Excessive vaginal bleeding due to fibroids; Symptoms and treatment of uterine fibroids

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Fibroids, also called myomas, are benign tumours of smooth muscles of the uterus. About 30 to 40% of females over 40 years of age have fibroids. These vary in size from very small to very large. Fibroids can develop anywhere in the uterus from deep within the wall of the muscle or on the outside of the wall. Only one in 800 develop into cancer.

What is the cause of fibroids?

The reason why fibroids develop inside the uterus is unknown. However, it is known that female hormones like oestrogen and progesterone are related to fibroids.

What are the symptoms?

Small fibroids can be asymptomatic but large fibroids can cause following symptoms

  • Heavy periods
  • Lengthy periods
  • Spotting between periods
  • Painful periods
  • Painful intercourse
  • Heaviness in the back
  • Frequent urination
  • Incomplete emptying of bladder

Diagnosis of fibroids:

Pelvic ultrasound is needed for initial assessment. Further investigations like hysteroscopy or CT/MRI of the pelvis may be needed. Full blood examination is performed to check for anaemia. Biopsy may be needed if cancer is suspected.

What are the complications?

  • Infertility
  • Anemia
  • acute pain
  • miscarriage
  • liver problems

What is the treatment?

If fibroids are not causing any symptoms or a few symptoms, then wait and see approach can be taken with regular monitoring. If women are above 45, the fibroids tend to get smaller or even disappear.

Special hormones are given to shrink fibroids.

Surgical options include removal the fibroid which is called myomectomy. Stopping the blood supply of a fibroid can help to shrink by a special procedure.

Hysterectomy which means removal of the uterus is needed if the symptoms are very severe.

Dr Sadaf Sarwar

MBBS (King Edward Medical College),

Fellow Royal Australian College of General Practitioner (FRACGP, Australia)

Ex-Assistant Professor, The University of Lahore, Pakistan

Consultant General and Family Physician

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