How Uterine Fibroids Causes Infertility in Women

The uterus is composed of a thick layer of smooth muscle (myometrium) surrounding a thin lining (the endometrium) into which the embryo implants and which serves to protect and nourish a growing pregnancy. It is the thin endometrium which is shed each month during the menstruation, if pregnancy does not occur. Some have stated that it is as though the uterus “weeps tears of blood in mourning for the fact that conception did not take place in the cycle. In other words, all hormonal events of the menstrual cycle, have a single purpose in mind – namely successful conception.

Approximately 20-40% of all reproductive age women will develop benign growths of the myometrium, referred to as fibroid tumors (leiomyomata). These tumors are rarely malignant (see below). They can be located in the wall of the uterus (intramural), on the outside of the uterus (subserosal), within the uterine cavity (submucosal), on a thin stalk (pedunculated) or any combination of the above. They are hormone dependent lesions and estrogen causes them to grow. African and African American women seem to have a much higher incidence of fibroid tumors. This is indicative of the fact that their cause has a fundamental genetic basis.
Most fibroids start as very small lesions (sometimes referred to as “seedling fibroids”) and they can grow to very large sized lesions. Fibroids as big as watermelons have been reported in the literature. The impact of fibroid tumors on successful reproduction, have a lot to do with location (see below).

Presentation, Symptoms and Signs associated with Uterine Fibroids

Fibroid tumors, even large ones, can occur without producing any symptoms at all (asymptomatic). However they can also cause a variety of symptoms depending on their size, location and the absence or presence of complications such as tortion (twisting) or degeneration (such as might occur when a fibroid grows so fast that it starts running out of its blood supply). The most common symptoms are heavy cyclical menstrual bleeding (menorrhagia) accompanied by menstrual pain (dysmenorrhea). Sometimes, especially when a fibroid protrudes into the uterine cavity, it can cause erosion of the endometrial lining and produce irregular or continuous bleeding (menomettrorhagia).Sustained non-menstrual pelvic pain may point to tortion of a pedunculated fibroid that is attached to the inner or outer wall of the uterus, or to degeneration, Other possible symptoms include pain with deep penetration during intercourse (deep dyspareunia), bladder irritability, rectal pressure, constipation and painful bowel movements (dyschezia). If a fibroid undergoes degeneration, it can become secondarily infected and in addition to pain, the patient may have fever and chills.

Effect of Fibroids on Reproduction

For the most part, only those fibroids that impinge upon the endometrial cavity (submucosal) affect fertility. Exceptions include large intramural fibroids that block the openings of the fallopian tubes into the uterus, and where multiple fibroids cause abnormal uterine contraction patterns. Another lesion that can cause significant problems is the one that grows off the back side of the uterus and occupies to a greater or lesser degree, the cui de sac (area behind the uterus). This location is very important in the physiology of conception, therefore it is not uncommon to see patients with these kinds of lesions present with infertility. Surgery to treat fibroids can also affect fertility in several ways. If the endometrial cavity is entered during the surgery, there is a possibility of post operative adhesion formation within the uterine cavity. This should always be checked for through the performance of a hysteroscopy or fluid ultrasound prior to beginning fertility treatment. Because myomectomy can be bloody, there is a high likelihood of abdominal adhesion formation, which could encase the ovaries, preventing the release of the eggs or block the ends of the fallopian tubes, or otherwise interfere with the normal functioning and relationships of the pelvic organs. For this reason it is important that only accomplished surgeons, who are familiar with techniques to limit blood loss and prevent adhesion foundation, perform myomectomies.In some cases multiple uterine fibroids may so deprive the endometrium of blood flow, that the delivery of estrogen to the uterine lining (endometrium) is curtailed to the point that it cannot thicken enough to support a pregnancy. This can result in early 1st trimester (prior to the 13th week of pregnancy) miscarriages. Large or multiple fibroids, by curtailing the ability of the uterus to stretch in order to accommodate the spatial needs of a rapidly growing pregnancy, may precipitate recurrent 2nd trimester (beyond the 131h week) miscarriages and/or trigger the onset of premature labor. As stated above, the location of the lesions is very important in the symptoms/impact. A lesion positioned just beneath the endometrial lining can make the structural integrity of the endometrium quite unstable and the therefore, unable to develop in a progressive manner in preparation for implantation of the embryo.

