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Focus on uterine fibroids: definition, symptoms, and treatments

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Focus on uterine fibroids: definition, symptoms, and treatments

Uterine fibroids are the most common benign female tumor. Abundant bleeding, cramps in the belly, abdominal pain, this disease can have a real impact on the quality of life of women.

Table of contents

The fibroid: A very common benign tumor

What is a fibroid? What are the symptoms? And the risks? This benign female tumor is still unknown to the general public. However, it is very common. Nearly 1 in 10 women suffer from symptomatic uterine fibroids. The main symptoms experienced are heavy periods (47%), cramps in the abdomen (47%), bleeding outside the period (42%), and pain (feeling of heaviness in the lower abdomen, constipation, and frequent urge to urinate). This disease can become very disabling in everyday life. The study indicates that the most crucial inconvenience concerns sentimental and sexual life, followed by professional inconvenience and, to a lesser extent, inconvenience felt in family life.

Uterine fibroid: what is the definition?

A fibroid consists of a proliferation of smooth muscle cells that roll up on themselves, welded together by connective tissue. There are three types of fibroids, depending on their location. The submucosal fibroid (fibroid 0.1.2) is located on the mucous membrane inside the uterine cavity. These fibroids are the rarest, but they often cause heavy bleeding. Interstitial fibroids (fibroid 3.4.5.) are most often implanted inside the muscular layer of the uterine wall. The subserous fibroid (fibroid 5.6.7.) is found outside the uterus. “In all cases, the fibroid remains benign, in the sense that it does not become cancer,” reassures Professor Fernandez, head of the Department of Gynecology and Obstetrics at the Kremlin-Bicêtre Hospital.

On the other hand, a fibroid can evolve in a very different way. This is why, when you know it exists, it is advisable to monitor it regularly because it can remain stable, increase in volume, either during pregnancy or when taking hormonal treatment. The main risk is anemia, with a significant loss of iron, which leads to fatigue and reduced resistance to effort.

Uterine fibroid and fertility

It isn’t easy to assess the impact of fibroid on fertility. Studies have shown that these tumors are directly involved in infertility in 2 to 3% of infertile patients. But it all depends on the type of fibroid. Patients with sub-mucosal fibroids (0.1.2.) would have affected fertility. Operating on them would seem beneficial, unlike interstitial fibroids, for which it has not been established that the operation brings benefits. A single study dating from 2011 compares a population of 106 infertile women with fibroids with the same number of infertile women without fibroids. It shows that the conception rate is significantly reduced in the presence of fibroids (11% versus 25%). However, the results of this study are questionable due to the small number of women included and the lack of precision on the size, number, and location of the fibroids.

Uterine fibroids: medical treatments

Nearly 30% of fibroids cause symptoms of varying severity. Heavy bleeding is the leading cause of gynecological consultations between the ages of 40 and 50. However, despite their symptoms, women rarely consult a doctor for this disease. The survey underlines only 38% of them are currently under treatment, and 9% confide in not taking their treatment. It is true that to date, there is no medical treatment for uterine fibroids. The drugs are intended to treat the associated symptoms or, indicated preoperatively, aim to reduce the size of the fibroid or correct the anemia.
Here are the main existing solutions depending on the size, the location of the fibroid, or of course, the woman’s request.

  • Progestin

Progesterone-based treatments can reduce bleeding because they create atrophy of the endometrium.

  • GnRh analogues

By blocking the hormonal secretion of estrogen, these treatments make it possible to reduce or even eliminate bleeding. GnRH analogs are mainly used for a maximum of 3 months to facilitate surgery.

  • Embolization

This consists of interrupting the vascularisation that feeds the fibroid by injecting synthetic microbeads into the arteries of the uterus using a catheter.

Surgical treatments

Myomectomy (removal of fibroids) is chosen for women who wish to preserve their fertility. The operation can be performed by hysteroscopy (introduction of a mini-camera into the uterus) through the vagina, by laparoscopy (through the abdomen by making small incisions), or by laparotomy (incision of the abdomen and uterus).
Hysterectomy (removal of the uterus) is reserved for the most extreme situations and is primarily intended for women who no longer wish to become pregnant. Some women whose lives have been severely affected by their fibroids want something definitive,” notes Professor Chabbert-Buffet, head of the obstetrics and gynecology department at Tenon Hospital. Nevertheless, today we have all the tools that allow us not to go to this radical solution.

Conclusion

Uterine fibroids are a common type of noncancerous tumor that can grow in and on your uterus. Many women experience uterine fibroids during their life. In some cases, fibroids are small and don’t cause any symptoms at all. Other times, fibroids can cause challenging symptoms like back pain and pain during sex. Fibroids can be treated, and often your symptoms can be improved.

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