Fibroids

Fibroids, also interchangeably referred to as uterine fibroids, fibromas, myomas, and leiomyomas in Singapore are a form of growth found on the wall of the uterus. Fibroids are usually non-cancerous growths occurring among pre- or perimenopausal women. The prevalence of fibroids is far more common than most perceive them to be, with an estimation of up to 60-80% of women having them.

The size and number of fibroids vary from one patient to another. Fibroids may manifest as the size of a seed, or as large as a fruit. They may also form as a singular tumour, or many, with one case study reporting 236 fibroids removed in a single operation.

The growth of fibroids is arguably one of the more mysterious occurrences in a woman’s body. 

Thus far, the fibroids growth patterns that have been identified are:

• Increase in growth and numbers during pregnancy.
• Tend to shrink when patients are administered anti-hormone medications.
• Stop growing or may even shrink when women reach menopause.

Fibroids are not usually painful as it is rare that one experiences any symptoms at all. Where pain is present, patients tend to get diagnosed promptly after seeking medical intervention.

Whilst the cause remains ambiguous, there are certain patterns to the occurrence of fibroids, these include:

• Age: fibroids tend to grow in women in the age range of 30-40, while the activities of fibroids tend to gradually slow down through menopause.
• Family history: statistically, it has been indicated that if one’s mother has fibroids, the chances of you having fibroids increase by 3 times.
• Obesity: obesity increases the risk of developing fibroids by 2-3 times.
• Diets: fibroids are more common among women who consume red meat in certain populations. On the other hand, the prevalence reduces among women with high fruit and vegetable consumption.

Fibroids are easily identifiable, some tests that may be administered to confirm a diagnosis include:

• Pelvic examination: your obstetrician/gynaecologist may attempt to physically feel/palpate if there are any lumps or masses in the pelvic region.
• Imaging tests: an ultrasound would show if there is a formation of solid masses in the uterus which are usually sufficient for the diagnosis of fibroids. Magnetic resonance imaging (MRI) may be additionally requested to determine the exact region and dimension of fibroid growth.
• Diagnostic laparoscopy: a laparoscopy would enable your obstetrician/gynaecologist to obtain a clearer image of the fibroids with a camera through incisions at the abdomen. A laparoscopy is usually conducted if a myomectomy is deemed necessary as treatment.

Fibroids can be treated in the following ways:

• Surgery: laparoscopic surgery is usually conducted to treat fibroids. A myomectomy procedure is performed during laparoscopy with the intention of removing fibroids whilst preserving the uterus. It may be worth noting that myomectomy does not stop fibroids from recurring. In more extreme cases, it is common for a hysterectomy (uterus removal) to be performed as treatment.
• Pain medication: anti-inflammatory drugs are prescribed to alleviate pain. These, however, will not stop the growth nor shrink fibroids.
• Hormone therapy and contraceptives: may be prescribed as treatment to reduce symptoms such as heavy menstrual flows. Additionally, hormone therapy encompassing injections may be administered to shrink fibroids.
• High Intensity Focused Ultrasound (HIFU): this method focuses ultrasound energy to a concentric point to generate heat energy within the fibroid. This then causes protein coagulation/denaturation and the central part of the fibroid undergoes degeneration and shrinks.
• Uterine artery embolisation: this is a radiological procedure whereby the main blood supply to the uterus is blocked. This starves and deprives the fibroids of blood supply and the fibroids undergo degeneration and shrinks. It may not be suitable for those who are looking to conceive/get pregnant as the blood supply to the uterus is affected.