Diagnosis

Sizable fibroid tumors are usually easily identified by simple bi-manual vaginal examination. However, even the smallest fibroid can be identified by transvaginal ultrasound. Sometimes it is difficult to tell if a fibroid is impinging on the endometrial cavity. In such cases, a hysteroscopy (where a telescope like instrument, is inserted via the vagina into the uterine cavity) or a hysterosonogram (where injected t1uid, distends the uterine cavity allowing for examination of its contour and inner configuration) can help distinguish between intramural and submucosal. Magnetic Resonance Imaging (MRI) can be used to distinguish between fibroid tumors and a related condition called adenomyosis, in which diffuse or localized foci of endometrial tissue can be found within the myometrium. Given the often-diffuse nature of adenomyosis, it is difficult to remove surgically. This contrasts with fibroid tumors, which are well defined and are usually relatively easily removed at surgery.

Enlarged Uterus: Causes Fibroid

The uterus is one of the first organs to manifest symptoms when a woman's hormones are out of balance. Two of the most common uterine symptoms of premenopause syndrome are an enlarged uterus, and uterine fibroids. Women with PMS often experience painful periods (dysmenorrhea) which are most often caused when the endometrial lining of the uterus extends into the muscular wall of the uterus (adenomyosis). When shedding of the endometrium occurs (menstruation), the blood is released into the muscular lining, causing severe pain. Conventional medicine treats this pain with NSAIDS (non-steroidal-anti-inflammatory drugs) such as ibuprofen, but ignores the underlying metabolic hormonal imbalance that caused it. The problem can often be simply resolved by restoring proper progesterone levels, which restores normal growth and shedding of the endometrium.
Estrogen dominance causes the uterus to grow, and without the monthly balancing effect of progesterone, it doesn't have the proper signals to stop growing. In some women this results in an enlarged uterus that presses on other organs, such as the bladder, and often on the digestive system, and generally causes discomfort and heavy menstrual bleeding. In other women estrogen dominance results in fibroids, which are tough, fibrous, non-cancerous lumps that grow in the uterus. Some fibroids can grow to the size of a grapefruit or cantaloupe, causing constant bleeding and such heavy menstrual periods that the blood loss is akin to hemorrhaging.
Fibroids always shrink at menopause, but the most common course of action a doctor takes when a patient comes in with a fibroid is to remove the uterus. The explanation given is that a fibroid is too difficult to remove without irreversibly damaging the uterus. But in most cases this is no longer true. If you do end up needing to have a fibroid surgically removed, find a doctor who can do it without removing your uterus with it. If you have many small fibroids, it may be more difficult to remove them. On the other hand, their smaller size may make it easier to treat them without surgery.

Do Growing Fibroids Mean Cancer?

Fibroids are benign uterine growths. Furthermore, fibroids do not turn into cancer. Genetic studies of fibroids and uterine muscle cancer (sarcoma) show that they have very different genetic mutations and that sarcomas do not develop from fibroids. However, a leiomyosarcoma, an extremely rare malignant tumor of the uterine muscle, also causes enlargement of the uterus. But only 1 out of every 1,000 women admitted to the hospital for surgery because of problems thought to be from fibroids will be found to have a sarcoma. And since 80 percent of women with fibroids are never admitted to a hospital for surgery, the incidence of sarcoma in all women with fibroids is extraordinarily low. The average age of women who develop fibroids is 38. Although sarcoma can rarely occur in young women, the average age of a woman who develops a sarcoma is 63. So, if you have fibroids, there is not much reason to worry about sarcoma.
Most gynecologic textbooks teach physicians that if a woman has a rapidly growing uterus, she should have surgery to see if she has a uterine sarcoma. Surgery would be needed to remove tissue for microscopic analysis. However, during the course of my training and years in practice, I have never seen a “rapidly growing fibroid” actually turn out to be a sarcoma.
To study this issue, I did a clinical study at the hospitals where I practice and reviewed the charts of 1,332 women admitted for surgery because of fibroids. Only three women (two tenths of 1%) were found to have a sarcoma. Of the 371 patients admitted because of rapidly growing fibroids, only one (three tenths of 1%) had a sarcoma. This study showed that the risk of developing a sarcoma is extremely low, even if your fibroids are rapidly growing.

