WOMEN’S BODIES: UTERINE PROBLEMS. FIBROIDS
Fibroids, also called fibromyomata, are benign (non-cancerous) tumours composed of fibrous and muscle tissue that grow in the wall of the uterus. At least one in five women are known to have them and probably many more have small fibroids that cause no problems and are never found.
You can have just one fibroid, but multiple tumours are much more common. They start when some of the fibrous and muscle cells start to grow and divide more quickly than the surrounding tissue, to form small pea-sized nodules within the wall of the uterus. Fibroids grow very slowly: they often stop growing before they reach the size of a golf ball but after growing for years may become as big as a baseball and very rarely, a football: there are some on record that weighed 10 kg! As fibroids grow they enlarge the uterus and distort its shape by bulging from its outer wall or into its cavity. If the uterus has become larger than a baseball you can usually feel a firm lump pushing up behind the pubic bone.
What causes fibroids?
We don’t know exactly, but their growth seems to depend on hormones, mainly oestrogen. Fibroids are rarely found in women under the age of 25 and they stop growing and shrink after the menopause.
What problems do fibroids cause?
Often none, but, depending on their size and position, they can cause any of the following.
• Large fibroids may press on the bladder, reducing its capacity and causing frequent need to pass small amounts of urine. Pressure on the rectum may make it hard to empty the bowel.
• Fibroids that bulge into the cavity of the uterus can cause heavier and prolonged menstrual bleeding. Occasionally a fibroid that hangs in the cavity by a stalk may push through the cervical canal to be felt as a lump in the vagina and to cause bleeding after sex and between periods.
• Pain is an uncommon symptom, but can happen if the tumour presses on a nerve or if a fibroid on a stalk twists so that its blood supply is disturbed.
• Fibroids don’t usually cause problems in pregnancy. Large tumours bulging into the uterine cavity may cause miscarriage or premature delivery. A tumour in or near the cervix could obstruct labour. Fibroids seldom interfere with fertility.
Is treatment necessary?
Only if the fibroids cause problems. For women who still want to have children the tumours can usually be removed, leaving the uterus. For those whose families are complete, hysterectomy is usually recommended.
*248/31/5*
