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Fibroids

Definition:

The scientific name for fibroids is Uterine leiomyomas. Fibroids are non cancerous tumors in the uterus. Fibroids are usually found in women their thirties or forties. These fibroids shrink in the absence of estrogen and in women in menopause. 

Research shows that fibroids is found two to five times more often in black women when compared to white women. High risk for developing fibroids occurs in those who are overweight 

Symptoms:
Only 20-25% of women who have fibroids display or experience any symptoms. Uterine bleeding that is abnormal and pressure in the pelvic are the most common symptoms. Abnormal bleeding can including menstrual bleeding that can last longer than seven days. Bleeding is heavy and it can also occur between menstrual cycles. Such abnormal bleeding should be brought to the attention of a physician.

When the size of the fibroid increases, the pressure in the pelvic area also increases. Usually this type of fibroid is found in the uterus which also increases in size. If the fibroid grows enough it can exert pressure on the bladder which can lead to frequent urination. 

Fibroids can lead to many reproductive problems such as: infertility, miscarriages, early labor and a difficult or complicated labor. Some of these dysfunctions may be avoided by careful monitoring by a physician and by determining the location and size of the fibroid and assessing whether its size or location within the uterus will hinder the growth of the fetus.

Procedures:

Since an abnormal growth in the uterus may cause the shape and function of the uterus to be affected, it is important to know how large and where the fibroid is located. To assess the condition of the fibroid physicians often perform a hysterosalpingograpy or hysteroscopy. 

A submucous fibroid, one that is found within the uterus, should be removed because it may cause reproduction problems. Small fibroids found in women who are not planning a pregnancy may not need to have the growth removed. A physician would assess each individual on a case by case basis.

The initial procedure a physician may use is a bimanual pelvic examination. This is similar to what is done during an annual examination at the gynecologists office. Using one hand, two fingers are inserted into the vagina and the physician palpates the abdomen and pelvic area with the other hand to feel any abnormalities. Physicians also use Computed Tomography (CT), Ultrasonography and Magnetic Resonance Imagery (MRI). MRI’s have been found to be most useful since it can distinguish a fibroid from other uterine abnormalities.

Although these imaging systems can provide a good assessment of a fibroid, usually a visual examination. Laparoscopy involves 2-5 incisions made in the abdomen area and a camera is inserted and visually explored for any presence of fibroids or other abnormalities.

Once diagnosed, the uterus may be removed if the woman is not planning on having any children. Those desiring to bear children, a myomectomy may be performed. Myomectomy is a surgical procedure where the fibroid is removed, not the uterus. There are some new techniques that involve freezing the fibroid (Cryomyolysis) amongst others. But the surgical procedures still remain the preferred method used by physicians in dealing with fibroids.

Medical Treatment

Medicine may also be helpful in treating fibroids. Gonadotropin releasing hormone agonists such as Zoladex and Lupron have been effective. These hormone agonists act by lowering estrogen levels in the body. Fibroids need estrogen to grow. When estrogen is lowered, the fibroid decreases in size and mass. This also relieves any pelvic pressure that may have caused discomfort. These medicines also stop menstrual flow, but menstruation will be carefully controlled by the physician and iron stores in the body will have a chance to replenish. 

The downside to using Gonadotropin releasing hormone agonists is that estrogen levels are reduced and estrogen is needed by the bones. This may leas to a loss in bone density also know as osterporosis. Therefore use of Gonadotropin releasing hormone agonists is usually for a relatively short time period between one to three months. This allows physicians to shrink the fibroid and replenish iron stores in the body before surgery.

 

 

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