Herbal Treatments for Uterine Fibroids

There are different approaches currently practiced to treat women suffering from uterine fibroid symptoms. The most common treatments for uterine fibroids include surgical intervention. But there are some non-invasive methods such as MR guided Focused Ultrasound Surgery.
There are also a variety of herbal treatment options for uterine fibroids. These herbal medicines effectively alleviating common symptoms related to fibroids such as abdominal pain and heavy bleeding. However, herbal treatments have not been proven to remove the uterine fibroids.

Herbal Medicines for Uterine Fibroid Include:

• Vitex (Vitex Agnus-Castus)
Vitex reduces estrogen levels by promoting the production of progesterone. For optimal results, Vitex should be taken for at least six months.
To make vitex tea: pour three cups of boiling water over two tablespoons of crushed vitex berries. Steep for 20 minutes, strain, and drink three cups a day.
Vitex has a spicy, peppery taste. You can also take one-half teaspoon of liquid extract or two capsules three times daily.

• Dandelion Root (Taraxacum Officinale)
Dandelion root affects the liver by improving bile flow. This leads to effective degradation of excess estrogen, which is flushed out of the body. For best results, take dandelion for at least three months.
To make Dandelion root tea: Simmer three tablespoons of dandelion root in three and one-half cups of water for 15 minutes in a covered pot. Remove from heat and let stand for an additional 15 minutes. Strain, and drink three cups a day.
Dandelion root has an earthy, slightly bitter flavor. You can also take 1 to 2 teaspoon of liquid extract or two capsules three times daily.

• Milk thistle (Silybum Marianum)
Milk thistle is a very effective herbal medicine which works on the liver by promoting the regeneration of liver cells. This helps to maintain effective liver function.
For best results, take an extract of milk thistle standardized for silymarin, which is considered to be the primary active ingredient.
Take 140 milligrams of silymarin 3 times daily for at least 3 months. If you prefer to use the whole herb, you can grind milk thistle seeds in a coffee grinder and sprinkle them on cereals, salads, or other dishes. Eat approximately two tablespoons daily.

• Nettle (Urtica Dioica)
Nettle is a superb broad-spectrum health tonic. It contains iron and other natural elements, which promotes the production of new red blood cells thus counteracting anemia caused by excessive bleeding. Nettle is safe and gentle and can be taken indefinitely.
To make nettle tea: Pour 3 cups of boiling water over 2 tablespoons of dried nettle, cover, and steep for 15 minutes. Strain, and drink three cups daily.
Nettle tea has a rich, pleasant flavor.

• Yellow Dock (Rumex Crispus)
Yellow dock is an outstanding purifying herb. It improves liver function by stimulating bile flow and has mild laxative properties. It acts as a tonic which improves the production of blood cells thus correcting anemia caused by excessive bleeding.
To make yellow dock tea: Simmer 2 tablespoons of dried root in 3.5 cups of water for 15 minutes in a covered pot. Remove from heat and steep for an additional 10 minutes. Strain and sweeten (if desired), and drink 3 cups daily.
Yellow dock has a bitter, earthy flavor. If you prefer, you can take 0.5 teaspoon of liquid extract or 2 capsules three times a day.

