Fibroids Flashcards
What are fibroids?
Benign tumours of myometrium of the uterus
Common in women above 30 - peak perimenopausal
What is the myometrium?
Layers of the uterus
What triggers fibroid development?
In response to oestrogen, fibroid contain more oestrogen and progesterone receptors than normal uterine muscle cells
What demographic is more commonly affected by fibroids?
Afro-caribbean women
How do fibroids present?
Menstrual dysfunction - heavy, painful
- subfertility if big enough fibroid
- palpable mass on abdo/pelvic exam
- urinary frequency if large enough to press on bladder
Imaging used for fibroids
1st line investigation?
TVUS - size + location
How to visulise submucosal fibroids?
Saline infusion Ultrasound : Hysterosonography
Why would a biopsy be required for a fibroid?
If in doubht to differentitate from endometrial cancer
How to manage fibroids 1st line
if under 3cm
Levorgesteral releasing intrauterine system
What other medications apart from IUS be considered in the management of fibroids?
Tranexamic acid
COCP
GnRH can be used short term to reduce size of fibroid
Myomectomy, hysteroscopic endometrial ablation
