The mystery of fibroids

Illustration by Conny Jude It is not known why women have fibroids, although it's believed that the female hormone estrogen promotes their growth.

Around one in three women have fibroids , yet many of them are unaware that they have this condition because there may be no symptoms. But what are fibroids, and what can you do if they do cause problems such as heavy or painful periods?

Uterine fibroids are the most common type of abnormal growth in the uterus and yet, outside medical circles, they remain a mystery. Usually, they remain small and are no trouble, but sometimes fibroids can cause problems because of their size, number and location.

What are fibroids?

Uterine fibroids are benign growths made of connective and muscle tissues that develop in the uterus. Fibroids are as individual as the women who have them: their size, shape and location vary greatly. You may have tiny, pea-sized growths or large ones that are more than 5-6 inches wide. They can appear in a number of places: inside the uterus, on its outer surface, within its wall, or attached to it by a stemlike structure. Fibroids that remain small may never require treatment. Unfortunately, it's hard to predict their pattern of growth. They could occur singly or in groups and they may remain small for a long time, then suddenly grow rapidly, especially during pregnancy.

Fibroids are most common in women aged 30-40 years (although they can occur at any age). Black women are also more likely than white women to have fibroids. It is not known why women have fibroids, although it's believed that the female hormone estrogen promotes their growth.

Common symptoms

Most fibroids, even large ones, don t produce any symptoms. When women do have symptoms, they can include:

• Heavy or more frequent periods
• Pain in the stomach or lower back
• Difficulty urinating, frequent urination or constipation
• Enlarged uterus and stomach
• Miscarriages and infertility

If you have any of these symptoms, you should see your doctor as they may also be signs of other problems.

When treatment is necessary

Most fibroids don t require treatment but certain symptoms may signal the need:

• Heavy or painful periods
• Bleeding between periods
• Uncertainty whether the growth is a fibroid or another type of tumor
• Rapid increase in growth of the fibroid
• Infertility
• Pelvic pain

If you have symptoms, see your doctor as soon as possible. He or she will be able to offer advice and treatment.

The main treatments are:

• Myomectomy (surgically removing the fibroids, leaving the uterus intact)
• Hysterectomy (removing the uterus entirely)
• Uterine artery embolization (blocking the blood supply to the fibroids)

If you have fibroids or have had them previously, see your doctor for regular check-ups.