Uterine fibroids are caused by the division of uterine muscle cells until they form a tumor mass, which is considered a silent threat that causes concern and threatens all women. Although medically the exact cause of uterine fibroids is still unknown, it has been found to be related to estrogen hormone levels, which are higher in women of reproductive age between 20–50 years old, which stimulates abnormal growth of the uterine muscles.
More than 50% of most women may not even realize they have this condition because it does not show obvious abnormal symptoms. It can only be confirmed through a detailed internal examination. Women should therefore be vigilant and not overlook symptoms that may be warning signs of this disease.
Uterine fibroids can be found in all areas of the uterus and are named differently according to their location as follows:
- Intramural fibroids are tumor masses that grow within the uterine muscle and are the most common.
- Subserosal fibroids are tumor masses that grow and push out to the outer surface of the uterus.
- Submucosal fibroids are tumor masses that grow and push into the uterine cavity.
- Pedunculated fibroids are tumor masses that grow and may protrude out from the outer surface of the uterus or into the uterine cavity, but the tumor is attached to the uterus by a stalk.
Abnormal signs indicating you may have uterine fibroids
- Severe or prolonged menstrual cramps that worsen every month. If you have never had blood clots during menstruation before but recently notice large blood clots, these symptoms are caused by abnormal growth of the endometrial lining, resulting in heavier and longer menstruation, or vaginal spotting lasting more than 1 week.
- Menstrual blood with a strong foul odor, which is caused by inflammation of the fibroid inside.
- A dull ache in the lower abdomen or chronic lower back pain. This symptom often occurs when there is a mass located at the back of the abdomen pressing on internal organs.
- Frequent urination with dribbling and difficulty holding urine, including painful urination, caused by the mass pressing on the bladder, resulting in reduced urine storage capacity.
- Chronic constipation and possibly a dull pain in the rectal area, painful bowel movements caused by the fibroid pressing on the large intestine.
- Bloating and indigestion because large fibroids cause discomfort, fullness, abdominal swelling, or enlargement in the lower abdomen or pelvic area.
- A palpable mass in the lower abdomen. If the mass is very large, the abdomen may appear enlarged as if pregnant.
- Pain during sexual intercourse, possibly caused by a fibroid protruding into the vagina or a fibroid located at the cervix.
- Infertility and frequent miscarriage due to fibroids growing into the uterine cavity, which may block the fallopian tubes and interfere with embryo implantation, reducing the chances of pregnancy.
If you experience these symptoms, you should promptly see a doctor for a detailed internal examination to find the appropriate management plan. Early detection is beneficial for treatment rather than leaving it to cause long-term harm to the body.
Diagnosis and treatment of uterine fibroids
Gynecologists will perform an internal examination along with an ultrasound. Treatment depends on several factors such as the patient’s age, size of the fibroid, desire to have children, symptoms, complications, and overall health. If abnormalities are found, women should not worry as uterine fibroids are benign tumors with a low chance of becoming malignant. Treatment for those with small fibroids and no symptoms may involve monitoring the size changes of the fibroid. For those with large fibroids or symptoms, gynecologists may consider removing the entire uterus or only the fibroid if the patient wishes to have children. The choice of surgical method will be determined by the gynecologist based on the suitability for each patient.
