Leiomyomas/Fibroids

Question 1

Definition of Leiomyomas/Fibroids

Answer 1

Leiomyomas, commonly referred to as fibroids, are noncancerous growths that develop in the uterus.

They are composed of smooth muscle cells and fibrous connective tissue.

Most commonly seen around 40 -50 years old, but symptoms can begin earlier.

Question 2

Causes of Leiomyomas/Fibroids

Answer 2

Hormones: Estrogen and progesterone, female reproductive hormones, play a role in stimulating the growth of fibroids.

Genetic predisposition: There may be a genetic component, as fibroids tend to run in families.

Growth factors: Certain substances in the body, such as insulin-like growth factor (IGF), may promote the growth of fibroids.

Question 3

Symptoms of Leiomyomas/Fibroids

Answer 3

Heavy or prolonged menstrual bleeding
Pelvic pain or pressure
Frequent urination or difficulty emptying the bladder
Constipation or rectal pressure
Lower back pain
Enlargement of the abdomen
Pain during sexual intercourse
Infertility or recurrent miscarriages (rare)

Question 4

Dagnosis of Leiomyomas/Fibroids

Answer 4

Pelvic examination: The healthcare provider can feel the presence of fibroids during a routine pelvic exam.

Imaging tests: Ultrasound, either abdominal or transvaginal, can provide detailed images of the uterus to confirm the presence, size, and location of fibroids.

MRI (Magnetic Resonance Imaging): MRI can offer a more detailed assessment of fibroids, especially for planning treatment options.

CT

Hysterosalpingogram/scopy

Question 5

Treatment of Leiomyomas/Fibroids

Answer 5

Watchful waiting: If fibroids are small and not causing significant symptoms, no treatment may be necessary, with regular monitoring being sufficient.

Medications:
Progestin-releasing intrauterine devices (IUDs), can help manage heavy bleeding and relieve symptoms.
GNRH agonist to inhibit growth.

Noninvasive procedures:
Uterine artery embolization (UAE)
MRI-guided focused ultrasound surgery (FUS), can help shrink or destroy fibroids without surgery.

Surgical interventions:
Endometrial Ablation.
Myomectomy (removal of fibroids while preserving the uterus)
Hysterectomy (removal of the uterus).
These options are considered for more severe symptoms, larger fibroids, or when fertility is not a concern.

Question 6

Complications of Leiomyomas/Fibroids

Answer 6

Heavy or prolonged menstrual bleeding leading to anemia.
Pain or pressure on adjacent organs.
Infertility or pregnancy complications (rare).