• Red Raspberry
Red Raspberry is used to control disproportionate menstrual bleeding while strengthening the uterine muscles. Red Raspberry is effective for helping the body return balance to the reproductive organs. Also it offers anti-inflammatory and anti-emetic effects making Red Raspberry a powerful herb for easing menstrual symptoms related to uterine fibroids.
Red Raspberry is a rich source of nutrients, including Calcium, Magnesium, Iron, Potassium, Phosphorus, and Vitamins A, B, C and E. This is a very useful tonic for women suffering from severe menstrual symptoms.

• Herbal Tea (Red Clover)
Herbal teas suggested for the treatment of uterine fibroids include a tea brewed from the blooms of the red clover herb. Red clover is rich in phytoestrogens. This naturally-occurring plant analogue compounds of naturally occurring estrogens. Red Clover inhibits the growth of uterine tissue making it an effective way to treat the uterine fibroids. Drink 2 to 3 cups of red clover tea to help shrink uterine fibroids.

• Essential Oil Supplements
Herbal essential oils like evening primrose oil, rich in omega 6 fatty acids: powerful antioxidants and anti-inflammatory substances, can reduce pain and inflammation of fibroids. Evening primrose essential oil is available in supplemental form at health food stores.

Herbal Treatment Alternative for Uterine Fibroids: Herbal Bath

This is an alternative topical method to treat uterine fibroids. For effective use prepare a warm sitz bath. Pour in 1 to 2 cups of herbal tea decoction brewed from Mexican wild yams into the water. Sit in the bath for 10 to 15 minutes; repeat twice a day. Herbal tea infusion brewed from horsetail can be substituted for Mexican wild yam.

Please note that herbal treatments for uterine fibroids are not clinically proven. Before starting any treatment, consult your doctor.

Reduce Uterine Fibroids Naturally With These Yoga Exercise

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Uterine fibroids mostly affect women in their child-bearing years, and while they are non-cancerous, they are often accompanied with painful symptoms. Heavy periods, pelvic and abdominal cramps during and after the monthly cycle are some of the common symptoms of uterine fibroids.
While medical practitioners usually recommend surgery to get rid of these painful and conflicting pockets in the uterus, mind and body exercises such as yoga can help reduce the pain and discomfort associated with uterine fibroids. Here are four yoga poses you can try.

Standing Forward Bend

Standing forward bend, or uttanasana, will lift and boost your uterus, according to yoga author Linda Sparrowe. While in a standing position, bend your knees a little and flex forward putting your hands on the floor, yoga blocks, or a chair. Slowly straighten your knees by lifting your tailbone up toward the ceiling. Hold for 30 to 60 seconds and repeat twice.

Inverted Staff Pose

Inverted personnel posture, or viparita dandasana, stretches the uterus and starves fibroids of blood, preventing them from growing. Stack 2 yoga strengthens on top of each various other versus a wall. Put a collapsible chair 2 feet in front of the boosts and place a towel on the seat. Sit on the chair in reverse, stretching your legs through the chair back. Lay in reverse and respectively place your feet on the reinforces, upper back on the chair, and head on an additional reinforce. Hang onto the legs of the chair and hold the position for 30 to 60 seconds.

Reclining Bound Angle Pose

Women with uterine fibroids can benefit from reclining certained angle position. While in a seated position, bring the soles of your feet together. Lay your upper body back onto a yoga strengthen, and relax your arms normally to the sides with the palms dealing with up. Remain in the present for up to five minutes.

COMMON FOOD THAT HELP SHRINK FIBROID NATURALLY

Fibroids are tumors that form in the uterus and affect one in five women. While the word "tumor" can seem scary, fibroids are benign, or noncancerous. They can cause bothersome symptoms, however, such as heavy or painful periods, uncomfortable fullness in your abdomen, frequent urination, pain during sexual intercourse and lower-back pain. By seeking any necessary treatment, you can prevent complications, such as reproductive problems and early labor. Foods aren't known to shrink fibroids, but certain foods in a healthy diet may help keep them from growing and minimize your symptoms. 
Fruits and Vegetables
  Fruits and vegetables provide rich amounts of disease- and inflammation-fighting nutrients and fiber, which help promote appetite and weight control. These factors are important because inflammation and excess pounds can contribute to fibroids. In a study published in "Asia Pacific Journal of Clinical Nutrition" in 2013, researchers analyzed the diets of premenopausal women and found that eating rich amounts of fruits and vegetables lowered the women's risk of developing fibroids. A high body mass index, on the other hand, increased the risk.

