After prolonged heavy bleeding, painful cramps and low-grade fever during periods, I finally decided to pay my gynaecologist a visit. An ultrasound and a few tests later, I was back again in her office, confident that it’s just my endometriosis acting up. The usually cheery medico put on a rather serious tone, squinting over my ultrasound results. “There are fibroids in your uterus,” she said with an air of concern. “Great,” I thought to myself. “As if endometriosis, adenomyosis and chocolate cysts were’nt enough.”
“We also need to keep a watch on them, you know, just in case they grow,” she said, peering at me through the space above her glasses.
This was in 2018. Since then, I haven’t lost any sleep thinking about the fibroids or kept a watch on them as my gynaecologist suggested.
In my defence, I have been following a specific diet (more on that later) and making some major lifestyle tweaks since then. Since then, I didn’t experience cramp attacks or fever during periods since then. Heavy bleeding, of course, is another story. (Seek professional help. Do as I say and not as I do.)
What are fibroids in the uterus?
Fibroids in the uterus are common benign tissue growth in women of reproductive age. While they are benign, they can severely impact women’s physical and mental wellbeing.
“Fibroids can be seen when the smooth muscles cells in a woman’s wall of the uterus get multiplied and become a hard mass,” says Dr Rajeshwari Pawar, Consultant, Obstetrics & Gynecology, Motherhood Hospitals, Kharadi, Pune.
“These are often seen in women after they start menstruating or in their childbearing years. These are also known as Leiomyomas or myomas,” says Dr Sangeeta Gomes, Consultant Obstetrician & Gynecologist, Motherhood Hospitals, Sarjapur, Bangalore.
“Uterine fibroids can steal one’s peace of mind,” emphasises Dr Pawar. ” You may panic, become anxious, and get stressed owing to their presence in the body.”
They can be as small as an apple seed and as large as a grapefruit. “They can also grow into the cavity of the uterus, develop in the uterine wall or appear outside the uterus,” she says.
Who gets uterine fibroids?
Fibroids are common in women in their childbearing age. “These are often seen in women after they start menstruating. They depend on estrogen and progesterone to grow and therefore only relevant in one’s reproductive years,” Dr Gomes adds. “They become more common in women as they age.”
There can be more than one, but it’s possible that there can be a single fibroid too.
— Dr Pawar
Symptoms of fibroids
Many women may not show any symptoms at all, according to Dr Pawar. But for others, they can cause a host of uncomfortable symptoms like heavy menstrual bleeding, frequent periods, frequent urination, spotting between periods, stomach pain and cramping, painful intercourse, increased abdominal size, infertility and even miscarriage.
Uterine fibroids are a common cause of heavy and abnormal bleeding.
How they cause heavy bleeding during periods
Heavy periods are a sign that all is not well with the plumbing downstairs. While it could indicate other dysfunctionalities of the uterus, heavy periods are a top symptom of fibroids.
“Heavy menstrual bleeding can be defined as a period that lasts more than 8 days and requires frequent changing of sanitary pads or tampons,” notes Dr Pawar.
They end up putting pressure on the uterine lining, causing more bleeding than usual. “The uterus fails to contract properly, which means it cannot pause the bleeding. These growths may stimulate the growth of blood vessels, which cause heavier, or irregular periods and spotting between periods,” adds Dr Pawar.
As mentioned earlier by Dr Gomes, hormones play a big role in causing fibroids. Prostaglandins — hormones that control inflammation, blood flow, clotting and labour induction — are often the culprit.
“Heavy menstrual bleeding linked with uterine fibroids is based on where the fibroids are located, contraction of the uterus, the presence of ancillary prostaglandins, and any distortion of the uterus lining,” points out Dr Pawar.
Can fibroids lead to cancer?
Sorry to invoke the big C word. But at one point, every woman diagnosed with the problem wonders if the growths could turn into cancer. Dr Gomes allays that fear…to an extent. “Fibroids don’t lead to cancer of the uterus often.”
But she has a caveat: They should not be ignored in any case!
When should I visit a gynaecologist?
Pardon the cliche but a stitch in time saves nine. It goes without saying that an early diagnosis and timely treatment help!
The first step is to monitor your periods and cycles, says Dr Gomes. Any abnormality should be flagged.
Scanty bleeding, heavy bleeding or even changes in the colour of the menstrual blood needs attention.
— Dr Gomes.
“This is because a woman’s period can be an indicator of her health condition or if anything is wrong with her,” she adds.
How are they detected?
Ultrasound is the first step towards detecting these growths. “Apart from that, An MRI or hysterosalpingography can also be carried out for knowing the location of the fibroids,” notes Dr Pawar.
Treatment for fibroids
Treatment is either medication or surgery, whichever doctor deems the best. “Your doctor may have to do hysteroscopy or laparoscopy to help you tackle fibroids if it’s the cause of infertility,” asserts Dr Pawar.
Do not self-medicate as it can be risky for you. Timely intervention can be helpful.
In any gynaecological illness, the possibility of hysterectomy often looms menacingly, but it is not the only treatment option, says Dr Gomes. “It can simply be the removal without damaging the chances of conceiving a child.”