A Visual Guide to Uterine Fibroids Flashcards
What is fibroid uterus ( uterine fibroids, uterine leiomyoma)?
Reference:
http://www.webmd.com/women/uterine-fibroids/uterine-fibroids
Uterine fibroids (leiomyomata) are noncancerous (abnormal) growths that develop in or just outside a woman’s uterus (womb). Uterine fibroids develop from normal uterus muscle cells that start growing abnormally. As the cells grow, they form a benign tumor.
It is unclear why fibroids develop, but several factors may influence their formation, such as hormones and family history. About 70 to 80 percent of women experience fibroids by the age of 50. Sometimes, these tumors become quite large and cause severe abdominal pain and heavy periods. In other cases, they cause no signs or symptoms at all. The growths are typically benign (noncancerous). The cause of fibroids is unknown.
Symptoms of Fibroids: Pressure
Fibroids may cause very mild symptoms or none at all. In women who do feel symptoms, these uterine growths can cause:
- Pressure on the bladder or rectum
- Frequent urination
- Constipation and/or rectal pain
- Lower back and/or abdominal pain
If fibroids become very large, they can distend the stomach, making a woman look pregnant.
Symptoms of Fibroids: Period Changes
Fibroids may also cause changes to a woman’s period, including:
- Mild to severe cramping and pain
- Heavier bleeding, sometimes with blood clots
- Longer or more frequent menstruation
- Spotting or bleeding between periods
Fibroids or Endometriosis?
Fibroids are one cause of severe menstrual pain, but the pain also can be caused by endometriosis. Endometriosis occurs when tissue from the inner lining of the uterus grows in other parts of the body – illustrated here by growths on the outside of the uterus and bladder. This tissue breaks down and bleeds during your period, causing painful scar tissue. The pain of fibroids or endometriosis also can occur between periods.
What Causes Fibroids?
The exact cause of fibroids is unknown. Their growth has been linked to the female hormones estrogen and progesterone. Estrogen and progesterone are the hormones produced by the ovaries. They cause the uterine lining to regenerate during each menstrual cycle and may stimulate the growth of fibroids. Studies have found that women who start their periods at a younger age are more likely to develop fibroids. Although taking female hormones is linked to fibroids, the use of birth control pills is not.
Types of Fibroids:
- Intramural fibroids, the most common, grow in the wall of the uterus and can make it feel bigger. In other words, Intramural fibroids are the most common type of fibroid. These types appear within the lining of the uterus (endometrium). Intramural fibroids may grow larger and actually stretch your womb.
- Subserosal fibroids grow (form) on the outside of the uterus, which is called the serosa. As they grow larger, they can cause pain due to their size or pressure put on nearby organs. They may grow large enough to make your womb appear bigger on one side.
- Submucosal fibroids grow just underneath the uterine lining and can crowd into the uterus cavity and lead to heavy bleeding and other more serious complications. These types of tumors develop in the inner lining (myometrium) of your uterus. Submucosal tumors are not as common as other types, but when they do develop, they may cause heavy menstrual bleeding and trouble conceiving.
- Pedunculated fibroids grow on small stalks inside or outside the uterus. In other words, when subserosal tumors develop a stem (a slender base that supports the tumor), they become pedunculated fibroids.
It’s possible to have more than one type of fibroid.
Who Gets Fibroids?
Who Is at Risk for Fibroids?
While it’s unclear why women develop fibroids, some patterns have been observed.
- They usually occur between the ages of 30 and 40.
- They are more common in black women. (being of African-American descent)
- They grow more quickly and appear at a younger age in black women.
- Having a family member with fibroids increases a woman’s risk. (Fibroids may run in the family. If your mother, sister, or grandmother has a history of this condition, you may develop it as well.)
- Being overweight or obese (having a high body weight) and having high blood pressure also may increase your risk.
- Pregnancy. Pregnancy increases the production of estrogen and progesterone in your body. Fibroids may develop and grow rapidly while you are pregnant.
