Uterine Fibroids

What are fibroids?

Fibroids are benign (non-cancerous) growths found in the uterus. Many women are affected without being aware of it as they may not experience any symptoms. If fibroids occur at an awkward position in the uterine cavity or are quite large, they may however cause symptoms and should then be treated.  

Fibroids are growths occurring in the muscles of the uterus. They are made up of smooth muscle fiber and connective tissue.

The growth of fibroids is associated with the female reproductive hormone oestrogen. This is why it almost always affects women of child-bearing age. Uterine fibroids, which cause symptoms, are not often diagnosed in women under the age of 25. Fibroids accompanied by symptoms typically occur between the ages of 35 to 50. They affect between 70 to 80 percent of all women up to the age of 50. Uterine fibroids are the most common reason for removal of the uterus (hysterectomy) in women of child-bearing age. After the menopause fibroids often shrink in size.


Symptoms of fibroids

Fibroids frequently (in around 30 percent of cases) cause a number of different symptoms and may significantly impair your quality of life. Fibroids are almost never associated with increased mortality rates. After the menopause there is relief from symptoms in many cases.

The most common symptom of fibroids is problems with menstruation. Monthly periods may become irregular or very heavy or last a long time. Heavy periods can cause anemia and so make a patient feel extremely tired.

The growth of fibroids may also give rise to pelvic pain and pressure. If the uterus increases in size, it presses on surrounding organs such as the bladder and bowel. This will make one feel constipated, cause ones lower back to hurt or make one want to pass water frequently.

Women with fibroids are also more likely to find sexual intercourse painful (inability to reach orgasm).

Although fibroids do not affect fertility in most women, they frequently cause problems during pregnancy and childbirth.


Types of fibroids

Besides the size and form of uterine fibroids, their position is also an important factor for the severity of symptoms and the decision taken regarding their treatment:

  • Submucosal fibroids – The wall of the uterus is covered on the inside with a layer of cells similar to the mucous membrane of the stomach and vagina. Some fibroids grow directly beneath this membrane.
  • Intramural fibroids – The uterus is made up of strong muscles, which expand during pregnancy and contract powerfully during childbirth. Some fibroids grow between the muscle fibers inside the thick wall of the uterus.
  • Subserosal fibroids – The outside of the uterus is covered by a special layer of skin (serous membrane). Some fibroids grow directly underneath this outer layer of the uterus.
  • Pedunculated fibroids – Some submucosal and subserosal fibroids are joined to the uterus with stalk-like structures.

Submucosal and intramural fibroids are particularly likely to cause problems with menstruation, which may be severe in some cases.