. 
1. Watchful waiting. 
2. Medical (i.e drugs). 
3. Surgical treatment. 

Watchful waiting- when the fibroid is not hurting at all. Afterall its gonna shrink after you enter menopause. You just watchout for the above symptoms. If you're experiencing none then there wont be need to subject you to the surgeon's knife. Most women probably had fibroid that are accidentally detected during a routine examination. 

Medical Treatment- your gynaecologist may give you drugs to shrink the size of the tumor and control the heavy and irregular bleeding. 

Surgical Treatment- surgery may be done if removing the tumor is deemed necessary by your gynaecologist. 

CONCLUSION
 Fibroid is a benign tumor of the uterine muscles. Though not deadly but should not be ignored. Any complaint similar to the one listed above should be taken seriously and reported to a doctor. Thank you.