By Livy-Elcon Emereonye
Everything exists in polarity: up and down, light and darkness, short and tall, male and female…
Human beings exist as either male or female though there have been cases of hermaphrodites – and every sex has its peculiarities.
Life is in phases, and every phase has its uniqueness and challenges.
As we advance in age, our body systems change – and such changes can predispose one to one medical condition or the other.
The female sex has certain features that manifest from time to time, probably at three or four years intervals.
Fibroid is one of the things that only female sex can encounter and the experience is more pronounced with age.
“An estimated 20% to 50% of women of reproductive age currently have fibroids, and up to 77% of women will develop fibroids sometime during their childbearing years. Only about one-third of these fibroids are large enough to be detected by a health care provider during a physical exam, so they are often undiagnosed.
In more than 99% of fibroid cases, the tumors are not cancerous and do not increase the risk for uterine cancer.”
What is Fibroid?
In a simple term, fibroids are abnormal growths that develop in or on the uterus. Sometimes they become quite large and cause severe abdominal pain and heavy periods.
Uterine fibroids, also known as leiomyomas, are non-cancerous growths that develop in the uterus. They are composed of smooth muscle and fibrous tissue and can vary in size, shape, and location.
Fibroids are benign (non-cancerous) tumours; composed of muscle and fibrous tissue; develop in the uterus; can vary in size, shape, and location; and are common in women of reproductive age.
It should be noted that fibroids can occur at any age, but they are most commonly diagnosed in women of reproductive age, typically between 30 and 50 years old.
Yes, fibroids can occur at any age, but most women start to notice symptoms between 30 to 50 years old. However, some women may experience symptoms as early as their 20s or even during adolescence.
Below is a breakdown of when fibroids can start to develop and when symptoms may become noticeable:
– Adolescence (15-19 years): Fibroids can start to develop during adolescence, but symptoms are rare at this age.
– Early adulthood (20-29 years): Some women may start to experience symptoms, such as heavy menstrual bleeding or pelvic pain, during their 20s.
– 30-39 years: This is a common age range for women to start noticing symptoms, such as heavy bleeding, pelvic pain, or pressure.
– 40-49 years: Symptoms may become more severe or frequent during this age range, especially as women approach menopause.
– 50 years and above: While fibroids are less common after menopause, some women may still experience symptoms.
The onset of fibroids and symptoms can vary significantly from woman to woman so the above information is a guide, and are general age ranges. Some women may experience symptoms earlier or later in life.
Certain factors that can influence fibroid age of onset include:
- Genetics: Family history can play a role in the development of fibroids.
- Hormonal influences: Oestrogen and progesterone can stimulate fibroid growth.
iii. Reproductive factors: Women who start menstruating at a younger age or have a higher number of pregnancies may be more likely to develop fibroids.
- Lifestyle factors: Diet, stress, and environmental toxins may also contribute to the development of fibroids.
The age-specific prevalence rates of fibroids are as follows:
– 20-29 years: 10-15% of women in this age group may have fibroids.
– 30-39 years: 20-30% of women in this age group may have fibroids.
– 40-49 years: 30-40% of women in this age group may have fibroids.
– 50 years and above: While fibroids are less common after menopause, some women may still experience symptoms.
The global prevalence of fibroids is a significant health concern, affecting approximately 20-30% of females, particularly those aged 30-50.
Global Incidence Rates
The global age-standardized incidence rate of uterine fibroids has been increasing over the years, with a 6.87% rise from 225.67 to 241.18 per 100,000 population between 1990 and 2019.
Regional Variations
Regional incidence rates vary, with Eastern Europe having the highest age-standardized incidence rate of 582.03 per 100,000 population in 2019. Tropical Latin America experienced the greatest increase in age-standardized incidence rates from 1990 to 2019, with an estimated annual percentage change (EAPC) of 1.44.
Socio-Demographic Index (SDI)
The incidence of uterine fibroids also varies by Socio-Demographic Index (SDI), with high and low-middle SDI regions experiencing significantly higher age-standardized incidence rates.
These statistics highlight the need for increased awareness and attention to the global burden of fibroids, particularly in regions with high incidence rates.
Uterine fibroids are growths that develop in or around the uterus. They can be classified based on their location, size, and number. Here are some common types:
Types of fibroids
– Intramural
– Submucosal
– Subserosal
– Pedunculated
– Parasitic fibroids
- Intramural fibroids: These grow within the muscular wall of the uterus. Intramural fibroids are non-cancerous growths within the walls of the uterus. These fibroids are often harmless but can cause symptoms including heavy periods or trouble conceiving.
- Submucosal fibroids: These project into the uterine cavity, potentially causing heavy bleeding and fertility issues. Submucosal uterine fibroids are benign tumors (not cancer) that grow in the uterus, just under the surface of the lining, or endometrium. Though a less common type of fibroids, they lead to significant symptoms including abnormal uterine bleeding that leads to low red blood cell counts (anemia). They bulge into the uterine cavity and project to the outside of the uterus. they can cause serious and unpleasant symptoms such as excessive menstrual bleeding.
- Subserosal fibroids: These grow on the outside of the uterus, sometimes pressing on surrounding organs. This type of fibroid grows under the lining of the outer surface of your uterus. They can become quite large and grow into your pelvis. A subserosal fibroid is a uterine fibroid that grows on the outside of the uterus and is almost always benign (not cancerous). While rarely dangerous, these growths can cause uncomfortable symptoms and interfere with nearby organ functions.
