fibroids

Fibroid Pain

Fibroid pain and symptoms are covered in detail here. Uterine fibroids are usually painless and do not normally cause symptoms, but this is not much consolation if your fibroids are painful. A fibroid is only painful for a reason. If one grows large enough then it can produce pelvic discomfort simply because of its size. A large fibroid will stretch uterine ligaments and press on other pelvic organs within the pelvis. Bodily movements and even simply walking around may cause a fibroid to produce pelvic pain if it is above a certain size.

Fibroids

A fibroid is a slow-growing and non-cancerous tumour that is found in the wall of the uterus. A fibroid is composed of smooth muscle and connective tissue. There may be one or more fibroids, and they may range in size from as small as a pea to as large as a grape-fruit.Fibroids are common, appearing most often in women between the ages of 35 and 45.

Clinical Fibroid Issues

Clinical Fibroid Issues

The prevalence of fibroids is high. In 1990, Cramer and Patel exhaustively examined 100 consecutive hysterectomy specimens at 2-mm slice thickness. Fibroid prevalence was 77%. In an US study, 1384 women between the ages of 35 and 49 were randomly selected for study in an urban health plan. Estimated cumulative incidence by age 50 was 70% for white women and >80% for black. The incidence of fibroids was measured in the study of 95,061 premenopausal nurses age 25 to 44. Incidence rate for white woman was 8.9 per 1000 and for blacks, 30.6.

Which Women Develop Fibroids and the Symptoms

The two most common symptoms associated with fibroids are heavy menstrual periods (termed menorrhagia) and pelvic pressure or discomfort. (There is a movement away from using these older words, such as menorrhagia, to make the terminology more understandable.) Menorrhagia involves periods that are either long or heavy or both. Typical menstrual periods last 4 to 5 days, so, generally, any woman who has 7 or more days of menstrual bleeding is considered to have menorrhagia. Some women have relatively short periods (in the range of 3 to 4 days), but their periods are excessively heavy.

What Are Fibroids?

Uterine fibroids are benign (meaning not cancerous or precancerous) growths in the uterine wall that often cause unpleasant and sometimes painful symptoms. To understand fibroids, you need to understand the structure of the normal uterus (see below).

pelvic organs from the front

Above: Uterus, fallopian tubes and ovaries, viewed from the front

Hysterectomy for Fibroids

Why would any woman choose to have a hysterectomy today when so many alternatives are available? For a woman with fibroids, there are several reasons. The first is that hysterectomy provides a cure for uterine fibroids and eliminates the problem of recurrent fibroids. If a woman wants to eliminate her risk of fibroid symptoms in the future, hysterectomy is currently her only choice.

Focused Ultrasound Surgery and Other Thermoablative Therapies

Many efforts have been made to try to find less invasive ways to destroy fibroids. Most of the less invasive techniques that have been developed involve either thermoablative therapies or image-guided therapy or both.

Thermoablative therapies use heat or cold to destroy tissue. This approach has been used in the treatment of other diseases, including freezing the cervix to treat abnormal Pap smears and using a variety of probes to heat lesions in organs such as the liver or the kidneys.

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