Uterine Fibroids

Fibroids (leiomyomas) are non-cancerous growths in the muscular wall of the uterus. They are extremely common — around 2 in 3 women develop at least one fibroid by age 50. Many fibroids cause no symptoms and need no treatment. Others cause heavy periods, pain, pressure symptoms, or fertility problems.

Symptoms

• Heavy or prolonged periods — sometimes leading to iron-deficiency anaemia.
• Pelvic pressure or fullness; noticeable belly enlargement.
• Frequent urination, urgency, sometimes retention (pressing on the bladder).
• Constipation, bloating (pressing on bowel).
• Lower back or leg pain.
• Pain during sex.
• Difficulty becoming pregnant, miscarriage, complications in pregnancy — depending on location.

Diagnosis

Pelvic ultrasound is the main test; MRI in selected cases; endometrial biopsy if bleeding pattern needs it.

Treatment — depends on symptoms, size, location, and plans for pregnancy

• Watch-and-wait — for small, asymptomatic fibroids.
• Medicines — hormonal contraceptives, tranexamic acid for bleeding, iron supplements for anaemia, GnRH analogues for temporary shrinkage (often before surgery).
• Hormonal IUD — particularly effective for heavy bleeding in smaller uterine cavities.
• Myomectomy — surgical removal of fibroids, preserving the uterus. Laparoscopic, hysteroscopic, or open, depending on location and size.
• Uterine artery embolisation — blocks fibroid blood supply; fibroids shrink; uterus preserved; not for women wanting future pregnancy in most protocols.
• Hysterectomy — removal of the uterus; definitive for fibroids; appropriate for women who have completed childbearing and have severe symptoms.
• MRI-guided focused ultrasound — non-invasive option in select cases, available at a few Indian centres.

Fibroids are almost never cancerous ("leiomyosarcoma" is very rare). But rapid growth after menopause always deserves evaluation. With the choice of treatments available in India today, most women with fibroids can get both good symptom control and, where desired, preservation of fertility — discuss options with a gynaecologist.