 Beans and Lentils
 Legumes, such as beans and lentils, are top fiber sources, making them prime choices for weight control. They also have a low glycemic index, or a mild impact on your blood sugar. High-glycemic carbohydrate sources, such as sweets, can cause inflammation and increase fibroid growth, according to Dr. Christiane Northrup, a physician and women's health expert. Replacing these foods with nutritious, low-glycemic carbohydrate sources, such as legumes, can help minimize your symptoms. As plant-based protein sources, beans and lentils also provide nutritious alternatives to fatty meats, which increase inflammation. Healthy legumes-based dishes include vegetarian chili, black bean and veggie burritos served in whole-grain tortillas and dal, an Indian lentil soup.
  Unprocessed Grains
White foods, such as starchy white bread, increase insulin production in your body and influence the way estrogen is metabolized, says Northrup, increasing your risk for fibroid symptoms. Skip refined starches and stick to whole, unprocessed grains for improved uterine health and protection from fibroid growth. Whole grains are also also lower-glycemic and richer in antioxidants, fiber and protein than their processed counterparts. Nutritious examples include oats, brown rice, wild rice, quinoa and barley.

 Low-Fat Dairy Products
 Uterine fibroids are up to three times more prevalent in black women than white women, according to a "Today's Dietitian" article by registered dietitian Megan Tempest, published in May 2012. Some evidence suggests this is likely because African-Americans consume significantly fewer dairy products than whites. The protective properties of dairy, according to researchers who've investigated this link, lie in the ability of calcium to inhibit cell growth that leads to the tumors. If you tolerate dairy products well, incorporate low-fat varieties, such as milk, yogurt and cottage cheese, into your diet. If not, choose lactose-free fortified milk or a nondairy equivalent, such as almond milk. Limit high-fat items, such as whole milk and fatty cheeses, which contribute to inflammation.  
Soy and Flaxseeds
 Soy and flaxseeds contain phytoestrogens -- natural substances with estrogenlike properties. Northrup says most women can benefit from phytoestrogens, which block the estrogen receptors on the cells in fibroids, potentially minimizing symptoms and lowering your risk for fibroid growth. Flaxseeds also provide fiber and omega-3 fats, which guard against inflammation and tumor growth and help rid your body of excess estrogen. For soy, which also offers a lean protein alternative to fatty meats, consume soy milk, tofu or edamame -- steamed, podded soybeans. Add ground flaxseeds to smoothies, yogurt and cereals.

