What is a uterine fibroid?

What is a uterine fibroid?

A uterine fibroid is a benign (non-cancerous) tumour that develops on the uterine wall, i.e. on the uterine muscle, either singly or in groups. It is the most common solid non-cancerous tumour in women of childbearing age.

In fact, these tumors generally appear in women over the age of 30 (30% to 50% of women over 30 are affected, and the percentage increases with age l), and particularly in women of African origin, who are 3 to 4 times more likely to develop a uterine fibroid. The risk of developing a uterine fibroid is also higher if the mother has developed one herself. 

The number, location and size of fibroids vary from woman to woman l.

Different types of fibroids

There are 3 types of uterine fibroid, distinguished by their location: 

• Intramural or interstitial fibroids (the most common type of fibroid: around 70%): they form in the muscular layer of the wall of the luterus.
• subserous fibroids: develop towards the outside of the uterus
• submucosal or endocavitary fibroids (the rarest): grow under theendometriumand may occupy a large space in the uterine cavity

Causes of uterine fibroids

Little is yet known about the causes of uterine fibroids. For the moment, it seems that the fibroid originates from a single cell in the uterine wall which undergoes a genetic mutation and begins to multiply uncontrollably. Estrogen then acts on this fibroid, enabling it to grow. 

A number of factors encourage their development, such as : 

• a history of fibroids in the family on the 1ster degree (mother, sister)
• lEthnic origin: fibroids are more common in African-American women
• hormonal fluctuations: the hormones play a role in the growth of fibroids. This is why they don't appear until puberty, and often stop growing at the menopause. Finally, during pregnancy, it is not uncommon to see lthe appearance and/or growth of fibroids.
• overweight and obesity, as body fat produces estrogens that contribute to the development of fibroids
• excessive alcohol consumption

The symptoms 

Fibroids usually cause no symptoms, and are therefore often discovered by chance during a check-up with a specialist.

Nevertheless, a fibroid can sometimes cause pain in the lower abdomen, frequent urination, constipation, painful painful intercourseabnormally long and abundant periods and/or bleeding. bleeding between periods, and sometimes even fertility problems, a risk of miscarriage or premature delivery.

In fact, it's often the size, location and number of fibroids that influence the onset and intensity of symptoms. 

Examinations

As we've just said, it's often the clinical examination that leads, somewhat by chance, to the discovery of a uterine syndrome.

Once a fibroid is suspected, an ultrasound scan will be performed to determine its size and location.

Next, a hysterography will reveal the appearance of the uterine cavity and its possible deformation. Then a hysteroscopy is performed to view the interior of the uterine cavity.

Finally, a blood test may reveal anemia in cases of heavy bleeding.

How to treat uterine fibroids

As a general rule, fibroids without symptoms do not require treatment. However, if symptoms do occur, treatment is available. These differ according to the size, location, number of fibroids and age of the patient.

• Regular physical activity reduces the risk of developing uterine fibroids.

• Applying warm compresses (or ice) to painful areas can help relieve pain.
• To counter constipation: eat plenty of fruit, vegetables and dietary fibre. You can also take laxatives.

• Drug treatments: drugs are used to reduce symptoms (pain, cramps, regulation of the menstrual cycle, etc.). Medications may also be prescribed to reduce the size of fibroids. They are often prescribed in preparation for surgery, to facilitate the surgical procedure. If patients experience heavy blood loss, iron supplements or IUDs may be prescribed to reduce the quantity and duration of menstrual flow.
• Surgery:
• Myomectomy to remove one or more fibroids while preserving the uterus for future pregnancies. However, fibroids may reappear afterwards.
• Endometrial ablation for women who no longer wish to have children, and to reduce heavy bleeding.
• Hysterectomy to remove the uterus: the only solution offering a definitive result

• Uterine artery embolization: to deprive the fibroid of oxygen and nutrients by blocking the blood vessels that irrigate it. In this way, fibroids dry out and gradually lose around 50% of their volume. However, this method is not recommended for all types of fibroids.
• Laparoscopic uterine artery ligation: clip the arteries. But this method is less effective than lembolization.

Other techniques are also available, depending on the type of fibroid and the symptoms it generates, and can be suggested by a specialist doctor.

The choice of treatment depends on age and the desire to become pregnant. pregnancythe importance of symptoms and possible complications, the type of fibroid and the patient's general condition.

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