Uterine Fibroids

This blog is for educational purposes only and does not replace professional medical advice or diagnosis. If you have health concerns, consult an AHPRA-registered telehealth doctor or request a medical certificate online if clinically appropriate. Please note: Hola Health does not currently offer Mental Health Care Plans.

---

Uterine fibroids, also known as leiomyomas or myomas, are benign growths originating from the muscle tissue of the uterus. They represent the most common pelvic growths in women.   Note: This content is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. Telehealth consultations are not suitable for physical pelvic examinations. Diagnosis of fibroids typically requires an ultrasound scan, for which a GP can provide a referral. We recommend sharing your consult summaries with your regular GP and bulk billing is available for eligible patients during Medicare-defined periods; otherwise, private fees apply.  

Varieties of fibroids:

These growths exhibit diverse sizes, shapes, and locations, residing inside the uterus, on its outer surface, within its wall, or attached by a stem-like structure. Fibroids can range from small, pea-sized entities to large, round growths exceeding 5 to 6 inches in width. They may distort both the internal and external aspects of the uterus, occasionally filling the pelvis or abdomen entirely.

Likelihood and risk factors:

While fibroids are most prevalent in women aged 30 to 40, they can occur at any age. Notably, they occur more frequently and grow more rapidly in black women. Factors contributing to these disparities include societal inequities and racism. Additionally, a familial history of fibroids may elevate the risk.

Causes and symptoms:

The precise cause of fibroids remains unclear, with theories suggesting they develop from misplaced cells present before birth. Hormones, particularly estrogen and progesterone, appear to play a role in their growth. Symptoms of fibroids may include changes in menstruation, abdominal pain, pressure, and complications such as infertility.

Complications:

While most fibroids are non-problematic, complications may arise, such as pain, nausea, or fever if fibroids with a stem twist. Rapid growth or degeneration can also cause pain. In rare cases, a fibroid on a stem can twist (torsion), cutting off its blood supply. This is a medical emergency. Call 000 or go to the Emergency Department immediately if you experience:

• Sudden, sharp, and severe abdominal or pelvic pain.
• Pain accompanied by fever, nausea, or vomiting.

 

Diagnosis and treatment:

Diagnosis:

Routine pelvic exams often reveal initial signs of fibroids. Diagnostic tools include ultrasound exams, hysteroscopy, hysterosalpingography, sono-hysterography, and laparoscopy.

Treatment options:

Treatment necessity depends on symptoms and may involve:

1. Watchful waiting: For asymptomatic, small fibroids nearing menopause.
2. Medication: Addressing symptoms using hormonal methods or medications like GnRH agonists, antagonists, or progestin-releasing IUDs.
3. Surgery: Myomectomy removes fibroids while preserving the uterus; hysterectomy removes the uterus. Surgical methods include laparotomy, laparoscopy, and hysteroscopy.
4. Other treatments: Uterine artery embolization (UAE), radiofrequency ablation (RFA), and  ultrasound surgery are emerging options with varying degrees of effectiveness.

Conclusion:

Understanding fibroids involves considering symptoms, risk factors, and available treatments tailored to individual needs. Collaborative decision-making with healthcare professionals ensures informed choices aligned with patient preferences and overall well-being. This content is shared with the permission of Dr. Baruah. You may find similar information in health publications.