HOW TO BE FREED FROM FIBROID PAIN

Compared to other women’s health issues, there is not a huge amount of research devoted to the study of uterine fibroids, probably because a fibroid is considered a benign growth. But don’t tell that to the women whose fibroids cause tremendous discomfort and excessive bleeding every month. Benign as a fibroid might be as far as tumors go, the symptoms it can cause aren’t always so benign, especially around the time of menstruation. Who’s affected by fibroids? Statistics show that at least 25 percent of all women have fibroids — and about one third of these women will experience pain and abnormal bleeding. The typical menstrual cycle lasts for three to seven days, starts off heavy, and gets lighter. Fibroids, however, can make your periods excessively heavy and longer lasting. Signs that a fibroid or fibroids may be affecting your flow include bleeding for more than eight days with more than two to three days of heavy bleeding at the outset of your period, and having many blood clots in your flow. (If you haven’t yet been diagnosed with fibroids and experience this kind of heavy bleeding, see your doctor — fibroids are not the only cause of these symptoms.) Fibroids’ Effects on Menstruation Each month, your uterus goes through a cycle: It creates a thickened inner lining in case a pregnancy occurs. If pregnancy does not occur, your body sheds that lining — this is your period. But if you have fibroids within the uterine wall, or fibroids that protrude into the uterine cavity, more surface area is created. Consequently there is more thickened lining to shed when during your period. It’s not the size but the location of the fibroid, or fibroids, that has the most impact. If your fibroids are big enough, you will feel a stronger sensation of pressure at the time of your period because of blood flow to the fibroids. Fibroids put more pressure on the uterine lining, also causing more bleeding and pain. In the days leading up to your period, you might feel more intense cramping as your uterus goes through its motions to force out the lining, and a stronger sensation of pressure when your period starts because of the heavier blood flow. Besides heavier, longer periods, fibroids can cause bleeding at other times of the month, and all this blood loss can cause anemia — which occurs when you don’t have enough iron in your blood. Ways to Ease Fibroid Pain Your choice of treatment depends on the amount of bleeding and the level of pain you regularly experience. Pain relief. Non-steroidal anti-inflammatory drugs, or NSAIDs, may help; popular choices include ibuprofen (Motrin and others) and combination products like Excedrin. These drugs are prostaglandin inhibitors — they cut down on the pain from cramps as they counter the production of chemicals called prostaglandins, which are produced naturally by the uterus for the contraction process that starts menstruation. You may also need to take an iron supplement to prevent or correct anemia. Hormone therapy. Although it's not clear what causes fibroids, they do seem to be affected by changes in hormone levels, particularly estrogen. When the estrogen level is high, like during pregnancy, fibroids may grow, and when it’s in decline, like at menopause, they often shrink. So your doctor may recommend hormone therapy that alters the production of estrogen. Birth control pills are often used to minimize the heavy bleeding and cramps that occur with fibroids, though they won’t reduce their size. Other hormone-based options to control heavy bleeding include progesterone-like injections (Depo-Provera) and an IUD that contains progesterone-like Mirena (levonorgestrel). Another class of drug, gonadotropin releasing hormone (GnRH) agonists such as Lupron (leuprolide), temporarily shrink fibroids. These drugs are often given before fibroids are surgically removed to reduce the risk of bleeding during surgery and to make surgery easier. In non-surgical situations, they are sometimes used to give you a break from heavy bleeding and a chance to recover from anemia. However, GnRH tricks your body into thinking you are in menopause, and it can have menopausal side effects like hot flashes and, over time, bone thinning, so it’s not a permanent solution, and is typically used for less than six months. Other therapies. Some women have found fibroid relief from the low-tech application of heat on the abdomen and from complementary and alternative medicine approaches, like acupuncture. The type of treatment you opt for will often depends on your age. If your symptoms are manageable with pain relief medication, you may decide to wait it out and not treat or remove the fibroids. If you are near menopause or premenopausal, strong medication that shuts down estrogen production may get you through until menopause officially starts and fibroids shrink on their own. But if you are younger, you may want to consider minimally invasive surgery or a new non-invasive procedure — focused ultrasound — that may help shrink a large percentage of fibroids and spare your reproductive organs.

