Fibroids

Several factors have been reported to contribute towards fibroid formation in the uterus:

• Hormonal factors: Fibroids are sensitive to hormones, particularly oestrogen and progesterone. These hormones stimulate the growth of the uterine lining during the menstrual cycle, and fibroids often shrink after menopause when hormone levels drop.
• Genetic predisposition: If you have a family history of fibroids, you may be more likely to develop them yourself. Certain genetic mutations have also been linked to fibroid formation.
• Cellular changes: Fibroids arise from smooth muscle cells in the uterus that proliferate rapidly. This growth may be influenced by various growth factors and hormones.
• Environmental factors: Research is ongoing regarding lifestyle and environmental factors that may contribute to fibroid development, including diet, obesity, and exposure to certain chemicals.

• Heavy menstrual bleeding
• Pressure in the pelvis or pelvic pain
• Frequent urination: when fibroids press against the bladder
• Dyspareunia (painful sexual intercourse) 
• Lower back pain
• Constipation

Usually, the diagnosis of fibroids involves a physical examination to check for any abnormalities in your uterus and pelvic area. The following accessory methods may also be used:

• Ultrasound: Sound waves are used to create images of the uterus; this will help ascertain the presence of fibroids and their size and location.
• Magnetic resonance imaging (MRI): This also helps provide detailed images of the uterus and can help differentiate between fibroids and other conditions.
• Hysterosalpingography (HSG): This is an X-ray-based procedure involving the injection of a contrast dye into the uterus to examine its shape and check for fibroids or blockages.
• Hysteroscopic surgery: A thin, lighted tube is inserted into the uterus through the vagina; thus, the doctor can directly view the inside of the uterus.

The approach to treating fibroids largely depends on their size, location, symptoms, and whether you plan to become pregnant in the future. Here are some common treatment options:

• Watchful waiting: If the fibroids are small and do not cause notable symptoms, the doctor may recommend that they be monitored over time.
• Medications: Hormonal therapies, such as birth control pills, can help alleviate symptoms such as heavy bleeding. Gonadotropin-releasing hormone (GnRH) agonists may be used to temporarily shrink fibroids.
• Minimally invasive procedures: Uterine artery embolisation (UAE) may be performed to block the blood supply to the fibroids; this will cause them to shrink.
• Laparoscopic myomectomy: Fibroids may be removed using this minimally invasive surgery; this surgery is beneficial as it helps preserve the uterus.
• Traditional fibroid surgery: Abdominal myomectomy may be recommended to remove fibroids through an incision in the abdomen; this is usually recommended for larger fibroids or those present in challenging locations.
• Hysterectomy: In some cases, removal of the uterus may be necessary, especially if the fibroids cause significant problems or if a woman does not wish to get pregnant in the future. Laparoscopic hysterectomy is a minimally invasive surgery.

• You experience heavy or prolonged menstrual bleeding that disrupts your daily life.
• You experience severe pelvic pain or discomfort.
• You experience changes in your menstrual cycle or bleeding patterns.
• You exhibit symptoms of anaemia, such as fatigue or weakness, due to heavy bleeding.
• You observe any concerning changes in bladder or bowel habits.