OVUM's Guide to Fibroids and Fertility

It’s Fibroids Awareness Month! So let's dive into the world of fibroids and explore some helpful tips for managing the pain they can cause and their impact on fertility.

What Are Fibroids?

First off, what exactly are fibroids? Uterine fibroids, also known as leiomyomas, are growths on the uterus's wall. They're made up of smooth muscle cells and other materials. Don't worry—fibroids aren't cancerous. In fact, they're the most common type of non-cancerous tumours found in women of reproductive age and are largely asymptomatic.

Awareness of Fibroids?

Whilst fibroids are incredibly common (2 in 3 women will get one at some point in their lifetime), only 39% of women and girls are aware of them, according to a Wellbeing of Women census in 2023. It’s clear that more awareness, such as Fibroids Awareness Month, is needed. The goal is to drive further research into fibroids, hopefully leading to quicker diagnostics and better treatments!

What are the symptoms of fibroids?

Not everyone with fibroids will feel discomfort, but it can be quite challenging for those who do. Depending on their location, fibroids can cause a variety of painful or uncomfortable symptoms, such as:

  • Heavy bleeding or painful periods
  • Pelvic pressure
  • Pain during sex
  • Bleeding between periods
  • Lower back pain

Fibroids can also lead to anaemia, frequent urination, infertility, early onset of labour, and a higher chance of needing a caesarean section when giving birth.

Causes & Diagnosis of Fibroids

Before diving into treatment options, knowing what causes fibroids and how they are diagnosed is important. We do not know the exact cause of fibroids yet. They have been linked to oestrogen, a group of essential reproductive hormones, as they usually develop just before menopause, when oestrogen levels are at their highest. Post menopause, when oestrogen levels are following, fibroids will usually shrink. 

To diagnose whether or not you have fibroids, your Doctor might use several methods, including:

  • Pelvic Exam: This is usually the first step, where the doctor feels for abnormalities in the shape and size of the uterus.
  • Ultrasound: A common imaging test that uses sound waves to create a picture of the uterus and detect fibroids.
  • MRI: This provides detailed images and helps determine the size and number of fibroids.
  • Hysterosonography: A special ultrasound technique where saline is injected into the uterus to get clearer images.
  • Hysteroscopy: A procedure where a small telescope is inserted through the cervix to view the inside of the uterus.

Discussing these diagnostic options with your doctor can help determine the best approach for your situation. Because fibroids are typically asymptomatic, diagnosis often occurs through routine gynaecological checkups followed by an ultrasound confirmation. 

Fertility and Fibroids

Fibroids can impact fertility and pregnancy, depending on their size and location. Here’s how:

Infertility: Large fibroids, or those that deform the uterine cavity, can make it difficult for an embryo to implant, potentially leading to infertility.

Pregnancy Complications: Fibroids can increase the risk of miscarriage, preterm birth, and placental abruption. They can also cause complications during labour, sometimes necessitating a caesarean section.

Treatment Considerations: If you plan to conceive, discussing treatment options with your doctor is important. Some treatments, like a myomectomy, aim to remove fibroids while preserving fertility, whereas others, like a hysterectomy, will make pregnancy impossible.

Understanding the relationship between fibroids and fertility is crucial for making informed decisions about your reproductive health.

Treatment Options for Uterine Fibroids

Fibroids often grow slowly, and some might even shrink independently, especially after menopause. However, if they cause pain or interfere with your reproductive health, treatment might be necessary. Here are some options:

Medications 

Prescription medications, including hormonal birth control, IUDs, hormone blockers, or hormone modulators, can manage symptoms like heavy or painful periods and sometimes shrink fibroids.

  • Hormonal Birth Control: Available as pills, patches, or vaginal rings, these can help control heavy bleeding but might cause fibroids to grow.
  • Progestin-Only Devices: Such as IUDs, these can relieve heavy bleeding and are recommended for large fibroids.
  • Hormone Agonists: These block hormone production, reducing fibroid size but can cause menopause-like symptoms.
  • Hormone Modulators: These can slow or stop fibroid growth and alleviate symptoms.

Most medical treatments offer temporary relief, so discussing options with your GP is crucial.

Surgeries 

For more persistent or severe cases, surgical options include uterine artery embolisation, endometrial ablation, ultrasound treatments, myomectomy, and hysterectomy.

  • Uterine Artery Embolisation: Blocks blood flow to fibroids, shrinking them and reducing symptoms.
  • Endometrial Ablation: Destroys the uterine lining to reduce bleeding.
  • Myomectomy: Removes fibroids while preserving the uterus.
  • Hysterectomy: Removes part or all of the uterus, a more permanent solution.

Keep in mind that some surgical methods may affect fertility, so understanding the potential side effects is essential before making a decision.

Home Remedies for Fibroid Pain Relief

If you're looking for ways to manage fibroid pain at home, here are some friendly tips:

Over-the-Counter Pain Medications Pain relievers like ibuprofen, naproxen, and paracetamol can help. Just follow the dosage instructions and consult your doctor if you plan to use them regularly.

Warm Compresses Applying heat to your abdomen with a hot water bottle, heating pad, or a warm bath can relax muscles and ease pain.

Exercise Though it might be the last thing you feel like doing, regular exercise improves blood flow and releases endorphins, helping with pain relief and maintaining a healthy weight.

Rest Ensure you're getting enough sleep and rest. For back pain relief, try lying with a pillow under your knees or curled up with your knees toward your chest.

Alter Your Diet Certain dietary habits can exacerbate fibroids. Avoid refined carbohydrates and high-sugar foods like white rice, pasta, sodas, and baked goods. Instead, focus on fruits, vegetables, and fibre-rich foods to reduce inflammation and fibroid growth.

Vitamins and Supplements Adequate levels of certain vitamins, like vitamin D, can decrease fibroid risk. Maintaining healthy levels of vitamins A, D, B3, E, and K can also improve fibroid size and symptoms.

Key takeaways

Always talk to a healthcare provider if you have pain or discomfort, or if you have questions about your fertility and overall health. While research continues to uncover more about fibroids, plenty of resources are available to help you manage your symptoms. 

  • Fibroids are non-cancerous growths on the uterine wall common among women of childbearing age.
  • Symptoms include heavy periods, pelvic pressure, pain during sex, lower back pain, anaemia, and frequent urination.
  • To get a diagnosis, it may include pelvic exams, ultrasound, MRI, hysterosonography, or a hysteroscopy.
  • Treatments include medications, various surgical procedures, and home remedies like pain relievers and warm compresses.
  • Fibroids can affect fertility and pregnancy, with some treatments preserving fertility while others do not.
  • Over-the-counter pain relievers, warm compresses, exercise, rest, and dietary adjustments can help manage pain.

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