5 MOST COMMON MYTH ABOUT UTERINE FIBROID

Fibroids are the most common type of pelvic tumor among women of reproductive age. Despite their prevalence, however, fibroids are widely misunderstood. A number of popular misconceptions, in particular, create confusion for women with fibroids who are trying to understand their condition and treatment options. To clear up some of this confusion, we’re breaking down five of the most common myths surrounding fibroids. MYTH: If you have fibroids, you will experience symptoms like heavy menstrual bleeding and pain. As common as the condition is, researchers estimate that between 50-80% of women with fibroids will experience no fibroid symptoms at all. Many women with asymptomatic fibroids never even know that they have the condition. And, because fibroid tumors are almost always benign, women who aren’t experiencing symptoms may opt to forgo treating their fibroids. MYTH: A routine ultrasound will detect any uterine fibroids that are present. If fibroids are suspected, the first diagnostic tool gynecologists employ to confirm the suspicion is transvaginal ultrasound. However, this imaging method doesn’t always reveal all existing fibroids. The size and location of uterine fibroids varies greatly, and extremely small fibroids, submucosal fibroids, and small fibroids that are hidden behind larger tumors, aren’t always detectable through a routine pelvic ultrasound. For clearer visualization of the tumors, physicians frequently rely on laparoscopic ultrasound, which requires inserting a scope through the vagina and into the abdominal cavity provides. Research has shown that laparoscopic ultrasound can detect up to twice as many fibroids as transvaginal ultrasound. MYTH: Fibroid tumors will become cancerous. Uterine fibroids, also known as leiomyomas, are almost always benign: in women of reproductive age, less than 0.01% of (removed) fibroids become cancerous. While fibroids typically shrink after menopause, those that do appear in post-menopausal women may be the cancerous type, called leiosarcomas. It’s important to note, however, that – regardless of age – simply having fibroids does not increase a woman’s chances of developing cancer in her reproductive organs. MYTH: Endometrial ablation is a method of treating fibroids Endometrial ablation (EA) is a commonly used to treat abnormal uterine bleeding. The technique entails destroying the layer of tissue that lines the uterus known as the endometrium, preventing new tissue from growing and thereby reducing or eliminating menstrual bleeding. While you may have heard EA discussed in the context of fibroids, it is not, in fact a fibroid treatment. The destruction of fibroids that can occur with EA is incidental, and is not likely complete. In such cases, the ablated fibroids will often regrow, since subserosal fibroids – the type that grow inside the uterus and are therefore subject to destruction during EA – often originate below the endometrium layer. MYTH: If left untreated, fibroids will continue to grow throughout a woman’s lifetime. Fibroid growth is fueled by estrogen. Accordingly, fibroids will grow and shrink in response to the body’s hormone fluctuations. Pregnant women often experience rapid growth in existing fibroids and may develop new fibroids during pregnancy, due to the heightened levels of estrogen that their bodies are producing. Conversely, fibroids typically shrink after menopause, because the ovaries have stopped producing estrogen. (Post-menopausal women undergoing hormone replacement therapy can expect the opposite to occur, however, since they are artificially replacing the missing estrogen.) Although fibroids do tend to disappear naturally after menopause, pre-menopausal women who are suffering with symptoms of uterine fibroids may not want to wait. When fibroids are interfering with the quality of life, it’s advisable to discuss treatment options with a gynecologist. With a plethora of treatments available to women with fibroids, including uterine conserving methods like Acessa Procedure, it’s not necessary to endure long-term suffering!

HOW FIBROID CAN AFFECT YOUR PREGNANCY

If you suffer from uterine fibroids, you may be wondering if it’s safe or even possible to become pregnant. Many women may not even realize they have fibroids until after they become pregnant and the doctor finds them in an ultrasound.


In most cases, fibroids do not pose a problem during pregnancy, but there are situations where they do. Depending on the size of the fibroid and where it is within your uterus, you may run into complications.

Pain throughout pregnancy

During pregnancy, hormones in your body cause your uterus to grow and enlarge to accommodate the growing fetus. The influx of these hormones may also cause the fibroids to grow. Because of the fetus that needs blood to grow, the fibroids may grow beyond their own blood supply, which can cause one of two things to happen.
The fibroids may undergo either red degeneration or white degeneration. With red degeneration, it bleeds into itself, and with white degeneration, portions may undergo cell death and become cystic. These can both cause temporary mild to severe abdominal pain, which can usually be controlled with over the counter medication.

Pregnancy complications

In early pregnancy, there may be bleeding and a slightly increased risk of miscarriage, depending on where the fibroid is in the uterus. If it is submucosal, or grown into the uterine cavity, it can prevent normal implantation of the pregnancy or disrupt the growth of the placenta.
In late pregnancy, there are three main concerns. The first is preterm labor, which is more likely if the fibroid is large or if there are multiple fibroids. The second, placental abruption (the abnormal separation of the placenta) can occur if the fibroid grows into the place where the placenta is attached. Lastly, fetus growth restrictions are possible, but studies have not shown that it is any more likely with fibroids than without.

