HYDERABAD: Not all the lumps in the uterus are dangerous/cancerous. Majority of them are fibroids, which are benign tumors of the uterus. The majority of them are even asymptomatic and do not cause any discomfort.
These simple, smooth muscle tumors arising from the wall of uterus are most commonly seen in the reproductive age group (30-45 years). They vary in size, starting from a small peanut size to large watermelon size. Every four-five women out of 10 screened have fibroid uterus, but not all are symptomatic. About 20-80 per cent of women develop fibroids by the age of 50.
The causes are not clearly known to scientists, but there is a definite genetic predisposition for its occurrence. High estrogen levels are a major cause, hence fibroids spontaneously regress in postmenopausal women.
Modifiable risk factors are obesity and eating red meat in large quantities. Diets high in fruits, vegetables, and antioxidants lower the risk. While the majority of women with uterine fibroids do not have symptoms, some have abdominal pain, anemia, and increased bleeding. They can also have pain during intercourse, depending on the location of the fibroid. Fibroids can cause miscarriages, too, if they are inside the uterine cavity.
A large fibroid can cause pressure symptoms such as constipation and incomplete emptying of the bladder, resulting in increased frequency or retention of urine. A simple ultrasound can detect the condition. A detailed evaluation, which includes the exact size, number, and location, can be better done on an MRI. Most fibroids do not require treatment unless they are causing symptoms.
Treatment is individualised and depends on the location of the fibroids, the symptom severity and the patient’s age and fertility status. But symptomatic uterine fibroids can be treated with medication for relief and to shrink their size. Surgical methods include non-invasive methods such as radio-frequency ablation, magnetic resonance-guided focussed ultrasound (MRGFUS) and invasive methods are myomectomy (lap/open) and hysteroscopic for fibroids inside the cavity. This is for women who want to preserve their fertility.
(Dr Sree Ramya, senior obstetrician & gynaecologist, Kamineni Hospitals)