- Pedunculated fibroids: These are attached to the uterus by a stalk-like structure. Pedunculated fibroids are benign (noncancerous) growths in the uterus. These fibroids are attached to the uterine wall by a stalk-like growth called a peduncle. The main difference between pedunculated fibroids and other fibroids is the peduncle. These fibroids can grow both inside and outside the uterus. Inside the uterus, this type of growth is called a pedunculated submucosal fibroid. Outside the uterus it’s called a pedunculated subserosal fibroid.
- Parasitic fibroids: These attach to other organs or structures in the pelvis. They are defined as a pedunculated subserosal fibroid that undergoes torsion, detaches from the uterus, and sustains its growth through neovascularization from adjacent tissues.
Fibroids can also be classified based on their size, ranging from small (seedling) to large as follows:
- Small fibroids (less than 2 cm): May not cause symptoms.
- Medium fibroids (2-5 cm): Can cause moderate symptoms.
- Large fibroids (5-10 cm): Can cause severe symptoms.
- Giant fibroids (larger than 10 cm): Can cause significant symptoms and may require surgical removal.
Size can impact symptoms and treatment options.
Larger fibroids may cause more severe symptoms, such as heavy bleeding, pelvic pressure, or discomfort.
Fibroids can also be classified based on their number as:
- Solitary fibroids: A single fibroid growth
- Multiple fibroids: More than one fibroid growth
- Diffuse uterine leiomyomatosis: Numerous fibroids scattered throughout the uterus
The number of fibroids can impact symptoms, treatment options, and fertility. Having multiple fibroids may increase the complexity of treatment.
In general, symptoms and treatment options can vary depending on the type, size, number and location of the fibroids.
Signs and Symptoms
Fibroids can cause a range of symptoms, including:
- Heavy or prolonged menstrual bleeding: Fibroids can cause heavy bleeding, clots, or prolonged periods.
- Pelvic pain or pressure: Fibroids can cause pain or pressure in the pelvic area, lower back, abdomen or cramping.
- Bloating and swelling: Fibroids can cause bloating, swelling, or discomfort in the abdominal area.
- Frequent urination: Large fibroids can put pressure on the bladder, leading to frequent urination.
- Constipation: Fibroids can also put pressure on the rectum, leading to constipation
- Abdominal pain/cramping
- Enlargement of the lower abdomen
- Pain during sex
- Infertility or miscarriage: Fibroids can affect fertility or increase the risk of miscarriage.
Possible complications of fibroids include:
– Severe pain or very heavy bleeding (may require emergency surgery)
– Twisting of the fibroid (may require surgery)
– Anaemia (low red blood cell count)
– Urinary tract infections
– Infertility (in some cases)
– Kidney damage (in rare cases)
There are chances that fibroids may cause complications in pregnancy, depending on factors such as the size of the fibroid or fibroid cluster. These complications may include:
Cesarean section delivery
Breech presentation
Preterm birth or miscarriage
Placenta previa
Postpartum hemorrhage
Treatment options for fibroids
Fibroids can be managed and treated through Orthodox medicine including surgery, Natural medicine and Integrative medicine. Depending on the position, size and number, they can be operated or caused to be shrinked.
Medical Treatments
- Hormonal therapies: Birth control pills, progesterone, or gonadotropin-releasing hormone (GnRH) agonists to regulate hormones and reduce symptoms.
- Pain relief medications: Over-the-counter pain relievers to manage pain and cramping but not everyone can use these products.
- Anti-inflammatory medications: Prescription medications like mefenamic acid to reduce inflammation and pain.
Minimally Invasive Treatments
- Uterine artery embolization (UAE): A procedure that blocks blood flow to the fibroid, causing it to shrink.
- Magnetic resonance-guided focused ultrasound (MRgFUS): A non-invasive procedure that uses ultrasound waves to heat and shrink the fibroid.
- Endometrial ablation: A procedure that removes or destroys the lining of the uterus to reduce bleeding.
Surgical Treatments
- Myomectomy: A surgical procedure that removes the fibroid while leaving the uterus intact.
- Hysterectomy: A surgical procedure that removes the entire uterus, often recommended for large or multiple fibroids.
- Laparoscopic or robotic surgery: Minimally invasive surgical procedures that use small incisions and a camera to remove the fibroid.
Alternative and Complementary Therapies
- Acupuncture: A traditional Chinese medicine technique that involves inserting thin needles into specific points on the body to stimulate healing.
- Herbal medicine/supplements: Certain herbs like turmeric, ginger, and chasteberry may help alleviate symptoms. Some herbal products can shrink and reduce the size of fibroids.
- Yoga and meditation: Stress-reducing techniques that can help manage symptoms and improve overall well-being.
- Therapeutic fasting: This is an emerging area that needs professional guidance.
Watchful Waiting
- Monitoring: Regular check-ups with your healthcare provider to monitor the size and symptoms of the fibroid.
- Symptom management: Managing symptoms with medication or lifestyle changes, rather than treating the fibroid itself.
Whatever the case, it’s essential to consult with a qualified and licenced healthcare provider to determine the best treatment option for your specific case. They will consider factors like the size and location of the fibroid, age, and the overall health of the patient in proffering solutions.
In conclusion, fibroids can be managed and treated. Depending on the position, size and number, they can be operated or caused to be shrinked by competent healthcare professionals.
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