Complications: Fibroids and Anemia
Some women with fibroids who experience unusually heavy bleeding during their periods may become anemic. Many cases of anemia due to iron deficiency from periods are mild and can be treated with a change in diet and iron supplement pills. Untreated anemia can lead to fatigue and lethargy – and, in severe cases, heart problems.
Complications: Getting Pregnant
Fibroids usually do not interfere with fertility and pregnancy. However, some women with fibroids experience more pregnancy complications and delivery risks. Fibroids may cause pelvic pain and heavy bleeding after delivery, which may require surgery. In some instances, fibroids may block your fallopian tubes. Fibroids growing along the inner uterine wall may make it difficult for a fertilized egg to attach.
When to See a Doctor?
See your health care provider if you have the following fibroid symptoms:
- Heavy menstrual bleeding
- Periods that became more painful
- Frequent urination or inability to control the flow of urine
- A change in the length of your period over three to six cyclesNew persistent pain or heaviness in lower abdomen or pelvis
Diagnosis: Exam and Imaging
http://www.webmd.com/women/uterine-fibroids/uterine-fibroids
Your doctor may feel moderate and large uterine fibroids during a routine pelvic exam. Tests, such as an ultrasound, can show information about size and location of other fibroids. For women with fibroids who are trying to get pregnant, a test called a hysterosalpingogram will show an outline of the uterus and fallopian tubes and may detect abnormalities. Other procedures to visualize the inside of the uterus or abdomen also may be needed.
http://www.healthline.com/health/uterine-fibroids#Diagnosis6:
You will need to see a gynecologist to get a pelvic exam. This exam is used to check the condition, size, and shape of your uterus. You may also need other tests, which include:
Ultrasound
An ultrasound uses high frequency sound waves to produce images of your uterus on a screen. This will allow your doctor to see its internal structures and any fibroids present. A transvaginal ultrasound, in which the ultrasound wand (transducer) is inserted into the vagina, may provide clearer pictures since it is closer to the uterus during this procedure.
Pelvic MRI
This in-depth imaging testing produces pictures of your uterus, ovaries, and other pelvic organs.
Treatment: Pain Medication
Pain medications, such as acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs), like as ibuprofen or naproxen, can help relieve menstrual cramping.
Treatment: Birth Control
Oral contraceptives manage levels of estrogen and progestin. This usually leads to lighter periods and can alleviate some of the pain associated with fibroids, such as heavy bleeding and cramping. Other hormonal birth control methods that may lessen fibroid symptoms include progestin injections or progestin-releasing IUDs.
Other Hormone Therapies
Drugs called gonadotropin-releasing hormone (GnRH) agonists may offer temporary symptom relief from fibroids by stopping periods and shrinking fibroids. GnRH agonists block the production of estrogen, so they can also cause bone loss, hot flashes, and vaginal dryness. Fibroids will return to their previous size once treatment ends. These may be used to shrink fibroids before fibroid removal surgery.
http://www.healthline.com/health/uterine-fibroids#Treatment7:
Medications to regulate your hormone levels may be prescribed to shrink fibroids. Gonadotropin-releasing hormone (GnRH) agonists, such as leuprolide (Lupron), will cause your estrogen and progesterone levels to drop. This will eventually stop menstruation and shrink fibroids.
Other options that can help control bleeding and pain, but will not shrink or eliminate fibroids, include:
- an intrauterine device (IUD) that releases the hormone progestin
- over-the-counter anti-inflammatory pain relievers, such as ibuprofen
- birth control pills
Treatment: Embolization
For mild to moderate symptoms, uterine fibroid embolization may be a good option. A catheter is guided to the uterine artery. Tiny particles of plastic or gelatin are then released into the blood vessels that feed the fibroid, causing it to shrink over time. Embolization should not be an option for women wanting to get pregnant at some point after treatment.