Obesity, oestrogen spike common cause of fibroids

Fibroids, the muscular tumours that are benign, grow in the wall of the uterus. Fibroids are the most diverse - from their size, to the numbers and the symptoms. While many women with fibroids do not have symptoms, there are many who experience symptoms like pain and heavy menstrual bleeding. 

Experts say that fibroids also can put pressure on the bladder, resulting in frequent urination, or the rectum, causing rectal pressure. In case of enlargement of fibroid, it can make the abdomen (stomach area)  enlarge, making a woman look pregnant. 

Dr Kavya Krishnakumar, Obstetrician-Gynaecologist, says that of late, with the increase in the number of scans, more women are being diagnosed with the condition. “From the usual prevalence of five per cent, there has been a spike due to increase in number of patients diagnosed with the condition and the frequency of scans in recent years,” she adds. 

Though common, so far there is very little information on the causes, she adds. Dr Lakshmi Shanmughasundaram, senior consultant, Madras Medical Mission,  says that the condition is very common among African women. “However, we still cannot explain why the incidence is higher among them. In India, too, we see women as young as 20 or 25 developing the condition.” 

Experts also add that genetic factors can be an important risk factor.  Dr Kavya adds, “The fibroids can also grow during pregnancy due to rise in oestrogen levels. Other conditions like obesity too can rarely lead to the condition.” 

However, while a growth in the uterus can be frightening, doctors assure that Fibroids are almost always benign (not cancerous). Rarely (less than one in 1,000) a cancerous fibroid will occur. They also add that it can cause fertility issues in some cases. “Fibroids are not a major cause of infertility, unless it is inside the uterus and obstructing the cavity. When it is outside it is nowhere related—even if it is big or small,” says Dr Kavya.

Dr Kavya explains that the medication for fibroids largely depends on the symptoms and size. “One may have a fibroid of about five cm and not even know about it. In such a case we keep monitoring it, but if there is a fibroid of about 12 cm, it has to be removed because it will obstruct the other organs surround it. In such a case, even without symptoms it is better to take it out. Similarly, a tiny fibroid inside the uterus can cause a lot of bleeding. Outside the same is just a scan finding,” she says. For someone who is nearing menopause, you can wait and see as it may shrink, she adds. 

While some can be resolved through medication, surgery options are also available. “These include removing the fibroids alone or the uterus. Dr Lakshmi adds, “We also have minimally invasive technique like uterine artery embolization (UAE) procedure to treat fibroids without surgery.”

Fibroids are the most frequently seen tumors of the female reproductive system. 

While it is not clearly known what causes fibroids, it is believed that each tumour develops from an aberrant muscle cell in the uterus, which multiplies rapidly because of the influence of estrogen. 

Heavy or prolonged menstrual periods. 

Abnormal bleeding between menstrual periods. 

Pelvic pain (caused as the tumor presses on pelvic organs).

Frequent urination Low back pain Pain during intercourse A firm mass, often located near the middle of the pelvis, which can be felt by the physician