Oheneba Kwakye Omane
Oheneba Kwakye Omane

Although many women don't even realize they have them, uterine fibroids are a common women's health problem. The awareness of uterine fibroids, however, is pretty low. Before we dive into the main theme of this write-up, let us explore a bit the anatomy of the uterus.

The Wonder And Anatomy Of The Uterus

The uterus is a hollow, pear-shaped organ in a woman's pelvis. The uterus is where a fetus or an unborn baby develops and grows. The uterus; also called the womb is sometimes affectionately called 'the organ of life'. All women are born with this wonderful organ [except those with a congenital disorder known as MRKH or vagina agenesis, thus, missing uterus]. Its normal size in adults is about 3 inches long and 2 inches wide. The uterus is a three-layered organ from inside to outside; those layers are
1. Endometrium
2. Myometrium
3. Perimetrium

This organ can expand over 200% of its size when it is time to house a fetus. When it senses fertilization it gets ready to hold a pregnancy by preparation and shedding of the endometrium of its own. It has the power to bear up to 150 times its weight. It is the only organ capable of creating another organ - the placenta. It is connected to one's emotions as well, it gets stressed if you are stressed and relaxes if one is relaxed.

Fun fact: A bicornuate uterus has 'two horns' and heart-shaped.

These twins were born from a bicornuate uterus

What are Uterine Fibroids?

Uterine fibroids are benign (noncancerous) tumors that can grow in and around the uterus. Although uterine fibroids can occur at any age, they are most common in women in their 30s, 40s and through menopause.

Now let's glance through some interesting facts about uterine fibroids. According to the Centre For Uterine Fibroids™, uterine fibroids are the number one reason why women undergo hysterectomies (surgical operation to remove all or parts of the womb) in the United States - approximately 100,000 procedures each year. Uterine fibroids are 3 times more prevalent in black women than in white women, and one in five visits to a gynaecologist is due to a fibroid-related health problem.
Other common factors that require hysterectomies are endometriosis, adenomyosis (presence of ectopic glandular tissue within the myometrium - causing heavy painful periods) uterine prolapse (slipping of the uterus into the vagina), hyperplasia (when the uterine lining is abnormally thick, causing heavy bleeding) and cancer.

The interesting fact is that a single cell divides repeatedly, eventually creates a firm, rubbery tissue. Uterine fibroids can grow slowly or rapidly, be single or multiple and can vary in size from microscopic size to the size of a full-term pregnancy!

Uterine fibroids are classified by their location as follows;
1. Submucosal [beneath the endometrium] 5%
2. Intramural [in the muscular wall of the uterus] 40%  and
3. Subserosal [beneath the uterine serosa or the outermost layer, which protrude into the uterine cavity] 55%.

What causes Uterine Fibroids?

Although exact and pinpoint causes are not known, some theories are believed to play a role in the cause of fibroids. These are:
Hormonal changes [estrogen and progesterone] -- these two hormones that stimulate the development of the uterine lining during each menstrual cycle in preparation for pregnancy; appear to promote the growth of fibroids. Fibroids have been found to contain more estrogen and progesterone receptors than normal uterine muscle cells do. Other risk factors:
Diet high in red meat
Family history of fibroids
High blood pressure

How uterine fibroids affect fertility.

The size and location determine whether fibroids can affect fertility. Approximately in 5%-20% of infertility cases, women have fibroids.
However, there are several ways uterine fibroids can reduce fertility:

  1. Changes in the shape of the cervix can affect the number of sperm that can enter the uterus.
  2. Changes in the shape of the uterus can interfere with the movement of the sperm or embryo.
  3. Fallopian tubes can be blocked by fibroids.
  4. They can impact the size of the lining of the uterine cavity.
  5. Blood flow to the uterine cavity can be affected. This can decrease the ability of an embryo to stick (implant) to the uterine wall or develop.

What are the symptoms of uterine fibroids?

Most women with fibroids show no clinical symptoms at all, but those who do, experience abnormal uterine bleeding, which presents with menorrhagia [menstrual periods with heavy or prolonged bleeding], pain in the abdomen or lower back, constipation and either difficulty urinating or frequent urination. Blood loss from fibroids can be heavy enough to cause chronic iron-deficiency anaemia. Depending on the size and location, the fibroids can compress the adjacent organs and cause additional complications such as constipation, frequent urination and venous stasis.

In women, the symptoms of uterine fibroids might be misdiagnosed, overlooked or even ignored. Before a lady's diagnosis, she had gained weight and said she felt something hard in her stomach, but she was unaware that the cause might be a benign tumor growing in her uterus. She didn't have any of the common symptoms of fibroids, like blood loss or heavy periods, so she thought she had digestive issues, just to be diagnosed with uterine fibroid.

Treatments for uterine fibroids

Uterine fibroids are generally harmless and often go away on their own. however, when symptoms occur, untreated fibroids can interfere with a person's quality of life and may lead to complications.

Treatment is indicated only when there's severe pain, heavy and irregular bleeding, infertility or pressure symptoms. There are medical therapies that decrease the estrogen levels and shrink the fibroid; and surgical treatments - myomectomy or hysterectomy.
Since uterine fibroids are under hormonal control, they grow rapidly when hormone levels are high, for instance during pregnancy; and they shrink when anti-hormones are used.

Raising Awareness

There is the need to raise awareness about uterine fibroids and educate people on the minimally invasive options available to women to treat fibroids. As stated earlier, black women are more likely to develop uterine fibroids than white women; and research has shown that black women, in particular, are more often offered hysterectomies [surgical operation to remove all or parts of the womb] to treat fibroids, rather than less-invasive procedures.

When to see a specialist for uterine fibroids

Remember that fibroids are not cancer and don't increase a woman's risk for uterine cancer!
If you are having symptoms of uterine fibroids that are affecting your quality of life, you ought to consult a specialist. Dr Kelly Wright recommends that, even if a doctor says what you are experiencing is normal, you need to seek a second opinion to get comprehensive treatment options.

Center for Uterine Fibroids - Brigham and Women's Hospital. Retrieved from https://www.fibroids.net/

Huyck, K. L., Panhuyse Yin, C. I., Cuenco, K. T., Zhang, J., Goldhammer, H., Jones, E. S., Somasundaram, P., Lynch, A. M., Harlow, B. L., Lee, H., Stewart, E. A., & Morton, C. C. (2008). The impact of race as a risk factor for symptom severity and age at diagnosis of uterine leiomyomata among affected sisters. American journal of obstetrics and gynaecology, 198(2), 168.e1–168.e1689. https://doi.org/10.1016/j.ajog.2007.05.038

Uterine Fibroids. Retrieved from https:/www.cedars-sinai.org/health-library/diseases-and-conditions/u/uterine-fibroids.html


Oheneba Kwakye Omane

Health Enthusiast and Futurist