Delivery complications

Depending on the size and location of the fibroids, they may cause complications during delivery, including causing the baby to lie in breech or transverse position or blocking the progress of labor or expulsion of the placenta.
If it seems like the fibroids may cause problems, the doctor may elect to perform a Cesarean section. At this time, he or she probably will not remove the fibroids because the risk of excessive bleeding is too high. Typically, your fibroids will shrink as your uterus recovers.

Learn more

Under normal circumstances, fibroids should not cause problems during pregnancy, but you should make sure they are closely monitored by your doctor. If necessary, there are options to remove the fibroids during pregnancy that you can discuss with your doctor.

Fibroids: Causes and Symptoms

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Fibroids are non-cancerous (benign) tumors that grow from the muscle layers of the uterus (womb). They are also known as uterine fibroids, myomas, or fibromyomas. The singular of uterine fibroids is Uterine Fibroma. Fibroids are growths of smooth muscle and fibrous tissue. Fibroids can vary in size, from that of a bean to as large as a melon.
Fibroids affect at least 20% of all women at sometime during their life. Women aged between 30 and 50 are the most likely to develop fibroids. Overweight and obese women are at significantly higher risk of developing fibroids, compared to women of normal weight.
Malignant (cancerous) growths on the smooth muscles inside the womb can develop, called leiomyosarcoma of the womb. However, this is extremely rare.

Four types of fibroids

There are four types of fibroids and these are:

A diagram of the female reproductive system.

1. Intramural
   
   These are located in the wall of the uterus. These are the most common types of fibroids.


2. Subserosal fibroids
   
   These are located outside the wall of the uterus. They can develop into pedunculated fibroids (stalks). Subserosal fibroids can become quite large.


3. Submucosal fibroids
   
   These are located in the muscle beneath the lining of the uterus wall.


4. Cervical fibroids
   
   These are located in the neck of the womb (the cervix).

Causes of fibroids

Experts cannot come to a common consensus about why fibroids occur.
During a woman's reproductive years her estrogen and progesterone levels are high. When estrogen levels are high, especially during pregnancy, fibroids tend to swell. When estrogen levels are low fibroids may shrink, e.g. during a woman's menopause.
Heredity may also be a factor. Women whose mothers and/or sisters have/had fibroids have a higher risk of developing them too.

Symptoms of uterine fibroids

Most women have no symptoms. That is why most patients with fibroids do not know they have them. When symptoms do develop, they may include:

• Anemia (as a result of heavy periods)
• Backache
• Constipation
• Discomfort in the lower abdomen (especially if fibroids are large)
• Frequent urination
• Heavy painful periods
• Pain in the legs
• Painful sex
• Swelling in the lower abdomen (especially if fibroids are large)

Other possible symptoms of uterine fibroids include:

• Labor problems
• Pregnancy problems
• Fertility problems
• Repeated miscarriages

Diagnosis of fibroids

In most cases, the symptoms of fibroids are rarely felt and the patient does not know she has them. They are usually discovered during a vaginal examination.

An ultrasound scan can often be used to diagnose fibroids.
• Ultrasound
  If the doctor thinks fibroids may be present he/she may use an ultrasound scan to find out. Ultrasound can also eliminate other possible conditions which may have similar symptoms. Ultrasound scans are often used when the patient has heavy periods and blood tests have revealed nothing conclusive.
  
• Trans-vaginal scan
  A small scanner is inserted into the patient's vagina so that the uterus can be viewed close up.
  
• Hysteroscopy
  This is a small telescope that examines the inside of the uterus. During this procedure, if necessary, a biopsy can be taken of the lining of the uterus (womb).
  
• Laparoscopy
  A laparoscope is a small device that looks at the outside of the uterus - where the doctor examines its size and shape. A laparoscope is a small flexible tube. During this procedure, if necessary, a biopsy can be taken of the outer layer of the uterus.
  
• Biopsy
  A small sample of the lining of the uterus is taken and then examined under a microscope.